Thorner: White House Conference on Aging: Will Elder Justice be addressed sufficiently?

July 7, 2015

Tuesday, July 07, 2015

Elder-abuse

By Nancy Thorner – 

As noted in Part 1, Tom Fields of Mentor, Ohio, as a 25-year advocate for legal reforms to fix the broken elder care system, provided links and documents for me to focus attention on the issue of Elder Justice.  At the same time, Mr. Fields alerted me to the upcoming White House Conference on Aging which should serve as a venue to discuss Elder Care Justice and the remedies and reforms so urgently needed to fix a failing system.

Next Monday, July 13, the White will host its 5th Conference on Aging, as it has once every decade since 1961, to identify and advance actions to improve the quality of life of older Americans. As 2015 marks the 50th anniversary of Medicare, Medicaid, and the Older Americans Act, as well as the 80th anniversary of Social Security, the 2015 White House Conference on Aging is an opportunity to recognize the importance of these key programs as well as to look ahead to the issues that will help shape the landscape for older Americans for the next decade.

Organizers of the July 13th conference have singled out the following four themes for consideration.

1)     Retirement Security

2)     Healthy Aging

3)     Long-Term Services and Supports

4)     Elder Justice

Each of the four themes have been addressed by the White House Conference on Aging (WHCOA) in a series of policy briefs made available on-line.  The WHCOA has also invited public comment and published them on-line along with its briefs.  This comment contributed by Tom Fields on the subject of Elder Justice can be found at 6/10/2015 3:01:04 PM.  In the past the conference processes were determined by statute with the form and structure directed by Congress through legislation authorizing the Older Americans Act.  Of concern is that to date Congress has not reauthorized the Older Americans Act, and the pending bill does not include a statutory requirement or framework for the 2015 conference.

In an effort to engage with older Americans, their families, caregivers, leaders in the aging field and others on the key issues affecting older Americans, the White House Conference on Aging did launch a series of five regional forums to help provide input and ideas for its July Conference, co-sponsored with AARP and co-planned with the Leadership Council of Aging Organizations (a coalition of more than 70 of the nation’s leading organizations serving older Americans).

Tom Fields, as an attendee at the Cleveland regional forum, encouraged WHCOA organizers to address a checklist of the kind that he has proposed for use in clinical and other settings at his website . Fields further requested at the Cleveland regional forum that his 3-minute video be presented and discussed, which  ABC News presents online at this site and reports on here.

Why the need to address a checklist at WHCOS?

The American Medical Association in the past has recognized the need for a checklist in clinical settings.  More specifically, the AMA reported the following:

“Every clinical setting should have a protocol for the detection and assessment of elder mistreatment. This may be a narrative, a checklist, or some other type of standardized form that enables all providers in that practice setting to rapidly assess for elder mistreatment and document it in a way that allows physicians to look at patterns over time.” (Source: Diagnostic and Treatment Guidelines on Elder Abuse and Neglect, American Medical Association, 1992, pages 7-12)

The AMA in the same report offered the following advice:

“Clinicians do not have to prove that elder mistreatment has occurred; they need only document a reasonable cause to suspect that it has. “Reasonable cause” reporting can be as simple as stating that the patient seems to have health or personal problems and needs assistance, especially if the clinician suspects forms of abuse or neglect that are difficult to quantify.”

The AMA even had thoughts on how the interview should be conducted:

“The interview and examination of an elderly patient should always be conducted first, away from the caregiver or suspected abuser.”

As suggested by Tom Fields, a well written checklist would identify specific signs of severe cognitive impairment, any one of which should provide a mandatory reporter of abuse to suspect and then report an abusive situation.

The checklist’s criteria could be determined by victims as well as experienced professionals in the fields of medicine and law; nevertheless, it is victims and experienced medical professionals who can best identify conditions which suggest severe cognitive impairment to competent medical authority.

As to the objectives of the checklist, it would be to assist in identifying those conditions which should provide competent medical or legal authority — not necessarily both — a reason to suspect that the subject is suffering severe cognitive impairment, where severe cognitive impairment is the condition, which, either alone or in conjunction with physical impairment, prevents a subject from performing everyday activities without assistance.

Value of playing and discussing  3-minute video at WHCOA

As Elder Justice is one of the four themes selected for consideration by the conference, it is urgent that a positive response be directed toward elder abuse, which often involves the exploitation of an elder’s cognitive impairment.

Accordingly, the message sent by the 3-minute video cannot be denied or overlooked: No scam should be simpler to prevent and remedy than one which takes place in the emergency room of a hospital.

The above statement of fact should prompt WHCOA members and others to ask and seek answers to questions such as:

  • What would it cost to prevent such scams?
  • What have federal and state lawmakers done to prevent such scams?
  • What has the U.S. Senate Special Committee on Aging done to prevent such scams?
  • What have the American Bar Association, state bar associations, and local bar associations done to prevent such scams?
  • What have the Elder Justice Act and other laws done to prevent such scams?
  • What has the Consumer Financial Protection Bureau done to prevent such scams?

Scams involving financial exploitation are rampant

The scams most authorities focus on today involve the exploitation of elders suffering a mild cognitive impairment, which has been characterized by the Investor Protection Trust and others as a condition of seniors “who can perform most daily functions, but have trouble or become confused with others, like following their medicine regimen and managing their finances”

Financial abuse of the elderly is running rampant in the country and is growing as the population ages. Yet, there are few consistent national standards for what financial advisors, who deal with the money elderly people have worked a lifetime to save, should do when they suspect abuse. Input is being sought at the site noted on fraud against the elderly.

Professionals’ judgements contribute to both the prevalence of abuse and the ability to prevent and intervene.  As suggested in this study:  “Identifying and enhancing risk thresholds in the detection of elder financial abuse: a signal detection analysis of professionals’ decision making”, it is desirable to try and bring novice professionals’ judgmental risk thresholds to the level of competent professionals as quickly and effectively as possible.

It is quite telling that the exploitation of mild cognitive impairment has not changed from what it was back in 1939 when Fred Rodell, wrote in his book, “Woe Unto You Lawyers”: “The legal trade, in short, is nothing but a high-class racket. It is a racket far more lucrative and more powerful and hence more dangerous than any of those minor and much-publicized rackets

In Conclusion

The following question should be of concern to all senior citizens.  If government and professional organizations are not going to do what is necessary in order to protect you from being scammed while your cognitive abilities are “severely” impaired, are they really going to do what is necessary to protect you from being scammed if their cognitive abilities are only “mildly” impaired or not impaired at all?

Over three years ago, in 2012, Tom Fields submitted a 16-page document in response to a request for

information by the CFPB’s (Consumer Financial Protection Bureau) on the financial security of older Americans.  So far the federal government has remained delinquent on the issues surrounding elder care.

With the White House Conference on Aging set for July 13, will the 5th conference accomplish anything of note to help prevent elder abuse scams?

Calls must be made to the White House and to elected legislators with a message reminding them that seniors are a powerful force in politics and society.  They deserve to be treated with dignity and should not be used as pawns by some in the legal profession as a means to enrich themselves financially from those who lack the cognitive ability to perceive what is happening, through devious means.

In Chicago and in many cities throughout the U.S., elder abuse scams happen with regularity in the Probate Courts, but justice is rarely served, as the fraud perpetrators are not apprehended.

Some supplementary reading material:

Part 1:  Thorner:  Elder Justice Act Under Obamacare Fails

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