Gema G. Hernández.

The safety and the security of our elders, disabled adults and children should be one of the most important priorities of government. After all, if there is a role for government to play, it is in making sure all its citizens are safe and protected. Keeping our elders, disabled adults, children and their caregivers safe is a multi task approach that starts with the individual family, but on a broader level it requires the involvement of a variety of agencies and programs. Creating a safe environment for our families begins with education and with knowledge of what constitutes abuse, neglect, abandonment and financial exploitation and how we can prevent those things from happening to our loved ones.

To truly address abuse the first thing we need to acknowledge is that abuse, neglect and exploitation could be committed by a person or an institution inside or outside the individual’s family setting. While the total number of abuse cases are not known, the assumption has been that most cases of abuse take place at home is not necessarily true, but leaves the perception that the majority of abuse cases are done by a family members. This assumption is misleading and immediately stigmatizes family caregivers that are trying to do their best for that frail individual. It is true that some cases of abuse, neglect, abandonment and exploitation are committed by family members, but it is also true that any and all forms of abuse is not confined to family caregivers or confined to the victims’ home.

The problem that I see is that if the nation passes the National Elder Abuse Law still thinking that most of the cases are committed at home by family members, this will present an unfair bias to the understanding, investigation and reporting of abuse. To make the National Elder Abuse Law a powerful and protective legal instrument it must include explicit sections on institutional abuse, on abuse committed by agency workers, and on abuse, neglect, or exploitation committed by a for profit businesses. It must have a section that addresses caregivers that are being abused while performing that role.

I understand it is more difficult to document or to prove the non family related cases of abuse for a number of reasons, but the protection of our elders, disabled adults and children is paramount to our society. To make the law effective the first step is to include in the act a definition of abuse, neglect and exploitation that is broad in nature; inclusive of all possible scenarios and situations. Secondly, it is important that only one data base be used to record all forms of abuse from all sources, family, institutional, business, etc. Now in some instances, if the abuse is committed by an agency, it is recorded under one category; investigated and penalized under different rules. Some states do not include financial exploitation done by a contractor or a company among elder abuse cases and only record financial exploitation cases committed by a family person. Other states exclude the investigation and findings of nursing home ombudsmen’s reports from the traditional abuse cases. The ombudsmen’s reports are handled outside the criminal justice system unless a family member brings criminal charges. In the majority of these cases, the abusing entity gets financial penalties, penalties that are not openly publicized or known, penalties that may be paid to a government agency, not to the family member or to the elder.

One reason the abuse, exploitation, neglect and abandonment committed by non family members are less documented is due to the hesitation of authorities or agencies to believe the testimony of the frail person or the caregiver versus the testimony of a legal guardian, administrator of a facility or business person. The more we understand what constitutes abuse, neglect or exploitation, the more cases will make it to the final phase. Knowledge is power, and we need the knowledge to properly identify, report, and assist in the investigation of these cases. This is why it is so important for caregivers to be on the alert and to properly report abuses committed by non family members against their loved ones. If we don’t report abuse it is very possible that the passage of the National Elder Abuse Law will have a slight tendency to concentrate more on the case of family abuse than intuitional abuse, placing caregivers in jeopardy if their good intentions are misinterpreted by a government agency.

Assisted Living Facilities have almost no cases of abuse, exploitation or abandonment. It is not clear whether there are no cases because they truly do not exist or whether the events are handled internally and never reported to the police, events like petty theft or the disappearance of property from the resident’s home. Perhaps the limited financial value of what was taken; anywhere from $100 to $500 discourages any further investigation from the authorities. After all, the law doesn’t measure the emotional value the items, just the financial one.

In cases when the abuse is committed by a non family member, the victim may feel embarrassed that he or she has been the victim of a financial scam or the victim of an identity theft. On other instances the victim may not know his or her rights and doesn’t know the appropriate office or government entity to call. Some victims and caregivers may fear further retaliation by the perpetrator, especially if the perpetrator is an agency or a worker the victim has grown attached to. This could also involve fear that they may lose the services they are presently receiving. Some elders and their caregivers may have no other place to go, and moving to a new nursing home or Assisted Living Facility may be too emotionally traumatic, so they keep quiet. Or the agency could be the only agency in town providing those services, so they see no point in reporting the abuse, neglect, abandonment or exploitation.

I have found that caregivers and their loved ones do not report abuse because they don’t know she or he has been the victim of abuse. The truth is that the great majority of caregivers are also victims of abuse. They are victims of abuse when agencies are asking them to do more than they are capable of emotionally, physically or financially being able to do. It is therefore important that if this country finally passes the National Elder Abuse Act there should be a section to protect the caregivers, those women and men that give it all to provide for the safe keeping of their loved ones. They deserve protection from unscrupulous parties.

They know the obvious cases of financial exploitation either through predatory lending, telemarketing, home repairs and remodeling schemes, but they may not know the less obvious cases like when are being told that they need a new roof or a new air conditioner when in reality all they may need is to repair, not replace the entire system. Other elders are buying services and products they really don’t need but they are being told they needed. Other cases involve products sold to the elders that don’t do what they are supposed to do. Some schemes involve long term care insurance, reverse mortgages and identity theft. They can all take away the financial safety net elders have built for their retirement. This is why the criminalization of elder abuse must be the third step to be addressed in the National Elder Abuse Act if we want our elders to live in a safe environment.

Individuals and organizations that prey on the elders are counting on the fact that the elderly victim, the disabled and their caregivers would not press charges for fear their intellectual competence would be questioned. In other cases, the caregivers blame themselves for not intervening on time, and therefore the guilt prevents them from reporting the incident. In cases where the elderly person, the disabled person and/or the caregiver decides to press charges, the abuser’s first line of defense is to suggest the person is confused and allege that the confusion is associated with old age or disability.

Sometimes not knowing what is normal aging and what is not normal aging provides the framework that policemen, attorneys, ombudsmen, and protective service workers use to not pursue the case. The myths which exist about aging contribute to a number of reports not being filed. This is why it is so important to educate the public as to the myths and realities of normal aging.

I am proud that during my tenure as Secretary for the Department of Elder Affairs, the Elder Justice Center was created, and under the leadership of Judge Sexton, became a national model. I am happy that subsequent to the success of the project, legislation was passed which led to the expansion of the Elder Justice Center to other parts of Florida. This, coupled with the first Domestic Violence Shelter with an elder component for elder abuse in St. Augustine and the multilingual elder abuse informational campaign with the Tallahassee Senior Center, were solid beginnings to build the safety net our elders and their caregivers need to feel protected. But this effort must not die; it should continue regardless who originated the effort.

Keeping our elders, disabled adults and children safe means teaching them and their caregivers about their rights. We also need to offer them a place where they feel at ease reporting abuse. We need to make sure agencies do not retaliate against caregivers that are trying to protect their family members. Keeping our elders, disabled adults and children safe means having more than just one agency providing services or one option when it comes to nursing home or adult day care facilities or the provision of other services. Having alternative places to live and alternative providers of services is in itself a form of prevention. Safety begins at home, but since the home is now open to other individuals, it is critical that we make sure laws are in place to properly address abuse, exploitation, abandonment and neglect.