Respect our elders by protecting them

By Maggie Baker and Page Ulrey
Special to The Times

The baby boomers are about to hit retirement age. In 2002, there were over 670,000 persons 65 years and older in Washington state. By 2020, those 65 and older will top 1.2 million.

For many older Americans, the retirement years are spent fulfilling lifelong dreams. Others are not so fortunate. As many Americans advance in age, they become increasingly vulnerable to elder mistreatment.

Several decades ago, we as a society recognized that child abuse and domestic violence were not being properly addressed. It is time that we mount a similar response to elder mistreatment.

Elder mistreatment ranges from physical, sexual, emotional and psychological abuse to financial exploitation, neglect and abandonment. It includes acts that are intentional and negligent.

Who are the most likely victims? In general, those who are unable to independently perform "activities of daily living" (ADLs), such as bathing, dressing and toileting, are at greatest risk for mistreatment.

While the state's 60-and-over population grew 14 percent from 1990 to 2000, that portion of the population with one or more ADL deficiencies rose 191 percent.

The state's Adult Protective Services, which investigates allegations of adult abuse and neglect, looked into 9,875 reports of suspected abuse and/or neglect in 2002. Of these, 2,274 cases were substantiated.

A study by the National Center on Elder Abuse tells us that for every elder-abuse case that is reported and substantiated, five cases go unreported. This means that more than 11,000 cases of adult abuse and neglect may have gone unreported in our state in 2002.

Why are there so many unreported cases? At a recent meeting of the King County Elder Abuse Council, experts offered several reasons. Older victims do not report mistreatment due to isolation; impaired cognitive or physical function; shame, guilt or fear of retaliation; fear of being institutionalized; cultural issues; dependence on the abuser for help; and pressure from family members.

Community members fail to report suspected cases because of a lack of knowledge of the signs of elder mistreatment, uncertainty about what and how to report, or a misperception that elder mistreatment is a family matter.

Neglect is the most common form of elder mistreatment, comprising 70 to 80 percent of the cases. In nine out of 10 cases, neglect is perpetrated by family members, including the victim's adult child, spouse or parent. Victims of neglect are often isolated, purposefully kept away from family, friends and neighbors. They are often unknown to social-service agencies and law enforcement.

How can individual citizens help?

People who walk into a home where a vulnerable adult is being abused or neglected are walking into a possible medical emergency and a crime scene. Because victims can so easily be hidden from the system for so long, it is of vital importance that family, friends, neighbors and those who work in the community report any concerns they may have to both law enforcement and Adult Protective Services.

It is only through individual involvement that we will ever begin to protect this most vulnerable population, while prosecuting those who so heartlessly mistreat our elders.

Last year, Mac McKinney, 82, of Bellevue, was found lying on his bedroom floor in sweltering heat and filth. He was wearing a garbage bag as a diaper. McKinney was suffering from advancing dementia. He had substantial assets, as well as a large annuity he had created for his own care.

But his son refused to place him in an assisted-living facility or to pay for consistent, professional, in-home care. Instead, he locked his father in his room and had taken away all of his furniture, leaving him with only a mattress on the floor. McKinney had been living in those conditions for several months before police were notified of the situation. His 47-year-old son pleaded guilty to criminal mistreatment and unlawful imprisonment and was sentenced to two years in prison.

Prevention efforts must be given the highest priority so that elders can learn strategies to enhance their safety. Law-enforcement agencies and prosecutors' offices must develop specialized units so that cases are handled by professionals with expertise in elder mistreatment. Adult Protective Services must receive sufficient funding so that reports of elder mistreatment are handled promptly and effectively. Social-service organizations must develop specialized counseling programs, as well as safe houses, for victims.

It has often been said that the hallmark of a truly civilized society is how well it treats its most vulnerable citizens. Mac McKinney, who died two months after he was found in squalor, deserved to live his last years in comfort, with proper care. It is time for us to treat our elders with the respect they deserve, by protecting their physical, psychological and financial well-being, and giving them a life with dignity.

Maggie Baker, left, a registered nurse who holds a Ph.D. in nursing science, is a research assistant professor at the University of Washington and a member of the King County Elder Abuse Council. Page Ulrey, right, is a King County senior deputy prosecuting attorney who manages the prosecutor's Elder Abuse Project. Ulrey chairs the King County Elder Abuse Council.