LA County Is Reporting More Elder Abuse Than Ever Before
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Stan Lee was an icon in the Marvel comics universe. But in his later years, people Lee trusted allegedly stole money and assets from him and physically assaulted the co-creator of Spider-Man, the X-Men, Iron Man and others. Lee died last November at age 95.
Last week, Lee's former business manager pleaded not guilty to elder abuse charges in an L.A. courtroom.
As an inventor of superheroes Lee was unmatched, but his vulnerability at the end was all too common. His is one of several thousand elder abuse cases opened in California each month.
Now zoom out to the national numbers: The National Adult Protective Services Association reports one in nine elders were abused, neglected or exploited over the past year.
"We truly are just seeing the tip of the iceberg," said Dr. Laura Mosqueda, dean of USC's Keck School of Medicine and director of the National Center on Elder Abuse.
Mosqueda believes the number of reported abuse cases belie what's actually happening to aging adults.
MORE SENIORS IN L.A., MORE REPORTS OF ABUSE
California's population is aging along with the rest of the country. In 2010, people 65 and older made up nearly 11% of L.A. County's population. By 2030, the state projects seniors will make up 21% of the county's more than 10 million residents.
As the population grows, so have reports of abuse.
Taking financial, emotional and physical abuse together, allegations of mistreatment have more than doubled in L.A. and Riverside counties since 2005. In Orange and Ventura counties, that number has nearly tripled over the same time period.
In L.A. County, reports of psychological and financial abuse are growing the fastest.
WHY ELDER ABUSE? AGEISM
"We live in an ageist society, where younger people are revered and older adults often get short shrift," said Dr. Mark Lachs, a geriatrician and the chief medical officer for the New York City Elder Abuse Center. "Elder abuse is the most extreme form of ageism."
Mosqueda agrees. "We treat many older adults — particularly those who have significant cognitive impairment — as less than human. And as soon as we start dehumanizing people we become less sensitive to their vulnerabilities and susceptibilities and to their needs," said Mosqueda.
That mentality can extend at times to a feeling of entitlement to the older adult's finances, she said.
FINANCIAL ABUSE IS MOST COMMON
Whether it's a scam artist over the phone, a fraudulent claim in an email or a family member dipping into a senior's savings account, financial abuse is the most common type.
Between 2005 and 2015, there were 10,153 reports of financial abuse in L.A. County, nearly double the 5,239 reports of physical abuse.
Experts estimate that U.S. seniors lose more than $36 billion each year to financial abuse and exploitation. And the National Adult Protective Services Association estimates only one out of 44 cases of financial abuse are reported to the authorities.
As in the case of Stan Lee, financial exploitation often comes with other types of abuse, according to L.A. County Adult Protective Services and other experts.
"Forms of elder abuse invariably coexist," said Lachs. "I've never seen a case of physical abuse, for example, that didn't involve psychological abuse, and financial exploitation often progresses to menacing behavior when the person won't part with finances."
HOME IS WHERE THE ABUSE IS
"The vast majority of abuse occurs at home. And the vast majority of abuse occurring at home occurs at the hands of family members, spouses and adult children," said Mosqueda. "I think it makes us feel better to think all that abuse is just happening at nursing homes. But the reality is not that."
National numbers suggest nine in 10 cases of abuse are committed by a person the older adult knows: a family member, friend or business associate.
AND IT'S COSTING YOU MONEY, TOO
"If a person is a victim of elder abuse and they end up physically harmed or in need of some hospitalization, Medicare may be paying for that — or Medicaid may be paying for that," said Bob Blancato, the national coordinator of the Elder Justice Coalition. "And that's a lot more money than had you been able to put resources into a prevention effort."
Abuse happens to elders of all races and socioeconomic backgrounds, the experts say. For those with few economic resources to fall back on, financial exploitation can mean they have to turn to social services for their basic needs.
One in 10 older adults who are financially exploited will have to get taxpayer-funded Medicaid (Medi-Cal in California) to pay for their medical expenses, according to the National Adult Protective Services Association.
MORE ABUSE... OR MORE AWARENESS?
"One could argue that it's a good thing to have more reports because more people are aware that, A, this is wrong and, B, when you have a suspicion you make a report," said Mosqueda. "So, we don't know if it is actually a true increase in the incidence of abuse or not."
Elizabeth Morales has been a social worker for L.A. County APS for 16 years. She's noticed more people are talking about elder abuse.
People she talks to on her route in Mid-City tell her, "I picked up this flyer at the senior center, or I received this in the mail, or a friend of mine told me."
"It would be great if the abuse didn't happen, but the fact that the community around the elders are more aware, to file, not be afraid, that is very helpful," she said.
Still, researchers, social workers and advocates argue that while awareness is growing, there may not be enough momentum to make a significant dent in the problem before we're hit with the so-called "silver tsunami" of aging Baby Boomers in California. The population of Californians over the age of 65 is growing faster than the population of children.
Sacramento lawmakers are beginning to notice that the state needs a plan. Gov. Gavin Newsom signed an executive order that would create a new Master Plan on Aging for California by October 1, 2020.
PROGRAMS EXIST, BUT THEY AREN'T WELL FUNDED
Whatever solutions are proposed will also need resources for interventions and support programs for older adults.
Support programs exist, but they aren't well funded, said the Elder Justice Coalition's Blancato.
For example, he pointed to the federal Elder Justice Act of 2010, which initially authorized nearly $200 million a year in nationwide funding for forensic centers that research better ways to detect elder abuse; training people who intervene in elder abuse cases; and elder abuse prevention. But Congress has still only funded a fraction of the money, to the tune of $12 million a year or less since it passed.
"So that's a disconnect," Blancato said.
The California legislature has agreed to renew funding to train Adult Protective Services workers in California to the tune of $5.7 million. Lori Delagrammatikas, executive director of the National Adult Protective Services Association, is thrilled lawmakers approved the money, but she worries that it might not be renewed after it runs out in June 2022.
"If you go to Starbucks, they spend at least a couple of days training their baristas how to serve a good cup of coffee," Delagrammatikas said. "Could we at least provide people who are making life and death decisions with a decent level of training before we send them out in the field?"
Training is critical because interventions can be very complicated, she said.
Adult Protective Services workers are asked to be experts in social issues, psychological issues, health issues, financial issues and government program issues, Delagrammatikas said. "We're asking for a lot of expertise in the package of one person."
Added Delagrammatikas: "We do know how to intervene, we just need the funding available to do that intervention. And that requires the public to think it's important."
WHAT CAN I DO ABOUT IT?
"I think one very important thing for people to know is that anybody can be a victim," said Mosqueda. "And anybody can be an abuser. We don't see ourselves for the most part as possibly being in any of those roles ... There are lots of things we can do to protect ourselves and our loved ones if we're willing to absorb that fact."
People who work with older adults say the most powerful way to prevent elder abuse of all kinds is to be involved in a community. Having friends and family checking in — particularly if they have a knowledge of the warning signs of abuse — can go a long way towards keep an older adult safe.
So what are you looking for?
- Signs of depression (these can include mood swings, sleep and appetite issues)
- Unusual financial patterns
- Bruising patterns
- Inability to take care of health needs
"If we can get every older adult to feel like they have something to contribute and they have a place in the world, even without it being productivity in the most typical sense, I think then we're doing a whole lot of prevention for elder abuse," said Dr. Bonnie Olsen, a clinical psychologist and elder abuse specialist at USC's Keck School of Medicine.
You can report elder abuse by calling local police or contacting LA County APS online or by phone at (888) 202-4248.
This story has been updated from an earlier version.
This story was supported by the USC Annenberg Center for Health Journalism.