The fight for elder justice in the U.S.
As part of a project to investigate best practices for older people’s rights, elder abuse, and protecting those with dementia, the executive director of Pennsylvania’s non-profit SeniorLAW Center, Karen Buck, travelled to New Zealand.
Lawyers who belong to the public law community in Philadelphia are strong advocates for seniors, women’s rights, and the disabled.
“We look at how we can use the law to protect our seniors, and in elder abuse cases, whether it’s fiscal, financial, emotional or sexual, psychiatric, psychological – the court system can have a very great impact so we’re very focused on that,” says Ms Buck.
“We’re here to serve them, make sure they can access all their resources and then we can fight for their rights.
“Whether it’s in court, out of court, with their family, their landlord, with their caregiver.”
The organisation has 15 attorneys and about 100 volunteer pro-bono attorneys.
“We will go to court with [seniors] and get a protection from abuse order, we will write a power of attorney or work on housing issues or homelessness, or we will advocate or negotiate,” says Ms Buck.
Philadelphia has one of the largest and poorest populations in the United States.
That does not prevent seniors from being able to access legal services.
“We run a state-wide legal helpline for seniors so that anyone from any place in our state can call and talk to a lawyer about any problem that they’re facing,” says the director.
“Even if you’re somewhere that’s really isolated, you’re disabled or you have mobility issues or language access issues, we have language lines that you can get an interpreter on immediately, they can just call.
“It’s actually proven to be one of the most effective models for seniors because it’s private, it’s confidential.
“If their abuser is in the home, they can call when they’re not.”
Ms Buck says seniors might not be able to get to an office to talk about their problem or they might be prevented from sending a letter but they can generally make a call, and the response is relatively immediate.
“We see a lot of physical abuse cases in the states, and it’s a real problem.
“We work very closely with the domestic violence community, and advocate strongly to make them realise that elder abuse is a different kind of family violence but it is domestic violence, it’s not just some ageing issue, it’s not just a nursing home issue.
“And, that’s been a real challenge.”
Dementia and financial risk
Another pressing issue, which other countries are also grappling with, is how those with dementia are at risk of financial abuse.
Ms Buck says reaching older people with dementia is difficult.
“[They] are not able to access services.
“They’re not going to call my office and say, ‘I need a lawyer, get my crazy niece out of my business, she’s a drug addict and taking all my money’.
“They’re kind of under the radar so how do we reach them?”
Many people with dementia, especially in the early stages, can still live in their own homes and go about daily tasks, but may need some assistance with finances which raises the question of supported decision making.
“A renowned psychiatrist [is] doing work on… the interaction between dementia decline and cognitive functioning, and the financial exploitation crisis in our country, because it’s one of those first decision-making capacities to check out,” says Ms Buck.
“You could be fully functioning otherwise but making decisions about your finances can be one of the first indications of serious decline.”
Protective Services system
Both the Older Americans Act and the Elder Justice Act offer some protection for seniors.
Legal services, meals and healthcare were considered top priorities for community based services by the Older Americans Act which was created in the 1960s for those aged 60 plus.
Ms Buck says it resulted in a Protective Services system in every community in every state in the country, and all reports of elder abuse, anonymous or otherwise, must be acted on.
“It’s not voluntary, they must investigate within 72 hours, and they’re well overtaxed but it’s required by law that every community has this.
“The question of substantiation of the report is a big issue and what they can do if they believe that this is happening because there’s the question of intrusiveness.
“Maybe your sister who doesn’t like you taking care of your mother [complains] but they have to come to your door and investigate.”
The lawyer says the question of autonomy and independence versus protection is something they grapple with “all the time”.
Ms Buck says it doesn’t mean people can’t make their own decisions.
“You have the right to make bad decisions at any age so if you decide you want to give all your money to your 20 year old boyfriend or whoever, that’s your choice.”
But if the investigator’s concerned, further questions are asked.
“The point is if [the older person] is incapacitated in any way, they have to do something.
“If they find they’re in danger, and are unable to take care of themselves and protect themselves, they’ll do an evaluation cognitively to decide.”
Ms Buck says the U.S. has a guardianship system in place but it has shortcomings.
“We’re always looking for options in the decision-making process because it’s very tricky.
“In the US we have a real problem with our guardianship system but we’re addressing it, particularly in Pennsylvania.”
The state’s Supreme Court has brought together a group of leaders comprising the Attorney General, judges, attorneys and legislators to address the problems of abuse and guardianship.
“The guardianship system, as well created as it is, is not well functioning,” says Ms Buck.
“It’s different in many communities.
She says not only is the guardians’ training an issue but there are flaws in the oversight.
“In the states, they’re supposed to be reporting on a regular basis but no-one’s looking for the reports, no-one’s reading the reports, no-one’s filing the reports so a lot of people really fly under the radar.”
Philadelphia takes the issue seriously and has financial exploitation taskforces and elder abuse taskforces throughout communities.
Protective Services are also very strong advocates and strong politically.
“It just shows the importance of having a political presence, lobbyists, someone constantly pushing for you – that’s the American way.”
If you or somebody you know is being abused, contact the Police.
You can also contact Age Concern.