[Senate Hearing 108-288]
[From the U.S. Government Publishing Office]
S. Hrg. 108-288
SHATTERING THE SILENCE:
CONFRONTING THE PERILS OF FAMILY ELDER ABUSE
=======================================================================
HEARING
before the
SPECIAL COMMITTEE ON AGING
UNITED STATES SENATE
ONE HUNDRED EIGHTH CONGRESS
FIRST SESSION
__________
WASHINGTON, DC
__________
OCTOBER 20, 2003
__________
Serial No. 108-25
Printed for the use of the Special Committee on Aging
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SPECIAL COMMITTEE ON AGING
LARRY CRAIG, Idaho, Chairman
RICHARD SHELBY, Alabama JOHN B. BREAUX, Louisiana, Ranking
SUSAN COLLINS, Maine Member
MIKE ENZI, Wyoming HARRY REID, Nevada
GORDON SMITH, Oregon HERB KOHL, Wisconsin
JAMES M. TALENT, Missouri JAMES M. JEFFORDS, Vermont
PETER G. FITZGERALD, Illinois RUSSELL D. FEINGOLD, Wisconsin
ORRIN G. HATCH, Utah RON WYDEN, Oregon
ELIZABETH DOLE, North Carolina BLANCHE L. LINCOLN, Arkansas
TED STEVENS, Alaska EVAN BAYH, Indiana
RICK SANTORUM, Pennsylvania THOMAS R. CARPER, Delaware
DEBBIE STABENOW, Michigan
Lupe Wissel, Staff Director
Michelle Easton, Ranking Member Staff Director
(ii)
C O N T E N T S
----------
Page
Opening Statement of Senator John Breaux......................... 1
Prepared Joint Statement from the Hon. Rahm Emanuel, the Hon.
Peter T. King, and the Hon. Roy Blunt.......................... 3
Prepared Statement of Senator Larry E. Craig..................... 4
Statement of Senator Elizabeth Dole.............................. 5
Prepared Statement of Senator Susan Collins...................... 10
Statement of Senator Herb Kohl................................... 10
Panel of Witnesses
Leanna Watts, accompanied by Daughter Diane Hamlin, Grayson, GA.. 5
Joseph Lofy, Officer, New Berlin Police Department, New Berlin,
WI............................................................. 11
Robert M. Stein, Deputy District Attorney, San Diego County, San
Diego, CA...................................................... 19
Kenneth Connor, Immediate Past President, Family Research
Council, and Attorney, Wilkes & McHugh, Leesburg, VA........... 31
Holly Ramsey-Klawsnik, Ph.D., Klawsnik & Klawsnik & Associates,
Canton, MA..................................................... 35
Joseph Snyder, on behalf of the National Association of Adult
Protective Services Administrators, Philadelphia, PA........... 43
(iii)
SHATTERING THE SILENCE: CONFRONTING THE PERILS OF FAMILY ELDER ABUSE
---------- --
MONDAY, OCTOBER 20. 2003
U.S. Senate,
Special Committee on Aging,
Washington, DC.
The committee met, pursuant to notice, at 1:34 p.m, in room
SD-628, Dirksen Senate Office Building, Hon. John Breaux,
presiding.
Present: Senators Breaux, Dole, Collins and Kohl.
OPENING STATEMENT OF SENATOR JOHN BREAUX
Senator Breaux. The committee will please come to order.
Good afternoon. I would like to thank all of our witnesses for
being with us and for the members that are here. I also would
like to thank our committee Chairman, Senator Larry Craig, for
his support throughout this investigation effort that we have
embarked upon.
I would also particularly like to thank the witnesses who
are here with us this afternoon. Your testimony obviously will
be of great importance to the Senate Special Committee on
Aging.
This committee in particular has conducted a number of
hearings over the past several years on the subject of elder
abuse. Our committee has examined elder abuse that has occurred
in homes and institutions as well. We have also examined
physical abuse, sexual abuse, as well as simple neglect of our
Nation's elderly. Moreover, the committee has also examined
various forms of financial abuse of older Americans as well.
Today, we will examine the subject of family elder abuse,
one of the most sinister forms of elder abuse that exists. We
will be looking at the very people who violated a profound
trust, a trust given by one elder to his or her own flesh and
blood. Family elder abuse is difficult for any of us to fathom
or to try and understand, but very sadly, it occurs.
Forty years ago, none of us wanted to believe that anyone,
much less a family member, could or would abuse a child. Now we
realize that child abuse obviously does occur. As a result of
attention to child abuse prevention at the State and Federal
levels, numerous programs aimed at addressing this issue have
been developed and also successfully implemented.
I believe we are in the same situation today with regard
our Nation's older Americans. It is almost impossible to
believe that a family member would physically abuse or neglect
a frail, older person, or take advantage of them financially.
However, our witnesses this afternoon will dispel that belief.
One of the difficulties in examining the issue of family
elder abuse is the lack of any available data that defines its
nature and also quantifies it. The only incidence and
prevalence study on the topic of elder abuse suggests that
family abuse is by far the largest category. The Adult
Protective Services programs in the 50 States probably has the
best data available addressing abuse within the family units.
The 2000 report of the National Association of Adult Protective
Services Administrators reflects that almost 62 percent of the
perpetrators of elder abuse are from families, as you can see
from the chart that we have prepared for the audience. This
data was published in 2003.
For the purposes of this hearing, we asked the Adult
Protective Services Administration to prepare an interim report
on data collected since the year 2000, but we were disappointed
to learn that they have no plans to repeat this study at this
time. This fact underscores the difficulty in obtaining elder
abuse data. However, they did agree to report on some data
collected in 32 States. Today, I am releasing that information,
which continues to highlight the importance of finding creative
solutions to this very serious national problem.
Although there is little data on the subject, we do know
from our committee's previous work that something like one out
of every four Americans will be a victim of elder abuse,
neglect, or exploitation at some point. We know that somewhere
between 500,000 to 5 million seniors are abused every year, and
further, we also know that the reported abuse is only really
the tip of the iceberg, since 84 percent is the estimate of
elder abuse believed to go completely unreported. Clearly the
Congress and the Nation must find some innovative solutions
that will protect our greatest generation from abuse.
I happen to believe the Elder Justice Act, Senate bill S.
333, that I introduced along with Senator Orrin Hatch, and
which is now cosponsored by some 30 additional Senators, is
just the type of jump start needed to begin the complex task of
developing the research and the training and programs that can
aid in combatting elder abuse.
I am pleased that we now have a companion bill in the House
of Representatives, H.R. 2490, which is a bipartisan bill
sponsored by Representative Rahm Emanuel, Congressman Roy
Blunt, Peter King, and approximately 60 additional Members of
the House of Representatives.
Also solidly behind the legislation are more than 190
organizations working toward passage of the bill, through the
Elder Justice Coalition. I think today's hearing will once
again emphasize the need for this kind of legislation.
Before introducing the witnesses, I would like to note that
we received a statement for the record from Congressmen
Emanuel, Blunt and King, and I would like to insert that in the
record, and also thank them for their support.
[The prepared statement of Senator Breaux follows along
with prepared joint statement from the Honorable Rahm Emanuel,
the Honorable Peter T. King, and the Honorable Roy Blunt and
prepared statement from Senator Larry Craig:]
Prepared Statement of Senator John Breaux
Good morning. I would like to thank all of you for
attending today's investigative hearing. I would also like to
thank the Committee's Chairman, Senator Larry Craig, for his
support throughout this investigation. Most importantly, I
would like to thank the witnesses for being here today. Your
testimony will assist the Committee greatly in building a
strong record on the need for solutions to combat the growing
problem of elder abuse, neglect and exploitation.
The Committee has conducted a number of hearings over the
years on the subject of elder abuse. The Committee has examined
elder abuse in homes and institutions. The Committee has
examined physical and sexual abuse, as well as neglect of the
elderly. Moreover, the Committee has examined various forms of
financial exploitation of the elderly.
Today, we will examine the subject of family elder abuse--
one of the most sinister forms of elder abuse. We will be
looking at the very people who violate a profound trust, a
trust given by an elder to his or her flesh and blood. Family
elder abuse is difficult for any of us to fathom, but sadly it
occurs. Forty years ago, none of us wanted to believe that
anyone, much less a family member, could or would abuse a
child. Now, we realize that child abuse does occur. As a result
of attention to child abuse prevention at the state and federal
levels, numerous programs aimed at addressing this issue have
been developed and successfully implemented. I believe we are
in the same situation today with regard to our older Americans.
It is almost impossible to believe that a family member would
physically abuse or neglect a frail, older person, or take
advantage of them financially. However, our witnesses this
morning will dispel that belief.
One of the difficulties in examining family elder abuse is
the lack of available data that defines its nature and
quantifies it. The only incidence and prevalence study on the
topic of elder abuse suggests that family abuse is, by far, the
largest category. Adult Protective Services programs in the 50
states probably have the best available data addressing abuse
within family units. The 2000 report of the National
Association of Adult Protective Service Administrators reflects
that 61.7% of the perpetrators of elder abuse are from
families, as you can see from the chart we prepared. This APS
data was published in 2003. For purposes of this hearing, I
asked APS to prepare an interim report on data collected since
the year 2000. I was disappointed to learn that there are no
plans to repeat the APS study at this point. This fact
underscores the difficulties in obtaining data elder abuse.
However, APS did agree to report on some data collected in 32
states. Today, I am releasing that APS information which
continues to highlight the importance of finding creative
solutions to preventing elder abuse.
Although there is little data on the subject of family
elder abuse, we know from the Committee's previous work that
one out of four Americans will be a victim of elder abuse,
neglect and exploitation at some point. We know that 500,000 to
five million seniors are abused every year. Further, we know
that reported abuse is only the ``tip of the iceberg,'' since
84% of elder abuse is believed to go unreported. Clearly, the
Congress and the Nation must find innovative solutions that
will protect our greatest generation from abuse.
I believe that the Elder Justice Act, S. 333, that I
introduced along with Senator Orrin Hatch and which is co-
sponsored by 30 additional senators, is just the type of jump-
start needed to begin the complex task of developing research,
training and programs that can aid in combating elder abuse. I
am pleased that we have a companion bill in the House, H.R.
2490, a bi-partisan bill sponsored by Representatives Rahm
Emmanuel, Roy Blunt, Peter King and approximately 60 additional
representatives. Also solidly behind the bill are more than 190
organizations working toward passage of the bill through the
Elder Justice Coalition. Today's hearing will, once again,
emphasize the need for this kind of legislation to help us
ensure the protection of all older Americans against elder
abuse.
Before introducing the witnesses, I would like to note that
I received a statement for the record from the Representatives
Emanuel, Blunt & King and would like to thank them for their
support. I would also like to recognize other Senators for any
opening remarks.
----------
Prepared Joint Statement from the Honorable Rahm Emanuel, the Honorable
Peter T. King, and the Honorable Roy Blunt
Chairman Craig and Ranking Member Breaux, we commend you
for calling this important hearing to address the problem of
family elder abuse in the United States. As sponsors of the
``Elder Justice Act'' (H.R. 2490) in the U.S. House of
Representatives, we are keenly aware that the growth in the
senior population has coincided with a rise in family elder
abuse. As people live longer and require more assistance in old
age, the problem of family elder abuse is likely to intensify.
We also recognize the painful choices that abused elderly
must face once they accept that a beloved child, grandchild, or
spouse is causing harm to them. We are hopeful that this
hearing will shatter the silence and shed light on the fragile
balance caseworkers strike as they strive to provide
individuals with healthy options while respecting their right
to autonomy. We believe this hearing will go a long way to
raising awareness surrounding the tragedy of elder abuse to the
same level as awareness of child abuse.
Although most cases of family elder abuse go unreported, it
is believed that the most frequent abusers of elderly victims
are relatives who are usually adult children or spouses. We
recognize that many victims of elder abuse and neglect often
deny or downplay the mistreatment they are receiving. Some
seniors do so out of fear of rejection and disruption of their
lives; some out of pride, embarrassment or shame; some out of
concern about their family's privacy and some out of concern
that legal action might be taken against the alleged abuser.
For the mentally infirm, many may not have the capacity to
report abuse. In any event, it is clear that families can have
undue influence over older Americans in a family setting. It is
essential that we provide families with the necessary training,
as well as options, to ensure that seniors are properly cared
for and afforded a high quality of life.
Family elder abuse includes more than physical
mistreatment. It also includes psychological and emotional
abuse and neglect. Yet, the most prevalent form of abuse may in
fact be financial exploitation. We support a comprehensive
public health and law enforcement approach to providing
resources to support State and community efforts on the front
lines dedicated to fighting elder abuse with scares resources
and fragmented systems.
Mr. Chairman, we look forward to working with you and the
distinguished members of this Committee to respond to the
perils of family elder abuse, and we once again commend you for
convening this panel today.
----------
Prepared Statement of Senator Larry Craig
I am pleased that Ranking member Senator Breaux has called
for this important hearing today. As you know, crimes of abuse
and exploitation perpetrated against the elderly are issues of
high priority to me as Chairman of this committee.
The abuse of our most vulnerable Senior citizens is a
reprehensible crime and those who commit such offenses should
be prosecuted to the full extent of the law. It is important to
note, however, that there are various forms of abuse. As
Chairman, I have convened several hearings on crimes which harm
the elderly. We have explored abuses perpetrated by court-
appointed guardians; financial exploitation by Social Security
representative payees; identity theft targeting seniors where
life savings have been lost; and Elder Abuse arising in the
homes and communities of our nation's Seniors.
According to nationwide statistics, over 60 percent of
those who commit Elder Abuse are family members of the victim.
This shocking fact highlights the need to punish offenders as
well as taking steps to prevent the abuse from occurring in the
first place. The support of our nation's caregivers, who are
largely family members, is an important way to prevent
instances of abuse and neglect.
We in Congress are considering a number of other important
initiatives that protect senior citizens from those who prey
upon them. We must continue to explore ways to coordinate
federal and state efforts to resolve these devastating crimes.
In addition, I continue to work with Senator Breaux on
Elder Justice issues. He and I both agree that we must provide
protections from abuse as well as preserve the dignity and
freedoms of our most vulnerable citizens.
I look forward to hearing today's testimony.
Senator Breaux. I recognize any of my colleagues for any
opening statements that they might have.
Senator Dole.
STATEMENT OF SENATOR ELIZABETH DOLE
Senator Dole. Thank you, Mr. Chairman. I am grateful to all
of those who are participating in this hearing today on family
elder abuse.
This topic is extremely disturbing to me. I was truly
horrified to read of the abuse that is being committed against
seniors, an estimated 500,000 a year, and that the majority of
this abuse comes at the hands of a member of the victim's
family.
What does this say about the way we treat our mothers and
our fathers when they are most in need? The pain that these
seniors endure when they are most vulnerable and most in need
is unfathomable. Fortunately, my State has temporary housing
options once it's discovered that a senior is a victim of elder
abuse. But key to assisting a victim, of course, is finding and
investigating cases where seniors are being abused,
financially, physically, sexually, mentally.
Even more important, how do we stop the abuse from
occurring in the first place? Our seniors suffering in silence,
especially at the hands of family members, deserve our full
attention. Those in our communities who are equipped to help
must communicate with each other, assisting family members who
are caretakers and mobilizing when an injustice is committed.
We must act early and as often as necessary to protect our
seniors.
I certainly look forward to working with my colleagues to
address these horrific abuses, and I want to thank you again,
Mr. Chairman, and also thanks to the panel, for your courage in
coming forth and your commitment to assisting those most in
need.
Thank you.
Senator Breaux. Thank you, Senator Dole.
If there are no other opening comments, we would like to
welcome our panelists. We have this afternoon with us three
individuals who are representing victims of physical and elder
abuse, and also three experts which will share their research
with us.
Our first witness is Mrs. Leanna Watts, who is currently
from Georgia, Grayson, GA, but used to be from Shreveport. She
is accompanied by her daughter, Diane Hamlin. We thank both of
you.
I guess Mrs. Watts will be giving the testimony, so why
don't you go ahead and tell us your story.
STATEMENT OF LEANNA WATTS, GRAYSON, GA.; ACCOMPANIED BY
DAUGHTER DIANE HAMLIN
Mrs. Watts. I thank you for this opportunity, first of all.
I just want to say that I can't begin to tell you all of the
horrible things that I have experienced. But since I only have
5 minutes, I have decided to tell you the things that are
beneficial.
I moved from Louisiana to Georgia to be near family. I
lived with my daughter and her husband. I decided I wanted to
maintain my independence, and during my search for independent
living, I found the following: you cannot have any type of
savings and obtain senior assistance housing.
My son and his wife convinced me that Ohio had programs
more geared towards seniors in my condition, mainly going to
dialysis three times a week. They told me that they had secured
me a senior apartment which was to be ready within 30 days of
my arrival. There was no apartment. Their living room became my
bedroom. Absolutely no privacy.
When they found out about my life's savings of $10,000,
things immediately changed. They drugged me and forced me to
sign over power-of-attorney to my son and to become payee over
my Social Security benefits also.
They took all of my cash. They began using my credit card,
forging my signature. They took all of my identification. They
forbade me to answer the door or to go outside, only on my
trips to and from dialysis. They suspended my telephone
privileges and told me that all calls were being monitored and
recorded.
They kept me drugged for doctors appointments so that I
could not answer questions or speak clearly. I had slurred
speech and was slumped over my wheelchair. They constantly told
me that dialysis patients do not live long and that I would
soon die.
I finally got help by telling the social worker at my
dialysis unit what was happening to me. She then contacted
Adult Protective Services, who contacted my daughter and they
made arrangements to rescue me.
We had to have a police escort to gather a few of my things
at my son's apartment. We were unable to obtain any other
personal belongings, such as my furniture or other clothing in
storage, because my son would not disclose the location nor
surrender the keys.
Since returning to Georgia, life is getting back to normal.
I am beginning to take walks again and I am able to go on
shopping trips and able to push a shopping cart. I am no longer
confined to a walker or wheelchair. I never would have imagined
that something so tragic would happen to me.
I want to say, last of all, that a word to the wise: pray
and ask God for help, and when you get the answer, act on it.
Thank you.
[The prepared statement of Mrs. Watts follows:]
[GRAPHIC] [TIFF OMITTED] 91381.001
[GRAPHIC] [TIFF OMITTED] 91381.002
[GRAPHIC] [TIFF OMITTED] 91381.003
Senator Breaux. Thank you very much, Miss Watts. I think
all of us are so glad to see you and doing well, doing much
better than before. You certainly have done a very fine job in
presenting your information to our committee here in Congress.
So we are very appreciative of you being with us this
afternoon.
Mrs. Watts. Thank you.
Senator Breaux. Senator Collins, did you have some opening
comments you wanted to make?
Senator Collins. Mr. Chairman, I will just submit it for
the record. Thank you.
[The prepared statement of Senator Collins follows:
Prepared Statement of Senator Susan Collins
Mr. Chairman, thank you for calling this afternoon's
hearing to discuss elder abuse, a crime that threatens too many
older Americans. Like all other forms of domestic violence,
this abuse is hidden behind closed doors.
Violence in the home has reached alarming proportions in
the United States, and vulnerable seniors are among the
victims. It is estimated that at least 500,000 of our nation's
elderly are abused, neglected, or exploited each year.
Moreover, the actual number of elder abuse and neglect cases
may well be higher. For every incident reported to the
authorities, another five go unreported.
Abused and neglected seniors are possibly the most isolated
victims of family violence. They are abused by the loved ones
that they depend on the most to care for them--their spouses or
adult children. Victims of elder abuse may be too physically or
mentally disabled to seek help, or they may not want to report
a member of their own family for mistreating them. As a
consequence, many seniors are not able to get the help that
they need, despite the well-intentioned efforts of Adult
Protective Services and laws in many states, including Maine,
that require mandatory reporting of suspected elder abuse and
neglect cases.
In my home state, it is estimated that there are 13,100
seniors who suffer some measure of abuse and neglect. Only
about one in five cases are referred to Adult Protective
Services. Moreover, the Maine Department of Human Services
reports that substantiated cases of elder abuse have risen to
45 percent of all referrals and that the nature of the abuse is
becoming more severe.
Maine's problem is compounded by the fact that many of our
elderly live in rural areas, making abuse less visible and
possibly putting advocacy programs, social networks, and
shelters out of reach. In addition, because Mainers pride
themselves on self-sufficiency and value their privacy, they
may even be less likely to report abuse or neglect or ask for
help.
Clearly, elder abuse is a complex problem that does not
have a simple solution. I am pleased to be an original
cosponsor of Senator Breaux's Elder Justice Act, which takes
steps to address this under-reported, under-researched, and
under-funded problem. The bill unites the social service,
health, and law enforcement communities in analyzing elder
abuse, improving the prevention and detection of elder
victimization, and making sure that mistreated seniors are able
to receive needed services.
Mr. Chairman, I commend you for calling this important
hearing. I look forward to hearing the testimony of the
witnesses today and to working with you and other members of
the Committee on this problem that will increase exponentially
as the Baby Boom generation ages.
Senator Breaux. Our next witness is from New Berlin, WI,
somewhere up in Senator Kohl's territory. Senator Kohl, do you
have any comments?
STATEMENT OF SENATOR HERB KOHL
Senator Kohl. Thank you, Senator Breaux.
It is my pleasure today to introduce Officer Joseph K. Lofy
as a distinguished member of our first panel. Wisconsin is
lucky to have people like Officer Lofy working in law
enforcement, and the Aging Committee is lucky to have the
benefit of your expertise here today.
Officer Lofy comes from a strong law enforcement family.
His father is a retired police supervisor, and his mother and
sister both work for the Milwaukee office of the FBI.
Officer Lofy has continued that record of service. He
served in the Village of Shorewood Police Department from 1990
to 2002 as a patrol officer and investigator. He also currently
serves as a patrol officer in the city of New Berlin Police
Department.
Throughout his service, Officer Lofy has attained a wealth
of expertise. He has attended numerous training schools on
child abuse and neglect, and he participated in the Wisconsin
Department of Criminal Investigation's death investigation
school. He has also distinguished himself as a Dare instructor,
a fire investigator, a police composite artist, an evidence
technician, a police photographer, and as part of the New
Berlin Police Department Honor Guard.
Over the years, Officer Lofy has successfully solved cases
involving arson, bank robberies, child abuse, international
kidnapping, serial burglars, and many other offices. Today his
experience in the case of the death of Mary Graichen will help
us shed light on a disturbing but very real tragedy of family
elder abuse.
Office Lofy, we welcome you here today. We thank you for
your participation and we look forward to your testimony.
Senator Breaux. Thank you, Senator Kohl.
Before your testimony, Mr. Lofy, I think we have a short
video we would like to show prior to your statement.
[Video Presentation.]
OK, Mr. Lofy.
STATEMENT OF OFFICER JOSEPH K. LOFY, CITY OF NEW BERLIN POLICE
DEPARTMENT, NEW BERLIN, WI
Mr. Lofy. Yes, sir. The first involvement the Village of
Shorewood Police Department had in this case was in response to
a request from the North Shore Fire Department. This is common
in cases of individuals that are in need of being placed in
protective custody for various reasons.
The North Shore Fire Department was sent to the Graichen
residence for a call of a woman with infected legs. The
original callers were two caseworkers from the Milwaukee County
Department of Aging. The caseworkers had been assigned to
investigate a report that Edward Graichen was neglecting the
needs of his mother.
On Monday, January 10, 2000, at 1:24 p.m., the caseworkers
arrived at the Graichen residence. They were able to get Edward
Graichen to open the door and gain entry to the house. The
conditions they encountered and the condition of Mary Graichen
prompted the 911 call for an ambulance.
The Graichen house, located at 4261 North Farwell Avenue in
Shorewood, WI, is in a middle class to upper middle class
neighborhood. The duplex and yard appear to be well kept on the
outside. You can refer to figure 1 in the packet. Edward
Graichen and his mother lived in the lower unit. The upper unit
of the duplex was unoccupied at the time of this incident.
The inside of the house, however, was a different and
tragic story. All of the rooms were almost nearly impossible to
enter, much less use in their designed function. Figures 2
through 6 will illustrate this. Each room had items piled three
to five feet deep covering the entire room.
Something else not evident from the outside was the
overpowering odor of urine, feces and decaying human body.
Police and fire personnel had to use masks covering their
mouths and noses, and also had to wear protective garments.
Other fire personnel had to use Vick's vapor rub beneath their
noses to reduce the effect of the stench so they could work.
While medical personnel worked to remove the victim from an
overstuffed armchair, exhaust fans were set up at the front
door to blow in fresh air and vent the air and odors from the
house out the windows of the residence. Officers who had been
at the scene for some time, when they returned to the police
station, the odor of the house was still lingering on their
uniforms for several hours.
The refrigerator in the house contained several bunches of
bananas, a sub sandwich, several cans of Chunky soup, and some
bags from the Hardee's fast food restaurant. There was no
evidence found at the house that a proper meal had been
prepared for some time. Inside of the freezer was empty ice
cube trays and insulated drinking cups.
The victim, Mary Graichen, was 88-years-old. It was
reported by family members that Mary had once weighed over 200
pounds. At the time she was discovered, she was under 100
pounds in weight.
Mary Graichen was discovered sitting in a chair in the
living room of her house in her own waste. Mary Graichen was
clothed and covered with blankets. She could barely lift her
head up, as it hung down. Her dentures were sitting next to
her, along with some food wrappers. Workers described Mary's
hair as being one big snarly knot. They observed that Mary's
eyes were open, but full of matter. She was filthy and smelled
of rotting flesh. She had open wounds on her legs that were
weeping fluid and blood. The workers were told that Mary
Graichen had been fed soft foods, such as the bananas, and
would only drink Diet Rite soda. She had been reported to be
eating very little at the time she was discovered.
The firefighters described Mary Graichen as having the
appearance of ``melting'' into her chair. The firefighters
aiding Mary Graichen again had to wear full firefighting
garments and self-contained breathing apparatus to be able to
stay close to her to render aid. When they lifted Mary from her
chair, they discovered that her legs retained the pattern in
the shape of the chair she had been seated in, and that the
fabric beneath her had been disintegrating.
Once at the hospital, doctors and staff discovered that
Mary's sores had gone right down to the bone. Doctors stated
that Mary was severely infected, septic, malnourished and
dehydrated. Hospital staff said that her wounds were so severe
that all they could do was to make Mary comfortable. You can
refer to figures 7 and 8.
Mary Graichen's son, Edward Graichen, was a 66-year-old
male who worked part time at a fast food restaurant. When
Edward Graichen was interviewed, he had told us he didn't want
to get any help for his mother due to the fact that he had
promised her she would not go into a nursing home. Edward
Graichen told us that he had taken some classes at the
Milwaukee Area Technical College to become a nurse's aid, and
had been employed for some time in the past as a nurse's aid in
a nursing home. He decided that he had taken proper care of his
mother.
How did this happen? The Graichen family was a family that
had slipped through the cracks of society. The Village of
Shorewood did not replace the village social worker upon her
retirement. This was a missed opportunity to make personal
contact, as she commonly did, and possibly prevent the
situation from occurring. The Village of Shorewood health
department made only telephone checks to attempt to follow up
on the Graichen family.
I have also assisted the North Shore Fire Department on
several other incidents similar to this. I recall the case of
an elderly woman who had open sores on her ankles that also
contained maggots at the time, and also there was a disabled
elderly gentleman whose walls of his apartment were covered
with his own feces as he attempted to care for himself.
The police agency that I am currently working for has a
``find a way'' attitude about solving community problems. Our
department employs two police social workers who make contact
and follow-ups with citizens that may be on the verge of
needing services that Waukasha County can provide them. They
also assist with officers making the correct referrals to the
correct county agencies.
Thank you.
[The prepared statement of Mr. Lofy follows:]
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Senator Breaux. Just in conclusion, what was the outcome of
this case with regard to the son?
Mr. Lofy. The son was given 7 years probation and ordered
not to conduct any care for any additional elderly people.
Senator Breaux. We will have other questions later that we
want to ask. It is an incredibly tragic story, and it's not the
only one that's out there.
Mr. Lofy. Correct.
Senator Breaux. Next we would like to hear a statement from
Mr. Robert Stein, from San Diego, the Deputy District Attorney.
We welcome you, and thank you so much for traveling across the
country to be with us.
I understand you have a power point presentation and would
like to present that.
STATEMENT OF ROBERT M. STEIN, DEPUTY DISTRICT ATTORNEY, ELDER
ABUSE PROSECUTION UNIT, SAN DIEGO COUNTY, CA
Mr. Stein. I have been a Deputy District Attorney for over
14 years. I am currently a prosecutor in the Elder Abuse Unit.
I prosecute cases of elder neglect.
Unfortunately, these types of cases are not uncommon in San
Diego County. Typically, the elderly victim is neglected by a
family member, usually the elder's adult son or daughter. While
working as the victim's caretaker, the perpetrator's real
intent is clear: to live off the elderly victim.
One such case is People v. Donnell Gilliam. I have Mrs.
Gilliam's picture displayed on the first slide. For 13 years,
Mr. Gilliam's only job was the sole caretaker for his mom. Mr.
Gilliam neglected his mom, contributing to her death. It is an
understatement to say that Mrs. Gilliam lived the last months
of her life severely neglected by her son.
Paramedics who first arrived at Mrs. Gilliam's home smelled
an overpowering odor. A police officer described the odor--and
these are his exact words during his testimony at trial--
``smelling like death.'' Mrs. Gilliam was lying in our own
feces. Mrs. Gilliam was found unconscious. Mr. Gilliam did not
clean his mom or bathe his mom.
Paramedics at the hospital emergency room smelled an
overpowering odor. The odor was so bad that hospital staff
could not remain very long in the emergency room. They took
turns coming in and out. Mrs. Gilliam was so dehydrated that
her skin was peeling off. Pus was oozing out of a bed sore in
her spine. I will show you a photo of the bed sore in a moment.
Mrs. Gilliam's toe nails were so long that they did not
look like toe nails. They looked like large growths, a large
mass. I will show you all a picture of that in a moment.
The emergency room doctor who treated Mrs. Gilliam
diagnosed her to be suffering from severe dehydration which
affected both her body and her mind, from severe malnutrition,
a stage III decubitus ulcer, the bed sore at her spine, and a
fever and infection which were caused by the bed sore.
During the trial of Mr. Gilliam, the ER doctor opined that
the Gilliam case was the worst case of neglect he had ever
seen. Unfortunately, the Gilliam case is not the worst case of
elder neglect that we have seen in the County of San Diego.
This is a photograph of the stage III decubitus ulcer at
Mrs. Gilliam's spine. A decubitus ulcer is caused when the
victim remains lying in one place for a long period of time,
cutting off circulation at the affected area. This is why the
elderly victim must be regularly moved so that he or she is
lying in different positions. Otherwise, the skin dies and eats
away at the affected area.
According to the emergency room doctor who treated Mrs.
Gilliam, he said that it took over one month for this bed sore
to develop, as it is shown here in the photograph.
Finally, this is a photograph of Mrs. Gilliam's toe nails.
According to the emergency room doctor, this picture is
obviously evidence of severe neglect. The doctor could only
testify that it took a long time for the nails to grow that
long.
Mr. Donnell Gilliam was charged with one count of felony
elder neglect under California Penal Code section 368(b)(1). He
requested a jury trial and we had a jury trial. At the
conclusion of that jury trial, Mr. Gilliam was found guilty of
elder neglect. He was granted probation for 3 years and was
sentenced to 120 days in local custody and was not allowed to
act as a caretaker.
Thank you all very much for inviting me to appear before
you today.
[The prepared statement of Mr. Stein follows:]
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Senator Breaux. Thank you as well, Mr. Stein.
The next witness will be Mr. Kenneth Connor, who is a
partner with the law firm of Wilkes & McHugh, and former
president of the Family Research Council.
Mr. Connor, we are delighted to have you with us and look
forward to your statement.
STATEMENT OF KENNETH L. CONNOR, ESQ., LAW FIRM OF WILKES &
McHUGH, AND PAST IMMEDIATE PRESIDENT, FAMILY RESEARCH COUNCIL
Mr. Connor. Thank you, Mr. Chairman, members of the
committee. I appreciate your willingness to address the
problems of neglect, abuse and financial exploitation of the
elderly in our society. In my experience, these are problems of
enormous magnitude but about which public law enforcement and
law makers frequently are largely uninformed.
I have been intimately involved with these problems for
over 20 years. As a trial lawyer, I have represented many
victims of elder abuse and neglect. As a member of Florida's
Task Force on the Affordability and Availability of Long Term
Care, I have wrestled first hand with the tensions that emerge
from the need to hold caregivers fully accountable for
wrongdoing toward the elderly, while at the same time
preserving the affordability of their services.
As President of the Family Research Council, I sought to
increase public awareness of the plight of the elderly in our
society and to drive home the proposition that those who claim
to be ``pro life'' or ``pro family'' have a moral and social
obligation to protect our elderly and to ensure that they are
treated with dignity and respect.
Theologian Francis Schaeffer and former Surgeon General C.
Everett Koop rightly observed in their book, Whatever Happened
to the Human Race: ``Cultures can be judged in many ways, but
eventually, every nation in every age must be judged by this
test: how did it treat people? Each generation, each wave of
humanity, evaluates its predecessors on this basis. The final
measure of mankind's humanity is how humanely people treat one
another.'' Mr. Chairman, the judgment of history about how we
treat our fellow man may well be impacted by the work of this
committee.
Even though we live in the most affluent country in the
world today, and during the most affluent period of human
history, and in a time in which our medical technology is
second to none, thousands of America's elders suffer from abuse
and neglect. As you have rightly noted, Mr. Chairman, your own
staff reports that one out of every four Americans will be a
victim of elder abuse, neglect or exploitation at some time in
the future. Sadly, reports suggest, as you have indicated, that
family members represent the largest category of perpetrators
of abuse against the elderly, a sobering statistic, I might
add, for the former president of a public policy, pro-family
group.
In truth, however, there is a dearth of data about these
matters upon which you as policymakers can make informed
judgments. Of one thing you can be confident, however: the
magnitude and intensity of this problem will only increase in
the future. Absent a seismic shift, all of the ingredients that
exacerbate this problem are likely to get worse.
Demographic trends are against us. Currently, there are 35
million people who are age 65 or older, and that number is
expected to double in the next 30 years. The over-85 age group
is the fastest growing age group in America. Presently, we have
a million and a half nursing home residents. That number will
likely double by the year 2035.
These demographic shifts will likely have a profoundly
negative effect on the economics associated with old age. In
1967, Medicare's cost was approximately $1 billion. but in the
year 2000, its cost was approximately $300 billion. Medicaid
spending in 1967 was approximately $1 billion, but in 2000, it
was approximately $200 billion.
When my generation, the ``baby boomers'' retire, estimated
Medicaid costs in real dollars may well quadruple. By 2020 or
2030, Medicaid could consume the entire budget of every State
in the Union.
The implications for Social Security are no less startling.
In 1950, America had 16 workers for every retiree. Today, that
ratio has slipped from 16:1 to 3:1. This data has intensely
negative implications for the future of the elderly in a
culture which has shifted from a sanctity of life to a quality
of life ethic, and which increasingly calculates one's net
worth in terms of cost-benefit ratios, quality of life
assessments and functional capacity studies.
Given those factors, and considering the increase in
families which are disintegrating because of divorce--a two
parent household is in a better position to care for its
elderly than a single parent home--the pressures and attitudes
that incline one toward abuse will intensify.
Indeed, how long will it take for the youth of America,
bending under the weight of ever-increasing costs for Medicare,
Medicaid and Social Security, strained by the pressures of a
single parent household, and sandwiched between caring for
children and elderly parents who have the same needs as
children, a generation raised on the disposable man ethic
fostered by Roe v. Wade, conclude that the elderly are more of
a burden than a benefit, useless eaters who are quite unwanted.
In his book, ``Culture of Death: The Assault on Medical
Ethics in America'', Wesley J. Smith states: ``Our culture is
fast developing into one in which killing is beneficent,
suicide is rational, natural death is undignified, and caring
properly and compassionately for people who are elderly. . .
disabled, despairing or dying, is a burden that wastes
emotional and financial resources.'' If you doubt that, Mr.
Chairman, please take a moment to reflect on the Terry Schiavo
case that is producing a firestorm of controversy in Florida
today.
Mr. Chairman, my earnest prayer for you and the members of
this committee, along with that of Mrs. Watts, is that you will
be accorded the wisdom to know what is right in this situation
and the courage to do it.
Thank you, sir.
[The prepared statement of Mr. Connor follows:]
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Senator Breaux. Thank you, Mr. Connor, for your
presentation.
Our next witness will be Ms. Holly Ramsey-Klawsnik. We're
delighted to have you with us.
STATEMENT OF HOLLY RAMSEY-KLAWSNIK, PH.D. KLAWSNIK & KLAWSNIK &
ASSOCIATES, CANTON, MA
Dr. Ramsey-Klawsnik. Thank you.
Seventy-three year old Clara T. is paralyzed and
incontinent following a stroke. She spends her day in a
hospital bed in her dining room. One day, her home health aide
observed her crying and asking her husband to bring her
medication. He told his wife to ``shut up.'' The crying
escalated. Mr. T. forcibly held a pillow over her face, stating
that when he tells her to shut up, she had better do it. He
then roughly grabbed her breast.
This case, like thousands each year, was reported and
investigated. I evaluated Mrs. T. as a consultant for the
Massachusetts Elder Protective Services program. She had been
abused for 50 years. She explained, ``but now it's worse''
Prior to retirement, Mr. T's work provided some escape from the
shoving, slapping, verbal and sexual assault. Before her
stroke, she fetched the things she needed--water, medication,
food. Now she only receives what her husband gives. She
described humiliation when her husband changed her soiled
clothing. He often took sexual advantage of these times.
Thank you for inviting me to share what I have learned from
clinical work and research with hundreds of victims like Mrs.
T. I have worked with family violence for a quarter century,
and the past 14 years of this work has been on elder abuse.
Abuse in long-term care is intolerable. We must realize,
however, that most seniors live in the community. Last year in
Massachusetts, three times as many elder abuse cases were
discovered in community as opposed to facility settings. Most
community dwelling victims are abused by family members. In a
study of 130 cases of suspected sexual abuse of elders residing
in the community, I found that 77 percent of the offenders were
family members.
Like Mrs. T, many seniors victimized by family members have
endured long-term violence. Others experience the onset of
abuse after becoming disabled. For example, 86-year-old Mrs. J.
moved in with her daughter and son-in-law to recover from a
broken hip. Subsequently, her daughter died and her son-in-law
became her caregiver. Mrs. J. disclosed to her visiting nurse
that he took nude photos of her. He instructed her to open her
legs and smile for the camera. He said the photos would prove
that he had not abused her and that her daughter would want her
to cooperate. He ``checked'' her genitals by inserting objects.
He forced her to sign papers naming him as her life insurance
beneficiary. This abuser earned his living as a home health
aide.
Much is required to end the suffering of people like Mrs.
J. Suspicious cases must be recognized and reported. Reports
must be competently and quickly investigated. Forensic experts
must examine victims and document evidence of abuse. Many
victims need medical and mental health care. Police officers
and prosecutors need training to accommodate the special needs
of older victims. Legal representation is needed to ensure
protection of rights. Concrete needs range from shelter to
food, medicine, transportation, assistive devices, and personal
care.
Are there adequate resources available for older victims?
No. Unmet needs abound. Caring helpers scramble to secure
scarce resources. Many victims do without.
Across America, an army of trench workers struggle daily
with unmet victim needs. This is the staff of our elder and
adult protective services programs. I can personally attest
that, from Florida to Oregon, Texas to New Hampshire, Hawaii to
Massachusetts, they have insufficient resources to fulfill
their mandate to protect the elderly, disabled and abused.
The lack of funding is pervasive, the consequences are
significant. Workers must venture into dangerous homes and
neighborhoods to investigate reports; yet their systems
typically cannot even afford to equip them with cell phones.
Their salaries are low, their case loads are high. They are
insufficiently trained to handle the complex problems
confronting them unceasingly.
The National Association of Adult Protective Services
Administrators reports that half of the States have no
protective services training budget. There are countless unmet
needs among those on the front line in the inadequately
financed war against elder abuse.
The study of elder abuse is in its infancy. The unknown
greatly exceeds the known. Who is most at risk? How can we
prevent it? What are best practice methods for case
investigation, intervention and prosecution?
Research needs are extensive. For example, there has not
been a national study of elder sexual abuse. How can we
successfully intervene without scientific knowledge? Do victims
deserve to have us show up, ready and willing to help, but
lacking social science findings to inform our efforts? I think
not.
I am on the board of the National Committee for the
Prevention of Elder Abuse. I have learned from my board
colleagues, representing fields including medicine, criminal
justice and aging services, of the critical need for inter-
disciplinary collaboration. Training is needed for the array of
professionals who must work cooperatively when seniors are in
danger.
Elder abuse victims rely upon society to respond to their
suffering with kindness, knowledge and resources. I applaud you
for learning about this problem. I support efforts to fund a
national response to elder abuse.
The Elder Justice Act addresses many problems. With your
support, this Act will result in needed changes, including the
creation of safe havens for abused elders, funding for
research, training of forensic experts, increased prosecution
and training in protective services systems.
I urge you to support the Elder Justice Act. I can promise
you that, if passed, it will make a real difference in what we
can offer victims.
Thank you.
[The prepared statement of Dr. Ramsey-Klawsnik follows:]
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Senator Breaux. Thank you so much. We appreciate your being
with us.
Our final witness will be Mr. Joseph Snyder of
Pennsylvania, of Philadelphia, who is here on behalf of the
National Association of Adult Protective Services
Administration.
Mr. Snyder.
STATEMENT OF JOSEPH SNYDER, DIRECTOR, OLDER ADULT PROTECTIVE
SERVICE; APPEARING ON BEHALF OF THE NATIONAL ASSOCIATION OF
ADULT PROTECTIVE SERVICE ADMINISTRATORS
Mr. Snyder. Thank you, Senator.
Good afternoon. I am Joe Snyder, Director of Older Adult
Protective Services at the Philadelphia Corporation for Aging
in Philadelphia, PA. Today I am representing the National
Association of Adult Protective Service Administrators, or
NAAPSA.
NAAPSA is the only national association that represents APS
administrators and their victims throughout the country. NAAPSA
is also a member of the National Center on Elder Abuse and
partners with various entities that are interested in the
welfare of the most at risk adults in our society. The mission
of NAAPSA is to improve the quality and availability of
services for disabled adults and elderly person who are abused,
neglected, or exploited, and other vulnerable adults who are
unable to protect their own interest.
Adult Protective Services are those critical services
provided to vulnerable adults age 18 and over, who have
physical or mental disabilities which prevent them from
protecting themselves from abuse, neglect and exploitation by
themselves or others.
Sadly, this abuse comes mostly from family members. In the
NAAPSA study referred to earlier by Senator Breaux, it was
found that 62 percent of all substantiated reports involved
family members.
Here are some case examples. An 85-year-old Pennsylvania
woman was the victim of physical abuse for over 50 years by her
husband. After repeated referrals to APS, she finally admitted
the abuse, stating ``he never hits me in the face. He only hits
me where people can't see it. He only hits me now when I can't
walk.'' She finally made the choice to move into a nursing
home, and at my worker's last visit, said to her, ``It's both
good and bad being away from him.''
An 84-year-old female from Tennessee lived alone with her
77 cats and dogs. The client appeared to have not bathed or
changed her clothes in years. She told APS that the animals
were her only company. She knew that her clothes were rotting
off, but her son, a local attorney who lived nearby, charged
her $20 to wash her clothes. In order to fight off the dogs and
cats, an APS worker remained with the client while she ate the
meals that were delivered, so that she could finish the food.
APS counselors were able to put in services to clean the home
and her clothes. APS contacted her daughter from out of State,
who came and took her home.
A Wyoming man stands accused of intentionally abusing or
neglecting his 91-year-old mother, after an investigation done
by APS and the police. The woman was found sitting in a
recliner, sitting in her own urine and feces, with multiple
bruises all over her body. Her son, who had been unemployed for
over 4 years, had been paying himself from her Social Security
check as her caregiver. Investigators found two cases of beer
and a half empty liter of whiskey when they arrived to do the
investigation.
These compelling stories are an everyday occurrence for APS
staff and their victims. While research is scant in many areas,
we do know certain things. We know that caregiver stress is not
a valid cause or excuse for abuse, neglect, and exploitation.
There are many caregivers under enormous stress who do not
abuse or neglect. We know that the elements of power and
control present and known to the folks who are in the domestic
violence field are also prevalent in our cases. We also know
that other characteristics of the perpetrators, like drug and
alcohol addiction and mental illness, are prevalent in a lot of
our casework.
APS continues to need support to serve this forgotten
population, however. According to information collected from 36
States in 2002, the number of reports to APS programs jumped 14
percent from 1999 to 2001, while at the same time an informal
survey of APS administrators showed that a 30 percent reduction
in staff had occurred to their programs.
According to a 2000 survey of State APS programs conducted
by NAAPSA, out of the 40 States that responded to the funding
question, 47.5 percent of the States relied solely on the
Social Services Block Grant, or SSBG, and an additional 20
percent depended only on State and local funds.
As part of welfare reform in 1996, the Congress and the
Governors reduced SSBG funding from $2.8 billion to $2.38
billion, with the promise of full restoration by fiscal year
2003. The agreement was broken and SSBG funding was reduced to
$1.7 billion, a reduction of more than one billion dollars from
the 1996 level. This has resulted in a reduction of APS
services in some States.
It is imperative that SSBG be fully restored to the $2.8
billion level. We hope that the Senate version of the CARE Act
will prevail in conference and SSBG will be restored to the
$2.8 billion level.
The APS community and all who care about this at-risk
population would like to thank Senators Breaux and Hatch and
the other cosponsors for the introduction of the Elder Justice
Act. This is the most important piece of Federal legislation in
the history of the adult protective services movement.
This bill provides a Federal home for adult protective
services along with a consistent funding source. The Elder
Justice Act provides support to State and community efforts to
assure adequate resources to prevent, detect and reduce the
significant social problem known as elder abuse. The Elder
Justice Act will increase the knowledge base as well as support
research and training activities dedicated to stopping this
epidemic that will only increase in the coming years. The
ability to provide a forensic capacity and increase
prosecutions and collaborative efforts is essential if the
field is to move forward.
NAAPSA and APS administrators across the Nation urge you to
help us combat this epidemic of family violence by supporting
the Elder Justice Act and restoring full funding to the Social
Services Block Grant. thank you for the opportunity to speak
today.
[The prepared statement of Mr. Snyder follows:]
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Senator Breaux. Thank you, Mr. Snyder. I thank all of the
witnesses that have been with us.
You know, these stories are so tragic and so horrible and
so difficult to understand, you would almost believe that they
were not true if they weren't so well documented. For most
Americans, the concept of having these types of tragic events
occur is truly unbelievable. To think they may be the
responsibility of family members is even more inconceivable to
so many of us. But, in fact, they do occur. As you said, Mr.
Snyder, it's almost an everyday occurrence seen by people in
the protective services. It's inconceivable.
I want to first recognize Senator Kohl, who was here first,
and then Senator Dole, for any questions you might have.
Senator Kohl. Thank you, Senator Breaux.
Mrs. Watts, we need to tell you how sorry we are that you
had to endure such a terrible ordeal. Obviously, there is no
excuse for what happened to you, and we are so glad you were
finally able to get the help that you needed. It is so
important that people like yourself come here and tell us your
stories, and we hope that Congress will do more to make sure
that we prevent further tragedies.
Can you tell us, did your son and your daughter-in-law ever
face any criminal charges as a result of what they did to you?
Mrs. Watts. No, I did not. Oh, they did not?
Senator Kohl. Did they face any criminal charges, your son
and your daughter-in-law, did they face any criminal charges?
Mrs. Watts. No, they didn't.
Senator Kohl. What happened? They just got away?
Mrs. Watts. Well, when I left, I was so glad to get away
from there, I just--I haven't done a thing about it yet. I have
been suffering so, trying to get over the things that they did
to me--you know, they drugged me, and they was putting drugs in
my food that I didn't know about. I found out about it. When I
go to the doctor, they would think that I'm mentally ill
because they would tell them that, to make them turn everything
over to them. It seemed like I was just a crazy person.
I was so drugged, I knew what was going on, but I just
couldn't help myself, you know.
Senator Kohl. OK.
Mrs. Watts. I was just slumped over in my wheelchair and I
couldn't answer.
Senator Kohl. All right.
Mrs. Watts. But I haven't pressed any criminal charges
against them, as yet.
Senator Kohl. Officer Lofy, you have recounted the tragic
story of Mary Graichen and have shown the committee these
terrible pictures of the abuse and neglect that she suffered at
the hands of her son. Many of us in the room are probably
wondering why Edward Graichen only received probation.
Can you and District Attorney Stein help us understand the
difficulty of getting harsh sentences for family members who
abuse their elderly relatives?
Mr. Lofy. In the Edward Graichen sentencing, he had no
criminal history. There was no sign of outward violence toward
society or individuals. Because the neglect was such a
nonviolent kind of sinister way of doing it, that there were no
other victims, they decided at his age probation would be more
appropriate rather than sending a 66-year-old man, possibly
sentencing him to death, by giving him a lengthy prison
sentence.
Senator Kohl. Mr. Stein.
Mr. Stein. Thank you, sir.
Those are basically the same reasons why Mr. Gilliam was
granted probation. In fact, I was surprised that he received
120 days custody. He was a man in his fifties, who had no
criminal record, who I can best describe as the most apathetic
individual that I have ever come into contact with. I mean,
totally apathetic, which explains the neglect of his mother. So
I would conclude that the judge decided he was not a danger to
the community and, based on his age, that's why he got
probation and got the time he did.
Senator Kohl. I would like to ask the panel how important
do you think the Elder Justice Act is in trying to deal with
these particular problems, these terrible problems in our
society. Mrs. Klawsnik, would you like to comment on that?
Dr. Ramsey-Klawsnik. I believe, sir, that the Act would be
of enormous benefit. One of the things that it would do is help
to train police officers and prosecutors. When you have a
victim, such as some of the victims we have heard about today,
and some of the victims I have met in my work, they can be very
challenging to interview. It can be very difficult for them to
come into court and give testimony. You need special methods
and you need specially trained people to investigate. These
cases are very time-consuming.
I believe the Elder Justice Act would help in many, many
ways, training not only for the law enforcement officers and
the prosecutors, but for the protective services workers who
are going to go out there, usually first, before law
enforcement. If they're properly funded, they can get there
quicker, they can do a better investigation.
We need to have cross-disciplinary training so the
protective service workers and the police officers are working
together, so we can get the cases to the prosecutors with
evidence intact. The forensic experts right now are missing. We
need doctors and nurses and mental health experts, trained in
forensics, who know geriatrics, who know elder abuse. They can
go out and assist in these investigations and assist in
evidence collection, so that when we give it to someone such as
Mr. Stein, he's got a case that he can take to court and win.
Senator Kohl. Does anybody else want to comment on the
piece of legislation that we're trying to get passed? Mr.
Connor.
Mr. Connor. Senator, I appreciate the opportunity.
I think this Act is of critical importance, especially in
terms of educating the public as to the magnitude and degree of
this problem. The way we treat our elderly in this country,
both in home settings and institutional settings, is really a
scandal.
I am not at all surprised by these sentences involving
probation. I think they reflect, first of all, a lack of
understanding about the problems of the elderly. Far too often,
prosecutors and others are under the impression that just
because somebody is old or in ill health, it's inevitable that
they're going to experience these kinds of problems. They
don't. Pressure sores can be avoided. Malnutrition and
dehydration can be avoided. People should not be chemically
restrained because their inconvenient.
Further, and a major concern I have, is a broader societal
notion that somehow the value of life diminishes with age. I
think the imposition of probationary sentences in no small
degree reflects poorly on the way in which our culture values
the elderly and the infirm.
Senator Kohl. Any comment, Mr. Snyder?
Mr. Snyder. Yes. Thank you, Senator Kohl.
As I said in my comment, I think it's the most important
piece of Federal legislation in the adult protective service
movement history, and to piggyback on what everyone else has
said, it does provide us with the ability to do collaboration.
We haven't even spoken of financial exploitation today and
the ability of people to understand that. I was lucky enough to
partner with Temple University and the Department of Aging to
get a grant from the Administration on Aging, to provide a
financial exploitation specialist in my department. The results
were phenomenal. We were able to put together cases to hand to
the police that resulted in forgiveness of debt, restitution
and arrest.
We were able to partner with Wachovia Corporation to start
a project that, in the first 100 days, we have documented
stopping over $1.4 million in assets from being exploited. That
is one financial institution, 100 days.
Imagine what we could do with more.
Senator Kohl. Thank you, Mr. Chairman.
Senator Breaux. Senator Dole, any questions?
Senator Dole. Yes, thank you.
I would like to ask Dr. Ramsey-Klawsnik, tell me a little
bit more about the fact that often it is the man, the males,
rather than the females, who are reported as elder abusers. A
hearing we had with the committee earlier highlighted the
different coping mechanisms that men and women develop over the
years and use to manage stressful situations. For many women,
it seemed that caring for a spouse or a child may not produce
the same feelings of anger or distress.
I'm curious if the frequent accounts of men committing
family elder abuse relate to their ways of coping with
stressful situations. How do we explain this?
Dr. Ramsey-Klawsnik. Well, you're absolutely correct. Men
in our society seem to engage in violence much more frequently
than women when you look at who commits most of the crime.
When you look at the domestic violence statistics, most of
the domestic violence is perpetrated by men against women. Not
all of it, and women certainly are capable of being violent.
In terms of the relationship between stress and violence,
stress didn't cause Mrs. J's son-in-law to produce pornography
with her. That is not something a person does when they're
stressed. We do know that caregiving is very stressful, and
perhaps more stressful for the average male than female, since
in our society females are more used to doing it. It is more in
keeping with how we've been brought up oftentimes.
However, we don't find that as a result of caregiver stress
people engage in the kind of serious horrendous acts you've
heard about today. Drugging your mother so that you can take
her to the doctor and be proclaimed her money manager, for
example, that's not a reaction to stress. When we do find
caregiver stress involved in elder abuse and neglect, we are
much more likely to find that it is an episodic kind of event
as opposed to chronic.
If you're finding chronic abuse and neglect, that's
typically not the result of stress. If a person is normally
competent to provide quality care and committed and motivated
to provide quality care to a mother, father, grandparent, they
may become stressed when they've lost sleep or they're working
too hard, where they're the only one doing it and they may lash
out and say or do something they know they shouldn't. Usually
those people have the competence to later recognize that they
said or did the wrong thing, to apologize and to take steps to
correct it.
When you find this chronic, severe, multifaceted abuse, the
physical abuse, the sexual abuse, the financial exploitation,
the profound neglect, there are other motivations and other
factors at work. Some of that is personality characteristics,
some of that is mental illness, some of that is substance
abuse, some of that is greed. There are many factors.
Senator Dole. What do each of you think is the next step in
conducting research on the topic of family elder abuse? What is
the most important next step in research?
Could I get you to start first, and then I would like to
hear what Mr. Connor and Mr. Stein say about that.
Dr. Ramsey-Klawsnik. Sure. There are so many research
needs, it's hard to answer your question in terms of what
should come first. First and foremost, we don't know enough
about how much abuse actually occurs. We know what statistics
Adult Protection Services have collected. Bear in mind, that's
not all the cases. Those are the cases that have been reported
and investigated, and then opened. Three steps.
The cases that didn't get reported we don't know about. The
cases that got reported and didn't get opened, in some cases
that's because there wasn't abuse, and in some cases that's
because the abuse wasn't on the surface and people didn't have
enough time to dig enough and it wasn't discovered.
I think my starting point with research would be some work
to really go out there and determine how often this is
happening, who the abusers are, who the victims are, and more
about the factors you are raising, which is motive and cause.
Senator Dole. Mr. Connor.
Mr. Connor. Senator Dole, one of the things that research
benefits from, obviously, is having a data base from which to
make judgments. My own assessment is that there is very likely
a limited amount of information involved among families with
respect to abuse, and there isn't much data on which to
operate.
But I can tell you from experience that our nursing homes
and adult congregate living facilities are virtual treasure
troves of data that could be reviewed and assessed by Federal
investigators who are interested in protecting the elderly. All
of us are shocked by the stories we have heard here today.
Elderly people lying in their urine and feces, with bed sores
to the bone, malnourished and dehydrated, chemically
restrained, and yet that is the stuff of existence of many,
many, many of our elderly in nursing homes today. These are
people who are being cared for by trained caregivers who are
being paid with Federal dollars, and yet whose patients and
residents are winding up in exactly the same shape and worse
than what you have heard today.
I have long felt that this was a problem that government
was too often willing to stick its head in the sand about, and
was unwilling to confront. The institutional lobbies hold great
sway in the American political process. The reality is,
however, if we really are concerned about the sanctity of life,
and we really do believe that these people are to be counted
among the least among us, I believe we have an obligation to
ferret out the data to identify the problem and to show zero
tolerance, absolutely zero tolerance, for those who are willing
to abuse or exploit or neglect these very vulnerable people.
Senator Dole. You know, you're taking me back to my days on
the Federal Trade Commission as you make some of these
comments, because I was in charge of an investigation then of
nursing homes. With the contracts we found that so often there
were things in the fine print that were actually taking away
all of the funds of the person who was being admitted to the
nursing home. There were just unfair practices.
Mr. Connor. Indeed. I couldn't believe, frankly--and I
don't remember the name of the fellow who was brought in
initially to head up the Center for Medicare and Medicaid
Services at the beginning of this administration. He indicated
that he thought it was a nutty idea that the Federal Government
would conduct annual inspections of nursing homes. That's the
nuttiest statement I have ever heard from somebody who is
charged with the responsibility of protecting the frail
elderly.
The reality of it is that people in this business, and
private individuals as well, respond to both ``carrots'' and
``sticks''. I think it's important for the Government to be
prepared to apply the stick where it needs to be applied and
when it needs to be applied.
Senator Dole. Mr. Stein, would you add anything else, or
any of you on the panel?
Mr. Stein. Yes, thank you.
I would concur with Dr. Ramsey-Klawsnik. I think the cases
that we prosecute, the cases that you heard about today,
represent just the tip of the iceberg about what is really
going on out there. Typically, what we find is that, believe it
or not, the elderly victim often defends the abuser. They
recant and ask not to prosecute. They downplay what happens,
and sometimes they go into court and they just absolutely
recant and deny it happened. So think there's a lot more abuse
going on out there, and that's where I think research would
help.
Senator Dole. Any other comments?
Well, I want to thank all of you for your testimony today
and for the tremendous work that you're doing, which is very,
very difficult work. With a mother who is currently 102-years-
old, I have a strong interest in protecting these seniors.
Thank you very much.
Senator Breaux. Thank you, Senator Dole.
I would just conclude by saying we've heard these witness
panels before, and there is a great deal of concern,
appropriately so, in the United States as a nation on the
question of child abuse. The Federal Government and the State
government has devoted a great deal of attention and a great
deal of resources to the question of child abuse--and
rightfully so. We have done the same thing with regard to
spousal abuse, and rightfully so.
But there is a real vacuum, and the vacuum is that we, as a
Nation, do not give the same degree of intense research, help,
coordination between the States and locals, when it comes to
the question of elderly abuse. It is the fastest growing
segment of our population. With the advent of the baby boom,
there are 40 million Americans soon to be older Americans and
moving into their golden years. This is an increasingly
difficult national problem.
That's why I was so pleased to hear the cases, and your
testimony, Ms. Watts, and also from the experts. I think almost
every one of you thought that the concept of an Elder Justice
Act is something we should be moving toward. We have over 30
cosponsors in the U.S. Senate of the legislation that Senator
Hatch and I have cosponsored, and over 60 cosponsors in the
House. The bill is certainly not perfect, but it is at least
representative of the concept of the United States, as a
nation, moving collectively toward addressing this huge
national problem which, if we neglect giving it the attention
it deserves, would only get much worse. So we will continue to
push in that direction and say to all of you, thank you so much
for helping make other people's lives hopefully a lot better in
the future.
With that, this committee hearing will be adjourned.
[Whereupon, at 2:43 p.m., the committee was adjourned.]
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