Lets Start Talking About Elder Abuse, And Then Act

On the heels of marking May as Older Americans Month and World Elder Abuse Awareness Day on June 15, we take pause to recognize advances in elder justice, including reauthorization of the Older Americans Act and accomplishments in all sectors of society.

But the Sumner Redstone case, so public, reminds us of what happens in private to seniors each day. What is playing out with Mr. Redstone should not be some schadenfreud spectator sport we watch from a distance or simply tune out.

We must act. I know this first hand.

My grandmother Brooke Astor was subject to undue influence by her son, my father. She was vulnerable and isolated, and suffering from cognitive impairment, when he started to take control of her assets, including millions of dollars she had bequeathed to New York City charities.

Exactly a decade ago, I helped save my grandmother from his abuse. Here is but one of too many incidents that raised red flags and compelled me, and her greater circle of support, to act.

In early 2002, while my father was cutting back on my grandmothers expenses, he had sold her favorite painting, Flags, Fifth Avenue, 1917 by Childe Hassam, which she had bequeathed to the Metropolitan Museum of Art. The sale realized $10 million, two of which my father kept as a commission. On hearing of the sale, my grandmother, who had been led to believe she was running out of money, asked, Now, can I buy dresses?

My grandmother went from the limelight center stage in New York City and, more importantly, as the lead actor in her own life to being gaslighted by her own son. He psychologically broke her down into believing she was going broke.

My fathers commission ended up being grand larceny in the first degree, one of 14 counts he was convicted of after a six-month criminal trial by the Manhattan District Attorney. Save one, all counts were upheld upon appeal.

Despite the successful outcome of my grandmothers case, the psychological manipulation by undue influence is often effective. It compromises seniors who have diminished capacity (and lack testamentary capacity) and, through their isolation, lack a circle of support of their family, friends and neighbors. This has led me to meet leading practitioners in diverse fields to address the concepts of cognitive impairment, capacity, undue influence, and circle of support.

Jason Karlawish, Professor of Medicine, Medical Ethics and Health Policy, University of Pennsylvania, has researched the assessment of decision-making capacity and developed the model of the ACED, or Assessment of Capacity for Everyday Decision Making.

Dr. Bennett Blum, an expert in the field of undue influence, and his colleagues of the American Academy of Psychiatry and the Law, explain that there are several behavioral models to help determine whether an elder has been coerced or inappropriately manipulated.

I am on the Advisory Board of a pilot helpline that will launch later this year. Developed by the NYC Elder Abuse Center, a project of Weill Cornell Medicines Division of Geriatrics and Palliative Medicine, the helpline will provide information, emotional support and referrals to family, friends and neighbors assisting NYC-residing older victims.

In addition to financial exploitation and psychological manipulation, elder abuse takes other insidious forms: physical and sexual, neglect and abandonment. Frequently, as happened to my grandmother, there is poly-victimization and re-victimization that escalates.

Elder abuse and its prevalence are numbing. A National Institute of Justice study estimates one in 10 seniors (older than 60) has been the victim of at least one form of abuse in the past 12 months. More than half of elder financial abuse in the U.S. is committed by family members, caregivers, and friends.

On World Elder Abuse Awareness Day, the New York State Office of Children and Family Services released a multi-agency study, The New York State Cost of Financial Exploitation, showing the statewide impact of financial exploitation costing at least $1.5 billion. This report changes the math and the calculus of our response, across the state and nation. The cost is enormous to society and to self; even when the sum is small the effect can be devastating.

After a spring and long, long summer of my fathers trial and after heart-wrenching testimony, the jurys verdict of guilty was a very bittersweet harvest. Yet, this harvest has so nourished the cause of elder justice.

After four years battling for my grandmother and against my father, I could have resumed my life as before. But, I realize, to be complacent about elder justice is to be complicit in elder abuse. Since 2010, I have been border to border, coast to coast, meeting face to face with elder-justice practitioners. I thank them for doing so much, for so many, often with so little.

In helping my fragile, abused grandmother, I was not alone. Her abuse galvanized a collective response by family, friends, staff, and caregivers all united by compassion and a common cause. Individuals with a great mixed skill-set, the strength of our diversity contributed much to our success.

Now, professionals are strengthening their approach to elder ecology, working not for, but with elders; with their circles of support; and with their communities.

Seniors are our shared joy and our responsibility. Professionals provide support along the way and, when elder abuse is suspected, encouragement to come forward and speak up.

Our silence protects perpetrators, not their victims strangers, our loved ones, or perhaps, in the future, ourselves. Seniors and society deserve more.

When it comes to elder abuse, being aware, alone, is insufficient. We must act. I could not turn a blind eye and walk away from my grandmother. Now, I am compelled to help empower others.

Sumner Redstones case must prompt broader, deeper conversations, public and private. I so hope that his family and families, friends and neighbors facing the same circumstances will not turn a blind eye, but will have the courage to voice their concern, tell the world their stories, and act.

Philip C. Marshall is professor of historic preservation, Roger Williams University, and grandson of the late Brooke Astor, New York City philanthropistand victim of elder abuse by her son, Philips father.