February 24, 2016 | Erin Bluvas, bluvase@sc.edu
The National Center on Elder Abuse estimates that one in 10 people over 60 experiences elder mistreatment (i.e., abuse or neglect), which translates to nearly six million cases every year. According to Macie Smith, Program Development and Training Manager for the Arnold School’s Office for the Study of Aging (OSA), this number is actually much higher due to underreporting. And as the U.S. population continues to age, this number will only increase over time.
“Elder abuse is one of the most overlooked public health crises in our country,” Smith says. “There are potentially thousands, if not millions, more cases than those that are currently reported. The present generation of the elderly population tends to be a silent one; moreover, 90 percent of abuse and neglect cases are committed by family members or others in positions of trust, such as staff at nursing homes and assisted living facilities, so there is an element of fear of retaliation.”
Due to their cognitive decline, people living with dementia are at an even higher risk. “Families and caregivers don’t know how to handle some of those challenging behaviors,” Smith says. The cost of caregiving in the U.S. (i.e., over $220 million annually) is another challenge that Smith emphasizes. “Over 15 million caregivers are providing more than 17 billion hours of unpaid care, and we need to be proactive in getting caregivers the support they need before they reach their breaking point,” she says. “A study conducted by the National Center on Elder Abuse reported that 20 percent of dementia caregivers fear committing abuse. This is alarming and clearly a cry for help.”
Smith suggests working with policymakers in order to educate them about the effects of chronic caregiving on the aging population and its impact on our society as a whole. “This educational opportunity should hopefully influence policy that will offer additional support for caregivers providing care to those with chronic illnesses” she says. “We need financial support to meet the needs of our most vulnerable population and their caregivers.” As an important first step, OSA and other aging stakeholders have successfully secured a proclamation [pdf] from Governor Nikki Haley that decrees February as Vulnerable Adult Awareness Month in S.C.
Indeed, another problem that the OSA team sees is lack of awareness about elder abuse in general and particularly about available resources. “People just don’t know that there are resources out there that can help them provide care for their loved ones,” says Brenda Stalzer, who is assistant director and training coordinator for the South Carolina Vulnerable Adult Guardian ad Litem Program (SCVAGAL) within OSA. Some of these resources include waivers for personal care aide services, Healthy Connections Prime (i.e., one professional to manage and coordinate the care and link the services and support for an individual who is 65 years or older and has both Medicaid and Medicare), respite and support groups, and more.
OSA’s SCVAGAL program offers an excellent example of an important resource for this population. The program recruits and trains volunteers to serve as Guardians ad Litem for vulnerable adults who are under the custody of the Department of Social Services—those who have been abused or neglected or exploited—by representing their best interests. OSA created SCVAGAL in 2010 when Jean Toal, former Chief Justice of the Supreme Court of S.C., determined that attorneys could no longer be appointed to serve in these roles, and there was no program in place to recruit and train these types of volunteers.
“The great thing about SVAGAL is that Guardians ad Litem are in positions to not only hear about abuse, but they can actually do something about it,” says Stalzer. For family members who want to serve as advocates for their loved ones, there is much they can do as well.
“It’s very important that people continue to report incidents of abuse and neglect,” Stalzer says. “To help prevent neglect or abuse, we recommend that family members put a plan in place for caring for their loved ones. It may be helpful to contact your Area Agency on Aging to learn more about the resources available.”
“Get educated about the type of care your loved one needs,” adds Smith. “Don’t wait for information to come to you—seek it out.”
For their part, OSA serves as a clearinghouse of expertise and knowledge regarding available programs. They also offer their own training, research, evaluation, and program development. For example, their nation-wide Dementia Dialogues program is a free education program for family members, caregivers and professionals working with individuals living with dementia. With funding from the Palmetto State Geriatric Education Center, OSA recently created Dementia Dialogues T.I.P.S., online videos to help caregivers and family members identify quick tips to improve the quality of life for love ones living with dementia.
This type of leadership has turned OSA into a respected authority in the field. Cynthia Hardy recently invited Smith and Stalzer on her WACH FOX 57 program, Onpoint!, to discuss this very issue (see video). Hardy sought their expertise not only because they do research on elder abuse, but because OSA works with it every day and tackles it head on.
OSA definitely has a unique position in the field of aging. “We conduct research to identify the disparities in our aging communities, and we also have the practice element to develop programs to empower caregivers to provide quality care to our older population as well as address those disparities that continue to exist within our aging communities,” says Smith. “Our overarching goal is to help our older population age in place successfully.”