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S. HRG. 112–61 

JUSTICE FOR ALL: ENDING ELDER ABUSE, 

NEGLECT, AND FINANCIAL EXPLOITATION 

HEARING 

BEFORE THE

SPECIAL COMMITTEE ON AGING 

UNITED STATES SENATE 

ONE HUNDRED TWELFTH CONGRESS 

FIRST SESSION 

WASHINGTON, DC 

MARCH 2, 2011 

Serial No. 112–1 

Printed for the use of the Special Committee on Aging 

( 

Available via the World Wide Web: http://www.fdsys.gov 

(II) 

SPECIAL COMMITTEE ON AGING 

HERB KOHL, Wisconsin, Chairman 

RON WYDEN, Oregon 

BILL NELSON, Florida 

BOB CASEY, Pennsylvania 

CLAIRE MCCASKILL, Missouri 

SHELDON WHITEHOUSE, Rhode Island 

MARK UDAL, Colorado 

MICHAEL BENNET, Colorado 

KRISTEN GILLIBRAND, New York 

JOE MANCHIN III, West Virginia 

RICHARD BLUMENTHAL, Connecticut 

BOB CORKER, Tennessee 

SUSAN COLLINS, Maine 

ORRIN HATCH, Utah 

MARK KIRK III, Illnois 

JERRY MORAN, Kansas 

RONALD H. JOHNSON, Wisconsin 

KELLY AYOTTE, New Hampshire 

RICHARD SHELBY, Alabama 

LINDSEY GRAHAM, South Carolina 

SAXBY CHAMBLISS, Georgia 

DEBRA WHITMAN, Majority Staff Director 

MICHAEL BASSETT, Ranking Member Staff Director 

(III) 

CONTENTS 

Page 

Opening Statement of Senator Kohl ...................................................................... 1 

Statement of Senator Corker .................................................................................. 2 

Statement of Senator Collins .................................................................................. 2 

Statement of Senator Blumenthal .......................................................................... 3 

Statement of Senator Manchin ............................................................................... 4 

PANEL OF WITNESSES 

Statement of Mickey Rooney, Actor, Entertainment Legend, Elder Abuse Victim and Advocate, Los Angeles, CA .................................................................... 4 

Statement of Kay Brown, Director, Education, Workforce and Income Security, Government Accountability Office, Washington, DC ................................ 10 

Statement of Kathleen Quinn, Executive Director, National Adult Protective 

Services Association (NAPSA), Springfield, IL .................................................. 11 

Statement of Mark Lachs, MD, MPH, Director of Geriatrics, New York Presbyterian Health System, Co-Chief, Division of Geriatric Medicine and Gerontology, Weill Medical College of Cornell University, New York, NY ........... 13 

Statement of Bonnie Brandl, Director, National Clearinghouse on Abuse in 

Later Life (NCALL), a Project of the Wisconsin Coalition Against Domestic 

Violence, Superior, CO ......................................................................................... 15 

Statement of Marie-Therese Connolly, Director, Life Long Justice (LLJ) (An 

Initiative of Appleseed), and Senior Scholar, Woodrow Wilson International 

Center for Scholars, Washington, DC ................................................................ 16 

APPENDIX 

WITNESS STATEMENTS FOR THE RECORD: 

Mickey Rooney, Actor, Entertainment Legend, Elder Abuse Victim and Advocate ........................................................................................................................ 26

Kay Brown, Director, Education, Workforce and Income Security, Government 

Accountability Office ............................................................................................ 28 

GAO report titled ‘‘Elder Justice: Stronger Federal Leadership Could Enhance 

National Response to Elder Abuse’’ .................................................................... 43 

Kathleen Quinn, Executive Director, National Adult Protective Services Association .................................................................................................................... 107

Mark Lachs, Director of Geriatrics, New York Presbyterian Health System 

and Co-Chief, Division of Geriatric Medicine and Gerontology, Weill Medical College of Cornell University ....................................................................... 119 

Bonnie Brandl, Director, National Clearinghouse on Abuse in Later Life, 

a Project of the Wisconsin Coalition Against Domestic Violence ..................... 127 

Marie-Therese Connolly, Director, Life Long Justice (an initiative of 

Appleseed) and Senior Scholar, Woodrow Wilson International Center for 

Scholars ................................................................................................................. 147 

ADDITIONAL STATEMENTS SUBMITTED FOR THE RECORD: 

Alabama Department of Human Resources, Adult Protective Services .............. 168 

American Bar Association ....................................................................................... 170 

Boulder County, Community Services Department .............................................. 172 

Brookdale Center for Healthy Aging and Longevity ............................................ 177 

California Elder Justice Workgroup ....................................................................... 213 

Chester County Department of Aging Services ..................................................... 220 

Council of Senior Centers and Services of New York City ................................... 221 

John Dornheim, Dallas Adult Protective Services Community Board ................ 225 

Page

IV 

The Elder Justice Coalition .................................................................................... 226 

Family Violence Prevention Fund .......................................................................... 228 

The Financial Services Roundtable ........................................................................ 230 

Tonya Gardner, Portsmouth, VA ............................................................................ 236 

The Hebrew Home for the Aged at Riverdale ....................................................... 237 

Investor Protection Trust and the Investor Protection Institute ......................... 243 

Jewish Women International .................................................................................. 248 

Leading Age ............................................................................................................. 252 

Lifespan .................................................................................................................... 255 

Philip C. Marshall, South Dartmouth, MA ........................................................... 263 

Rebekah McGowan, Shawnee, OK ......................................................................... 266 

State of Michigan, Department of Human Services ............................................. 268 

National Adult Protective Services Association .................................................... 270 

National Adult Protective Services Training Partnership ................................... 271 

National Association to Stop Guardian Abuse ...................................................... 273 

National Committee for the Prevention of Elder Abuse ....................................... 275 

National Hispanic Council on Aging ...................................................................... 285 

National Organization to End Guardianship Abuse ............................................. 294 

North Carolina Department of Health and Human Services .............................. 304 

Safe Havens ............................................................................................................. 308 

Norman Shaifer, Tappan, NY ................................................................................. 311 

Shawano County Adult Protective Services .......................................................... 313 

Beverly Sorenson ..................................................................................................... 315 

Texas Elder Mistreatment Institute ...................................................................... 316 

Thelma Tone ............................................................................................................ 318 

UJA-Federation of New York ................................................................................. 319 

Utah Division of Aging and Adult Services ........................................................... 321 

Wisconsin Adult Protective Services ...................................................................... 340 

Wisconsin Coalition Against Domestic Violence ................................................... 343 

(1) 

JUSTICE FOR ALL: ENDING ELDER ABUSE, 

NEGLECT, AND FINANCIAL EXPLOITATION 

WEDNESDAY, MARCH 2, 2011 

U.S. SENATE, 

SPECIAL COMMITTEE ON AGING, 

Washington, DC. 

The Committee met, pursuant to notice, at 2:05 p.m. in Room 

SD–106, Dirksen Senate Office Building, Hon. Herb Kohl, Chairman of the Committee, presiding. 

Present: Senators Kohl [presiding], Wyden, Manchin, 

Blumenthal, Corker, and Collins. 

OPENING STATEMENT OF SENATOR HERB KOHL, CHAIRMAN 

The CHAIRMAN. Good afternoon to everybody. We’d like to thank 

our witnesses, in addition to welcoming everyone attending today’s 

hearing. 

It’s very easy to lose sight of problems that aren’t right in front 

of us every day. However, today we’re going to focus on a problem 

that doesn’t often get the attention it deserves, namely elder abuse. 

To those victims of abuse, there is no bigger problem in the world. 

And to the rest of us charged with stopping it, it should be a top 

priority. 

The physical, mental, and the financial abuse of our Nation’s 

seniors is all too common. In 2009 in my State of Wisconsin, over 

5,000 cases of suspected abuse, neglect, or financial exploitation 

were reported. And this was a 9-percent increase over 2008. 

These crimes are being committed by people because their victims are often fragile, and their chance of getting caught is slim. 

We need to find solutions and then take action. To begin, we must 

ensure that Federal, State, and local agencies work cohesively to 

combat elder abuse. To do so, I’m asking Congress to enact a series 

of commonsense legislation. 

Today, along with my colleagues, Senators Blumenthal, Casey, 

Gillibrand, and Nelson, we will be introducing the Elder Abuse Victims Act, with a strong endorsement from the Elder Justice Coalition. The bill will establish a first-ever Office of Elder Justice within the Justice Department that will protect America’s seniors by 

strengthening law enforcement’s response to elder abuse. 

In addition, I will introduce the End Abuse Later in Life Act. 

And I’m an original cosponsor of the Senior Financial Empowerment Act. While no legislation can end all exploitation, we must do 

everything in our power to help those victims that come forward 

asking for help. 

2 

We’ll start today’s hearing with a legendary performer and a 

World War II veteran, Mr. Mickey Rooney, who has come here 

today to bravely share his personal story of abuse. 

We’ll then review the findings of a Government Accountability 

Office report, which shows that our Federal response to elder abuse 

is lacking. 

We’ll also hear testimony from the National Adult Protective 

Services Association and new information about the prevalence of 

elder abuse in the State of New York. 

Finally, our panelist from the Wisconsin Coalition Against Domestic Violence and Lifelong Justice will share their knowledge of 

abuse in later life and highlight the need for leadership and coordinated response. 

It’s our hope that today’s hearing will inspire others who find 

themselves in situations where they are being exploited to ask for 

help. We’ll hear from Mr. Rooney. We will hear from more of our 

experts, but they are only the smallest fraction of the heartbreaking stories too many older Americans are living through at 

this time. 

For those of us on the dais, I know our witnesses will challenge 

us not to forget this issue when we leave this hearing today, and 

I hope and pray that we’ll meet the challenge. 

The Ranking Member on this Committee, Senator Corker. 

STATEMENT OF SENATOR BOB CORKER 

Senator CORKER. Thank you, Mr. Chairman. 

I’m going to be very brief, because I want to hear as much of 

your testimony, if not all, that you provide, and I have a number 

of conflicts. 

I want to thank you for coming. Because of who you are, there 

are a lot of people paying attention. I know that we talked, back 

behind the meeting room, and you talked about your story, and you 

said, ‘‘No, this was a story that many, many seniors around our 

country are dealing with.’’ I know it’s tragic. We thank you so 

much for being here today. 

We have about 63 provisions right now in Federal statute regarding elder abuse. And one of the responsibilities of this committee 

is to really do the oversight necessary. So, I hope, after your testimony today, we’ll have rigorous hearings just on the oversight of 

what is occurring. But, I thank you very much for being here, for 

traveling this distance, for lending your outstanding reputation and 

the love of the American people towards you to this issue. 

Thank you very much. 

The CHAIRMAN. Thank you, Senator Corker. 

Senator Collins. 

STATEMENT OF SENATOR SUSAN COLLINS 

Senator COLLINS. Thank you, Mr. Chairman. 

First let me commend you for calling this hearing to shine a light 

on this extremely troubling and often hidden issue. 

I want to join both you and Senator Corker, in particular, in welcoming Mr. Rooney to our hearing today. Your presence here will 

help encourage so many others. 

3 

While elder abuse is a significant problem in our society, it has 

received far less attention and study than other forms of domestic 

violence. According to the most recent National Incidence Study, 

more than 14 percent of our non-institutionalized older adults have 

been victims of physical, psychological, or sexual abuse, neglect, or 

financial exploitation in the past year. Moreover, this is likely just 

the tip of the iceberg, since most cases are never reported. And, as 

a consequence, the true dimensions of elder abuse are still not 

known. 

Abused and neglected elderly persons are often among the most 

isolated victims of family violence. Tragically, they are most often 

abused by the very people closest to them, their spouses or their 

children. And the abuse happens in what should be the safety and 

security of their own homes. Generally, they’re in a position of dependency on their abuser, and are either unable or unwilling to report that their loved ones have abused them. 

The problem of identifying the victims of family violence in my 

State is particularly difficult because we Mainers pride ourselves 

on our self-sufficiency. It’s very difficult for seniors in Maine to ask 

for help. And we also hold our privacy in such high regard that we 

simply don’t like to talk about what goes on behind the closed doors 

of our homes or in the private lives of our families and our neighbors. 

So, Mr. Chairman, I thank you so much for holding this important hearing. Combating elder abuse should be a national priority. 

It is no longer just a family responsibility. 

Thank you. 

The CHAIRMAN. Thank you very much, Senator Collins. 

Senator COLLINS. Thank you. 

The CHAIRMAN. Senator Blumenthal. 

STATEMENT OF SENATOR RICHARD BLUMENTHAL 

Senator BLUMENTHAL. Thank you, Mr. Chairman. And I want to 

join my colleagues in thanking you for your leadership and for 

other Senators who are here today. 

And, to Mr. Rooney, I know that inevitably you will somewhat 

steal the show, but I’m grateful to you for being here, but also for 

the other witnesses who are here and others who are in the audience who are blowing the whistle on this all too often hidden 

scourge in our society. 

And I know, as someone who served as attorney general for 20 

years and fought this problem in homes, in nursing facilities, in assisted living situations, that it is all too often denied and hidden 

and invisible. And the reason often is the shame and embarrassment that comes with reporting being a victim. To be very blunt, 

let me tell you something that all of you already know, that it is 

unreported because people are embarrassed and ashamed. And 

they should not be, because we are all victims, at some points in 

our life, of these frauds, abuses, mistreatment, other kinds of 

crimes. They are crimes. And people should report them. 

And we’ve made great advances, thanks to the leadership of Senator Kohl and others in the Elder Justice Act, the Nursing Home 

Transparency and Improvement Act, the Patient Safety and Abuse 

Prevention Act. But, we need to do more. That’s why we’re here 

4 

today. We need to do more, because it is unconscionable and unacceptable and intolerable, in our society, that we permit so many of 

our senior citizens to be victims of this kind of abuse, which can 

take many, many forms, but all of them are absolutely unconscionable and intolerable. 

And again, my thanks to all of you for being here today and giving us the benefit of your wisdom and insight into this problem. 

Thank you, Mr. Chairman. 

The CHAIRMAN. Thank you very much, Senator Blumenthal. 

Senator Manchin. 

STATEMENT OF SENATOR JOE MANCHIN, III 

Senator MANCHIN. I, too, want to reiterate what all of my colleagues have said. And I appreciate so much the courage that all 

of you come—and Mr. Rooney, yourself—for coming in and sharing 

with us, that we can make it a better society for all. 

I represent the State of West Virginia. We have the second largest per capita basis, as far as seniors, in the United States, next 

to Florida. Tremendous. 

And I was Governor for a 6-year period. My main concern was— 

is, How do we allow people to live with the dignity and respect and 

the pride that each and every person deserves in the confines of 

their home—own homes, with assistance? So, everything we did 

was setting a priority about how people could live a quality of life, 

no matter what our age may be, or our condition. 

So, I thank you for this—bring this to light and how we can do. 

And I look forward to hearing how you believe that we can assist 

and make it better, I truly do. So, on behalf of a grateful State, let 

me say thank you for coming. 

The CHAIRMAN. Thank you very much, Senator Manchin. 

We’ll now welcome our first witness, Mickey Rooney, to testify 

before the Aging Committee. 

Mr. Rooney began his acting career when he was less than 2 

years old. In the middle of his career he was drafted to serve in 

World War II, which he did so with pride. He has appeared in over 

365 films over the course of his distinguished career. In 1983, he 

won an Academy Award for lifetime achievement. Mr. Rooney joins 

us today to share his very personal story of elder abuse. 

Thank you for being here, Mr. Rooney. And we’d love to hear 

from you. 

STATEMENT OF MICKEY ROONEY, ACTOR, ENTERTAINMENT 

LEGEND, ELDER ABUSE VICTIM AND ADVOCATE, LOS ANGELES, CA 

Mr. ROONEY. Thank you, Chairman Kohl, Ranking Member 

Corker, and members of the committee. My name is Mickey Rooney. And I want to thank you for this opportunity to testify today. 

We are here today on an issue preventing the abuse, neglect, financial exploitation of seniors. Unfortunately, I’m testifying before 

the committee today, not just as a concerned citizen, which we all 

should be, but as a victim of elder abuse, myself. And that’s true. 

Throughout my life, I’ve been blessed with love and support of 

family, friends, and even the people who like my pictures, who are 

called fans. I have worked almost my entire lifetime in the busiVerDate Nov 24 2008 14:31 Aug 18, 2011 Jkt 066957 PO 00000 Frm 00010 Fmt 6633 Sfmt 6633 C:\DOCS\66957.TXT SHAUN PsN: DPROCT
5 

ness I love, like you do. I was lucky enough to be in a business I 

love, to entertain and to please other people. I worked with joy, but 

I’ve worked hard and diligently. But, even with success, my monetary thing, called money, was stolen from me—yes, stolen—by 

someone close. Close. I was unable to avoid becoming a victim of 

elder abuse. 

Elder abuse comes in many, many different forms: physical 

abuse, emotional abuse, and financial abuse. Financial. Each one 

of these causes are devastating, ladies and gentlemen, in its own 

right. Many times, sadly, as with my situation, the elder abuse involves a family member. 

When it happens, you feel scared, disappointed—yes, and angry. 

And you can’t believe that it’s happening to you. You feel overwhelmed. The strength you need to fight it. Complicated. You’re 

afraid, but you’re also thinking about your other family members, 

about the potential criticism of your family, your friends. People 

you know, they may not want to accept the dysfunction that you 

feel and need to share, because one should love their families, as 

I do. I love my family. And, for other reasons, you might feel hesitant to come forward, you might not be able to make rational decisions, intelligent decisions. 

What other people see as generosity, may in reality be the exploitation, manipulation, and, sadly, emotional blackmail of elders and 

people who are vulnerable. I know it because I, myself, happen to 

be one. My money was taken, was used, what finances I had. When 

I asked for information, I was told that I couldn’t have any information of my own. ‘‘What the hell? What are you talking about?’’ 

I was told it was ‘‘none of my business’’, ‘‘it’s none of my business.’’ 

And when you’re told that, you’re left to leave powerless. 

You can be in control of your life one minute, ladies and gentlemen, and in the next minute, like that, you have absolutely, believe 

it or not, no control of your life. Sometimes this happens quickly, 

but other times it’s very, very gradual. You might wonder when all 

this truly began. 

In my case, I was eventually and completely stripped of the ability to make even the most basic decisions—where we go or what 

do we do—decisions that everyone likes to make. Over the course 

of time, my daily life became unbearable because all of this seemed 

to come out of nowhere. At first, it was something small, and I 

could control it. But, then it became something sinister that was 

completely out of my control. I felt trapped, scared, used, and frustrated. And, above all, when a man feels helpless, it’s terrible. And 

I was helpless. 

For years, I suffered silently. I didn’t want to tell anybody. I 

couldn’t muster the courage. And you have to have courage to 

say—‘‘I need help.’’ And I knew I needed it. Even when I tried to 

speak up, I was told to, ‘‘Shut up and be quiet. You don’t know 

what you’re talking about.’’ It seemed that no one—no one wanted 

to believe me. 

But, ladies and gentlemen, I want you to know that I never gave 

up. I continued to share my story with others. I told them about 

the abuse my family and I have suffered. I’m now taking steps to 

right all of the wrongs. I’m now taking steps, ladies and gentlemen 

6 

of the Senate, to right all the wrongs that were committed against 

me. 

I’m also thankful to my family, friends, and I like to call them, 

fans all over the United States and the world, who have expressed 

their support and caring for me. 

Ladies and gentlemen of the committee, I didn’t tell you just a 

part of my story so that you, the Senators and Madam Senators, 

would feel sorry or feel sympathy for me. I came here for you to 

think of the literally millions of seniors who are abused. 

I am here today because it’s so important that I share my story 

with others, especially those who may be watching at home or driving; suffering, maybe silently, as I was. 

To those seniors, and especially elderly veterans, Army, Navy, 

Marine—you veterans, like myself—I want to tell you this: You’re 

not alone. And you have nothing—nothing, ladies and gentlemen— 

to be ashamed of. You deserve—yes, you deserve—better. You all 

have the right to control your own life. Everyone does. You have 

the right to control your life and be happy. Please, for yourself, end 

the cycle of abuse and do not allow yourself to be silenced anymore. 

Tell your story to anyone—someone—and let them know. And, 

above all—above all—have faith and have hope. Someone will hear 

you if we all stand strong together. Speak up and say, ‘‘I’m being 

abused. This happened to me.’’ If you speak up, we can take the 

necessary steps—the altogether two very necessary steps—to end 

the cycle—to end it—of elderly abuse. 

The elder abuse happened to me—that’s why I’m here to tell you 

a little about it—to me, Mickey Rooney. I’m just a man doing a job, 

like you are. It was my job to entertain; it’s your job to end things 

like this. It’s why I’m here. And if it can happen to me, oh, God 

willing it—and unwilling it—it can happen to anyone. I know who 

I’m talking about. And I—I’m not speaking just for myself. What 

I hoped to be and what I was, was taken from me. I’m asking you 

to stop this cycle of elderly abuse. I mean just stop it. Now. Not 

tomorrow, not next month, but now. Let’s stop—and you all have 

to vote to get this bill passed—two bills passed, so that it can go 

to our Congress, and Congress can send it to our President of the 

United States, Mr. Obama, and end it and say that it’s a crime, 

and we will not allow it in the United States of America. 

Thank you. Thank you. 

Thank you, Senator Kohl. 

[Applause.] 

[The prepared statement of Mr. Rooney appears in the Appendix 

on page 26.] 

The CHAIRMAN. Thank you very much, Mr. Rooney, for your outstanding presentation in behalf of a very important issue, the 

abuse of seniors. 

Turn to Mr. Corker for a question or two. 

Mr. ROONEY. Yes, Mr. Senator. 

The CHAIRMAN. Mr. Corker. 

Senator CORKER. Mr. Chairman, I’m going to need to step out; 

I’ve had another meeting starting about 3 minutes ago. 

But, Mr. Rooney, I don’t know of anybody who could be a better 

spokesman for this issue than you, and I thank you for coming 

forth. I know we’re going to have another panel to talk about some 

7 

of the stats and other kinds of issues. So I don’t have a question, 

I just—I thank you for being here today, for the impassioned plea 

that you’ve laid out before us, and—— 

Mr. ROONEY. No, it—— 

Senator CORKER [continuing]. For having—— 

Mr. ROONEY [continuing]. Just, Mr.—— 

Senator CORKER [continuing]. For having the willingness to come 

do this, to share something that is very personal and, I know to 

some seniors, very embarrassing to talk about. 

Thank you. 

Mr. ROONEY. Thank you, Mr. Senator. 

My thanks is to you, the United States Senate. And I truly hope 

they don’t read your two bills with their eyes, but with their heart, 

and pass this bill so that it can go to the Congress of the United 

States and be signed into a law, by our President, Mr. Obama, that 

it’s a crime. 

Thank you for listening. And God bless America. 

Senator CORKER. Thank you, sir. 

The CHAIRMAN. Any more questions from anybody on the panel? 

Mr. ROONEY. Anything you like. 

The CHAIRMAN. Any comments? 

Go ahead, Mr. Blumenthal. 

Senator BLUMENTHAL. Thank you, Mr. Chairman. 

I want to join my colleagues in thanking you very sincerely for 

being here and providing a model of coming forth and courageously 

articulating your own personal experience. 

And maybe you could just give us one or two thoughts about 

how, for other seniors, they can take steps on their own, through 

their own initiative, to protect themselves against the kind of abuse 

that you suffered. I know you—in your case, you said you couldn’t 

have prevented it, but perhaps others can, and maybe you can give 

us some insights about it. 

Mr. ROONEY. Mr. Senator and you ladies of the Senate, you 

know, I feel for your having asked for me here. 

A lawyer, someone who has your personal interest at heart and 

feels what you’ve been through. We all know that, whether you’re 

a sports fan or Arnold Palmer, whom I’ve played with—I went to 

the University of Southern California for 2 years, trying to learn 

more, and I had to get back to work—but a lawyer is—basketball 

players have lawyers, football players, tennis stars, golfers. Why 

can’t the citizens afford a lawyer? And I’ll tell you why. Very simply, they haven’t any money. I had no money. 

And, is it all right for me to mention the company that—— 

No. Well—— 

Senator BLUMENTHAL. I think you’ve been very helpful, and 

you’ve given us the benefit of a lot of information, and it’s very—— 

Mr. ROONEY [continuing]. Well, I—how are these elderly citizens 

going to be able to afford a lawyer? I didn’t. I had no money. Mine 

had been gone. You’ve got to stop it. 

And I thank you all for listening to my—do you have another 

question for me? 

Senator MANCHIN. Mr. Rooney—— 

Mr. ROONEY. Any question at all. 

8 

Senator MANCHIN [continuing]. If I could ask you the question, 

sir. I don’t think there’s a person I know in the Senate, or probably 

in Congress, who doesn’t want to help. I wouldn’t know of a soul. 

And I appreciate the Chairman for taking this upon—he has two 

pieces of legislation. 

With that being said, what would be the easiest way—when you 

detected you were having a problem and you knew that there was 

someone taking over your life, what would have been the best way 

for you to have been able to reach out? Are we looking—like a 9– 

1-1 number? You know, we have different numbers, emergency 

numbers. How is it best that we’re able to help to make sure that 

someone, when they see their life slipping away, can say, ‘‘Listen, 

hold on. I’m going to call. I need help?’’ 

What do you think—since you’ve lived through it and you were 

able to count on your fans and your friends and your family to pull 

together. Some seniors have nobody, except maybe that one contact. And we’ve just got to find the right combination to make sure 

we’re able to be effective. So, if—whatever you think. 

Mr. ROONEY. May I tell you how fortunate I was? 

Senator MANCHIN. Please do. 

Mr. ROONEY. You’ll hear the story. I won’t make it long. 

I made about five pictures for the Disney Company, Walt Disney. 

When I was a child, I met Mr. Disney, who would draw a little 

mouse, and he said, ‘‘I want you to see this.’’ And I said, ‘‘Thank 

you, Mr. Disney.’’ He said—I said, ‘‘What do you call him?’’ He 

says, ‘‘Mortimer Mouse.’’ I said, ‘‘He’s wonderful.’’ He said, 

‘‘Thanks, Mickey.’’ Then Mr. Disney said to me, ‘‘Mickey. Mickey 

Mouse. How would you like me to name this mouse after you? I’ll 

call him Mickey Mouse.’’ I said, ‘‘Thank you.’’ Well, as years went 

on, I made five pictures for Disney—— 

[Pause.] 

Senator MANCHIN. We have lawyers telling us what to do, too, 

so don’t—— 

Mr. ROONEY. No, I was going to say—— 

[Laughter.] 

The Disney legal firm didn’t like what was happening. And I was 

fortunate enough—I was fortunate enough—to get my lawyers, who 

care. 

My stepdaughter—I mean, my daughter-in-law—I’ve got a lot of 

stepdaughters—but, my daughter-in-law helped immensely, and 

my wife’s son, Mark. 

So, that’s the story. Disney afforded me. People are not going to 

be able to afford these things. Now, how—who can they call? Have 

you got a number that you could say—or is the government going 

to—in villages and across our great country, a line where you can 

call and say, ‘‘I’m being abused, and I can’t take it no more?’’ ‘‘What 

was your number?’’ 

Senator MANCHIN. So, you recommend an elder abuse number. 

An elder abuse number. Basically, a very—— 

Mr. ROONEY. I certainly do. 

Senator MANCHIN. Yeah. 

Mr. ROONEY. You bet I do. 

Senator MANCHIN. I gotcha. 

9 

Mr. ROONEY. How else—and then they should have a team somewhere, that the government will supply to them, for the people, to 

say, ‘‘Don’t worry.’’ 

Senator MANCHIN. Well, the Chairman’s bill does that. I mean, 

the—he’s running on the right track. We just wanted to make sure 

that we were moving down the way that would be of best help to 

you. 

Mr. ROONEY. Well, I’m sure he feels as I feel. And I’m sure, ladies and gentlemen of the Senate, and Madam Senators—I’m sure 

that you’ll pass this bill. It is so badly needed in our great United 

States of America. 

Thank you for inviting me here. 

Senator MANCHIN. Thank you. 

The CHAIRMAN. Thank you, Mr. Rooney. You’re—— 

Mr. ROONEY. God bless. 

Chairman KOHL [continuing]. You were outstanding today. 

Mr. ROONEY. No, I wasn’t. I’m—— 

[Laughter.] 

I think it was a bad performance. 

The CHAIRMAN. You’re the best. 

Mr. ROONEY. Thank you. 

God bless you all. And God bless our country. 

[Applause.] 

[Pause.] 

The CHAIRMAN. We’ll now move on to our second panel. 

If you would step, please, to the front. 

Our first witness on the second panel will be Kay Brown, a director in the Government Accountability Office’s Education Workforce 

and Income Security Team. Throughout her 25-year career at GAO, 

Ms. Brown has focused on improving government performance and 

delivering benefits and services to low income and vulnerable population. 

Mr. ROONEY. Here’s a man that’s done it all. 

[Laughter.] 

The CHAIRMAN. All right. 

And our second witness will be Kathleen Quinn. She is the Executive Director of the National Adult Protective Services Association 

and advisory board member of the Elder Justice Coalition. Ms. 

Quinn previously served as a policy advisor to the Illinois Attorney 

General and as a chief of the Bureau of Elder Rights for the Illinois 

Department on Aging. 

Next, we’ll be hearing from Dr. Mark Lachs. He is Director of 

Geriatrics for the New York Presbyterian Health System, also CoChief of the Division of Geriatric Medicine and Gerontology at the 

Weill Medical College of Cornell University, and a tenured professor of medicine at the college. 

Next, we’ll be hearing from Bonnie Brandl. She’s the director of 

the National Clearinghouse on Abuse in Later Life, a project of the 

Wisconsin Coalition Against Domestic Violence. She’s facilitated 

trainings for law enforcement, victims’ services providers, and 

other professionals on elder abuse throughout the United States. 

Finally, we’ll be hearing from Marie-Therese Connolly. She’s the 

Director of Life Long Justice, a strategic advocacy initiative, with 

other leaders in the field, to advance elder justice. Ms. Connolly is 

10 

also senior scholar at the Woodrow Wilson International Center for 

Scholars, and a consultant to the U.S. Department of Justice 

project on elder abuse. 

We thank you all for being here. 

Ms. Brown, we’ll take your testimony. 

STATEMENT OF KAY BROWN, DIRECTOR, EDUCATION, WORKFORCE AND INCOME SECURITY, GOVERNMENT ACCOUNTABILITY OFFICE, WASHINGTON, DC 

Ms. BROWN. Mr. Chairman and members of the committee, 

thank you for inviting me here today to talk about our work on 

elder abuse. 

Each day, we hear news reports, similar to what you’ve just 

heard from Mr. Rooney, about older adults who are abused, exploited, and denied needed care, often by those they depend on the 

most. In addition to harming individuals, elder abuse results in 

added costs to society for increased healthcare, social services, and 

long-term residential care. 

My remarks are taken from a report, requested by Chairman 

Kohl, that we are releasing today. And I will cover two topics: the 

challenges faced by State Adult Protective Service programs, which 

are the programs that receive and respond to allegations of elder 

abuse at the State level, and the Federal actions taken to help 

these programs do their jobs. 

First, regarding the State programs. They face daunting challenges when responding to elder abuse. In many States, caseloads 

are growing and cases are becoming more complex, often involving 

multiple types of abuse. At the same time funding is not keeping 

pace, which affects both staff levels and training. Access to information on how to resolve elder abuse cases is limited, and not 

enough is known about what interventions can make a difference. 

Further, needed collaboration with law enforcement, prosecutors, 

and financial institutions is uneven. And lastly, Statewide administrative data systems can be outdated or incomplete. These data, for 

example, could help identify programmatic trends, such as the 

characteristics of the most vulnerable adults. 

Moving on to my second topic, regarding Federal activities. Although States are primarily responsible for protecting their older 

residents, the Older Americans Act and the Elder Justice Act have 

both established a Federal role in this area. In our study, we found 

that Federal activities have provided some assistance to State programs, but have fallen short in several key areas. For example, the 

Departments of Justice and HHS spent a combined $11.9 million 

in 2009 for certain projects, such as ones to help States and localities develop multidisciplinary elder abuse teams or to identify barriers related to elder abuse prosecution. However, these activities 

have been on a small scale and have not helped States address 

some of their most pressing challenges. For example, they have not 

helped States address or obtain information and guidance on effective interventions, nor have they resulted in any real progress toward a nationwide Adult Protective Services reporting system. 

State program officials and other experts told us that a national 

data system would help them target their efforts, appropriately allocate funds, and share practices. In our report, released today, we 

11 

recommend that HHS take steps to address these needs for information and for a national data system. 

Finally, we found a lack of strong leadership. Federal efforts are 

scattered across multiple offices in Justice and HHS, as you can 

see from the graphic before you, which we call our ‘‘spider graphic’’ 

because of the many different directions that the efforts are spreading. Under the Older Americans Act, the primary responsibility for 

national leadership in the elder justice area rests with HHS’s Administration on Aging. But, this agency has yet to assume a leadership role. According to its officials, they are constrained by limited 

funding. 

Lacking leadership, there is no assurance that these Federal efforts are addressing the most critical priorities, are mutually reinforcing, or are making the most efficient and effective use of scarce 

resources. The Elder Justice Act created vehicles for developing 

and implementing national priorities through a Federal Elder Justice Coordinating Council and a non-Federal advisory board. However, as yet, neither has been established. 

In conclusion, while this Nation’s public policies encourage adults 

to remain in their homes and communities as they age, the system 

in place to protect them may not be well positioned to meet their 

needs as the number of older adults grows in the coming years. 

This concludes my prepared statement. I’m happy to answer any 

questions. 

[The prepared statement of Ms. Brown appears in the Appendix 

on page 28.] 

[The GAO report titled ‘‘Elder Justice: Stronger Federal Leadership Could Enhance National Response to Elder Abuse’’ appears in 

the Appendix on page 43.] 

The CHAIRMAN. Thank you very much, Ms. Brown. 

Now we’ll hear from Kathleen Quinn. 

STATEMENT OF KATHLEEN QUINN, EXECUTIVE DIRECTOR, 

NATIONAL ADULT PROTECTIVE SERVICES ASSOCIATION 

(NAPSA), SPRINGFIELD, IL 

Ms. QUINN. Chairman Kohl, Senator Corker, distinguished members of the committee, thank you for convening this first ever congressional hearing addressing Adult Protective Services, or APS. 

Senator Kohl, the Nation’s APS programs thank you for requesting the GAO report on APS. And thanks, to the GAO, for doing 

such an outstanding job on the research and the report. 

I’m Kathleen Quinn, director of the National Adult Protective 

Services Association, NAPSA. We’re the only national voice for APS 

programs, staff, and clients. Our mission is to enhance the capacity 

of APS to effectively protect and serve abuse victims. I bring to this 

work 30 years experience in the fields of domestic violence, elder 

abuse, APS, and the long-term-care ombudsman program. 

APS is—as has been mentioned, is the formal system in every 

State for receiving reports of abuse, neglect, and exploitation of 

older persons, and, in nearly all States, of younger adults with severe disabilities, as well. Just as any response to child abuse begins 

with the State Child Protective Services systems, the response to 

elder abuse must start with APS, which is a public safety program. 

We are, in fact, the 911 number that victims and concerned people 

12 

about them can call. We investigate the allegations of abuse and 

we provide emergency, protective, and other services to protect and 

assist the victims. 

We know over 95 percent of older persons live in the community, 

in their own homes, and roughly 90 percent of the abuse perpetrated against them is done by their own family members. 

Front-line APS staff, typically the first responders in these abuse 

cases, face extremely complex situations, often involving life-anddeath medical conditions; criminal activities, including violence, 

drug dealing, and weapons; mental illness; dementia; complex financial frauds; intergenerational family disputes and dysfunctions; 

legal issues; filth and extreme neglect, often causing years of horrific suffering and undoubtedly killing far more older persons than 

does physical abuse. 

Any criminal activity which occurs, within the family or not, 

needs to be investigated and vigorously prosecuted. But, I need to 

establish that APS responds to many, many cases that do not involve criminal conduct. When there is criminal behavior, we call in 

law enforcement and work closely with them to make sure the 

abuser is held accountable. But, whether there’s criminal behavior 

or not, APS must make sure the victim is both cared for and protected. 

Many extremely complex cases do not involve a clearly culpable 

offender, but they do have mentally and physically ill, developmentally disabled, and/or demented people struggling to get 

through each day. APS must deal with the entire situation. If we 

only considered the elder abuse that does rise to the level of crime, 

I fear we risk leaving out thousands upon thousands of invisible, 

forgotten victims whose situations may not—not only involve any 

crimes, they may not even involve any malice, but who are nonetheless suffering and have significantly jeopardized health and 

safety. 

One group that would be left out are people who self-neglect, 

those who are unable to provide for their most basic needs and may 

be a danger to themselves and others. Why should we be concerned 

about hoarders and others living isolated lives in filth and disease? 

Besides human compassion, they cost us a lot of money by triggering repeated calls to public health, zoning, fire code, animal control, law enforcement, and APS; and, most importantly, they often 

require repeated healthcare interventions. APS works with these 

victims to prevent this cycle of deterioration and expense. 

APS—a recent study in Utah found that, of APS substantiated 

cases involving financial abuse, 9 percent, or almost 1 in 10, of the 

victims had to turn to Medicaid for healthcare, specifically because 

they lost their own money to exploitation. Given the extremely high 

rates of elder abuse, you can just imagine the enormous drain that 

elder financial abuse causes Medicaid and other public programs. 

APS is the only response system we have whose primary function 

is to respond to vulnerable adult abuse, neglect, and exploitation. 

We’re also the only system serving victims of crime and abuse 

which relies solely on State funding decisions. As a result, as the 

GAO has pointed out, we have almost no national infrastructure 

for APS and we are faced with ever-increasing caseloads and 

shrinking State budgets. We struggle just to answer the phones 

13 

and provide the most basic service to extremely vulnerable adults. 

There is not even a single national APS resource center that could 

help struggling State programs provide cost-effective training, information, practice and data-collection standards, technical assistance, policy development on critical and complex issues, such as 

interstate compacts, and so on. Such a center, modeled on the literally dozens of such centers in child abuse, domestic violence, and 

other fields, could, for minimal expense, greatly enhance the capability of APS to provide the most effective and efficient services to 

abuse victims. 

NAPSA’s the only national organization working to build capacity in APS, and we would really appreciate some help, so we can 

provide genuinely needed work, so that we can help APS programs 

work both effectively and efficiently in protecting our most vulnerable older citizens. 

Thank you very much. 

[The prepared statement of Ms. Quinn appears in the Appendix 

on page 107.] 

The CHAIRMAN. Thank you very much, Ms. Quinn. 

Dr. Lachs. 

STATEMENT OF MARK LACHS, MD, MPH, DIRECTOR OF GERIATRICS, NEW YORK PRESBYTERIAN HEALTH SYSTEM, COCHIEF, DIVISION OF GERIATRIC MEDICINE AND GERONTOLOGY, WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY, NEW YORK, NY 

Dr. LACHS. Senator, I testify before you not only as a primary 

physician who cares for older people and has seen the ravages of 

elder abuse firsthand, but also as a scientist who’s conducted research in elder abuse, much of it funded by NIH and NIJ, for the 

last 25 years. In addition to my Cornell and New York Presbyterian Hospital roles, I also run New York City’s Elder Abuse 

Center, which I’ll talk about. 

The hearing today is timely, not only because of the release of 

the GAO report, but also because it coincides with the release of 

a Statewide New York Study that my group at Cornell conducted 

with the New York City Department for the Aging and Lifespan of 

Greater Rochester. Funded by the New York State Office of Children and Family Services, it had two simple goals. First, to determine the annual incidence of elder mistreatment in our State, and 

second, to figure out how much of it we miss. 

The study is notable in a couple of respects. The first is that it’s 

enormous. It’s the largest of its kind in any single State. We directly interviewed over 3,000 older people to directly ask them 

about their experiences with mistreatment. And second, over the 

same period, we went to the many agencies, governmental and 

NGO, who formally respond to abuse, to see how many people they 

served. Our goal was to compare the numbers of people who experienced abuse—self-report it, that is—as opposed to those who actually come to light. And missing cases, we are. 

Of these 4,000 individuals, about 7.6 percent, 1 in 13, reported 

some form of mistreatment in the past year. The most common 

form was financial exploitation, which is why Mr. Rooney’s testiVerDate Nov 24 2008 14:31 Aug 18, 2011 Jkt 066957 PO 00000 Frm 00019 Fmt 6633 Sfmt 6633 C:\DOCS\66957.TXT SHAUN PsN: DPROCT
14 

mony was so compelling, about 1 in 25 older Americans. Next common was physical abuse—2.2 percent, about 1 in 50 Americans. 

So, Senators, this is out there. I tell the residents that I train 

that if you’ve seen 15 older people today in the clinic, whether you 

know it or not, you have seen an elder abuse victim. 

When we compare the known cases to the undiscovered cases, we 

found that, for every one we find, we miss about 23 or 24. And, for 

this reason, we entitled our report, ‘‘Under the Radar.’’ 

Senators, in the remaining couple of minutes, I’d like to outline 

two or three recent developments in this field which I think have 

enormous promise. 

The first is the development of multidisciplinary Elder Abuse 

Centers or teams—in fact, Mr. Rooney, suggested this as an intervention—like those that have been created for child abuse, in 

which teams of physicians, social workers, attorneys, protective 

service workers collaboratively work to identify victims of mistreatment and meet their multitude of legal, medical, and other needs. 

We’ve created two such teams in New York City, and they grow on 

a monthly basis. I think this is a national model for assistance to 

victims, not only because it addresses injuries, but because it 

averts financial exploitation that ultimately robs people of the nest 

eggs that they have accumulated over the lifetime, and puts them 

on programs of public assistance. 

We know, from research that we’ve conducted, for example, that 

elder mistreatment is an independent risk factor, beyond your diseases, for going to a nursing home. And Medicaid is the major 

payer for nursing home care. So, in short, elder mistreatment victims, not only suffer, they suffer expensively and they suffer in 

ways that tax our public welfare systems, our healthcare systems, 

and our entitlement systems. 

And while my remarks today have focused primarily on abuse in 

the community, we should not forget that residents of nursing 

homes still remain at risk. And here, too, there will soon be new 

data. NIH and NIJ and the Department of Health in New York 

have recently funded innovative studies about a new form of recognized abuse, so-called resident-to-resident mistreatment. So much 

of the focus has been on staff abuse, we now know of situations in 

which patients with behavioral problems, mental health problems 

live together with frail older people. In a number of cases, there 

have been serious injuries, even deaths, from this. And those numbers will come out shortly. 

Everyone here today will tell you that this problem is underresourced. You’ll get no argument from me. But, if I had to make 

investments in two areas that have the major return on investment, I would suggest it’s investment in multidisciplinary teams 

and centers that combat abuse and, I think, more research into this 

area that could really avert the financial toll of mistreatment that 

ultimately we all pay for in the form of premature nursing home 

placement. 

Senators, thank you for requesting the GAO report, letting me 

speak, and addressing the most hideous form of ageism imaginable. 

I’d just like to end by saying that we did not need to be reminded 

that Mickey Rooney is a national hero, but today we were, once 

again. 

15 

Thank you very much. 

[The prepared statement of Dr. Lachs appears in the Appendix 

on page 119.] 

The CHAIRMAN. Thank you, Dr. Lachs. 

Now we’ll hear from Bonnie Brandl. 

STATEMENT OF BONNIE BRANDL, DIRECTOR, NATIONAL 

CLEARINGHOUSE ON ABUSE IN LATER LIFE (NCALL), A 

PROJECT OF THE WISCONSIN COALITION AGAINST DOMESTIC VIOLENCE, SUPERIOR, CO 

Ms. BRANDL. Chairman Kohl, Senator Corker, distinguished committee members, thank you for the committee’s continuing leadership and focus on elder justice. 

My name is Bonnie Brandl and I am the director of the National 

Clearinghouse on Abuse in Later Life, which is a project of the 

Wisconsin Coalition Against Domestic Violence. 

Miss Mary, age 96, lived with her grandson and his wife for 5 

years. Let’s hear a few moments of her story, in her own words. 

[Video presentation.] 

Ms. MARY [from video]. Every month when he’d bring me a 

check, he—He didn’t have no money to pay the mortgage, $500-amonth mortgage. And he’d say, ‘‘Hey, Granny, have you got any 

money?’’ and said, ‘‘Well, I’ll get the next check and I’ll pay you 

back.’’ I let him have it. I gave him two $500 checks one time. And 

I said, ‘‘Now, Bill, go pay that mortgage.’’ And he said, ‘‘Bring it 

back.’’ Came back drinking. I never did see it. I never have seen 

any of my money. 

[End of video presentation.] 

Ms. BRANDL. Ms. Mary never reported the financial exploitation. 

Then late one night, Ms. Mary called 911. When law enforcement 

arrived, they found a bloody and battered Ms. Mary, who had been 

beaten and sexually assaulted for hours by her middle-aged grandson. After raping his grandmother, Ms. Mary’s grandson fell asleep 

in her bed. 

Paramedics transported Ms. Mary to the hospital, where she received medical care. Law enforcement arrested her grandson. Adult 

Protective Services helped place Ms. Mary in a nursing home. Prosecutors prosecuted her grandson, who is currently in prison. Sexual 

assault advocates provided advocacy and emotional support for Ms. 

Mary. 

Although the harm Ms. Mary experienced was horrific, this case 

illustrates an ideal collaborative response from health, social services, criminal justice, and advocacy systems. 

Unfortunately, in most communities the responses of these systems are imperfect and allow many victims to suffer in silence. 

Factors contributing to the current inadequate response include insufficient resources, limited or no training on elder abuse, and lack 

of collaboration among professionals. 

Unfortunately, many older adults like Ms. Mary are abused, neglected, or exploited by persons known to them. Offenders include 

spouses, partners, family members, caregivers, and others in positions of trust. A significant percentage of elder abuse is perpetrated 

by a spouse or partner. 

16 

Years ago, I met a woman attending a support group in Wisconsin who was discussing her upcoming wedding anniversary. She 

described how she had been married for 60 years and abused 

throughout that marriage. 

As the GAO reports have described the Federal response to elder 

abuse is woefully inadequate. We must scale up our current responses and leverage existing resources and expertise to develop 

cost-effective prevention and intervention strategies. 

One small Federal program that is making a difference is funded 

by the Violence Against Women Act. The Abuse in Later Life Program is one of the smallest discretionary programs at the Office on 

Violence Against Women, with only about $3 million distributed 

throughout the country each year, yet this is one of the largest 

Federal initiatives dedicated to elder abuse. 

The Office on Violence Against Women’s Abuse in Later Life Program has four major components. First, law enforcement, prosecutors, court personnel, and victim service providers receive model 

training on identifying and responding to elder abuse, neglect, and 

exploitation. Second, cross training encourages and promotes costeffective collaboration. Third, coordinated community response 

teams improve policies and protocols for responding to elder abuse 

cases. Finally, a fraction of the funding can be utilized for direct 

victim services. 

Each year, only 9 to 11 communities are funded, receiving approximately $400,000 over a 3-year period. The communities represent large urban and small rural communities, tribes, counties, 

and States. 

The Violence Against Women Act, the Older Americans Act, and 

the Elder Justice Act present opportunities to make a difference in 

the lives of older victims. Additional resources are needed to create 

and enhance victim services and to hold offenders accountable. 

This year, the Violence Against Women Act is up for reauthorization. I would like to thank Senator Kohl and Representatives Baldwin and Poe for being outspoken champions for the Abuse in Later 

Life Program. 

In conclusion, you are in a unique position to raise awareness 

and to look for opportunities and additional resources for those who 

are combating and responding to elder abuse. Older victims, like 

Ms. Mary, deserve to live their lives with dignity and respect. 

Thank you for focusing this hearing on the needs of older victims. 

[The prepared statement of Ms. Brandl appears in the Appendix 

on page 127.] 

The CHAIRMAN. Thank you very much, Ms. Brandl. 

Now we’ll hear from Marie-Therese Connolly. 

STATEMENT OF MARIE-THERESE CONNOLLY, DIRECTOR, LIFE 

LONG JUSTICE (LLJ) (AN INITIATIVE OF APPLESEED), AND 

SENIOR SCHOLAR, WOODROW WILSON INTERNATIONAL 

CENTER FOR SCHOLARS, WASHINGTON, DC 

Ms. CONNOLLY. Thank you. Chairman Kohl, Senators of the 

Aging Committee, thank you so much for your leadership on this 

long invisible but growing problem. 

17 

I’m here to testify about how a modest investment in Federal 

leadership, research, and new programs, and a new office, could 

have a profound impact on the lives of millions of Americans. 

Let me begin with Ruby Wise. Last year, her son, Chris, was 

charged by Seattle prosecutors with her murder. His crime? Letting 

her rot to death with huge pressure sores, several bone-deep, while 

he played Internet poker and lived off her pension. His excuse? He 

was just respecting her wishes. She didn’t want to go to a doctor 

or a nursing home. 

Ruby Wise was imprisoned in her bed by dementia, immobility, 

and isolation. She cried out for help continuously in the weeks before her death, but neighbors closed their windows and her son put 

in earplugs to muffle her cries. No one called Adult Protective Services or 911. No one called for help. It’s hard to believe that the response would have been the same had the cries come from a child, 

a younger woman, or even a dog. 

What happened to Ruby Wise is not a fluke. Dr. Lachs’ study 

found that only 1 in every 57 cases of elder neglect ever comes to 

light. Ruby Wise was one of the 56 who did not. 

And the phone surveys done by Dr. Lachs and others can’t capture the elders at greatest risk: those who live in facilities; those 

who can’t answer or don’t have a phone; those who are too scared 

to speak because an abuser is close by; and those with dementia, 

like Ruby Wise. 

A 2010 University of California, Irvine study found that a staggering 47 percent of people with dementia who live at home—that’s 

almost half—were abused or neglected by caregivers. Translated 

into human lives, these studies indicate that some 6 million Americans—mothers, fathers, grandparents—are victims of elder abuse 

every year. And those numbers don’t even include people who live 

in facilities where many of the most vulnerable elders live. Most 

nursing homes are dangerously understaffed, and countless people, 

like Ruby Wise, remain in risky, degrading, and even lethal situations to avoid them. 

This growing body of data presents a strong moral imperative for 

immediate attention. There’s a strong fiscal imperative, too, because one kind of elder abuse often begets the next, setting off a 

cascade of untold suffering and expense. Costly acute and longterm care required by elders injured by abuse or neglect depletes 

Medicare and Medicaid. Dr. Lachs talked about his 2002 study 

finding that elder abuse victims are four times more likely to end 

up in nursing homes. And nursing home chains that neglect residents and bill for care they don’t provide defraud Medicare and 

Medicaid. Financial exploitation pushes victims, whose life savings 

are stolen, to rely on public programs for housing. And abusive 

guardianships squander court resources. 

What’s the total cost? It’s likely many billions of dollars a year. 

But, we don’t know yet, which is one reason we desperately need 

more research. 

What we know about elder abuse lags some 40 years behind 

child abuse and 20 years behind domestic violence. We need to 

know more about why it occurs, what practices and programs are 

effective in addressing it, and how to detect and prevent it. And 

yet, the National Institute on Aging, our government’s leading 

18 

agency for aging research, spends just 1/1,000th of its budget for 

elder abuse research. And private funders spend even less. 

As noted by the GAO and on these charts, the Federal effort on 

elder justice issues, pursued by a few dedicated officials, mostly 

juggling multiple responsibilities, is wholly inadequate. The problem deserves and urgently needs increased Federal priority, with 

resources to match. DOJ and HHS have for years had offices providing sustained leadership on elder abuse and domestic violence 

issues. 

The new Elder Justice Office proposed for DOJ, where I previously headed up the Elder Justice and Nursing Home Initiative, 

is a high-impact, low-cost measure that would provide coordination 

and evaluation, sustained attention, assistance for States and jobs, 

and, together with other agencies, lay a foundation for collection of 

elder abuse data, like the child abuse field has done for decades. 

Elder abuse can arrive unannounced in any family. It’s not just 

an aging issue; it’s an issue for all of us who care about the older 

people in our lives. We’ve spent countless billions to extend how 

long we live, but relatively little to assure the safety and well-being 

in the years that we’ve gained. Like Chris Wise, the son who ignored his mother’s cries, we, as a Nation, have also been wearing 

earplugs. It’s time that we remove them. 

Thank you. 

[The prepared statement of Ms. Connolly appears in the Appendix on page 147.] 

The CHAIRMAN. Thank you very much, Ms. Connolly. 

We’ll turn now to Senator Blumenthal for some questions. 

Senator BLUMENTHAL. Thank you, Mr. Chairman. 

And again, I want to thank you for your really tireless and relentless work on this issue and the legislation you’ve offered, and 

particularly the work today, on bringing together this remarkable 

panel. 

And thank you, to each of you, for being here, especially to Ms. 

Brown and Dr. Lachs, for your scientific work that really provides 

a intellectual and factual framework for the cries that we hear 

through the voices that have been transmitted through Mr. Rooney 

and through the many people who are not heard in our society 

when they’re victims of this type of neglect and abuse. 

And I might say, Ms. Connolly, that many of the remarks that 

you made about abuse and neglect of elders can be said about victims of domestic violence, women who are unheard, and even children, who are often victims of abuse and neglect in their own 

homes, and have to be moved, if they’re heard. 

But, I want to ask Dr. Lachs a specific question about the educational framework, education of lawyers, doctors, nurses, care providers, public officials. I know that you supervise residencies and 

training of members of your profession. What can be done to make 

those professions more sensitive and aware—and I would be interested in the views of others, as well—about the problems that they 

may encounter but may not recognize? 

Dr. LACHS. Well, you know, Senator, when I applied for a medical license in the State of New York, as a family violence expert, 

a geriatrician, an internist who practices geriatric medicine, I had 

to pass a—child abuse training, even though I don’t take care of 

19 

children, other than the sniffles of my own kids, periodically. 

There’s no such requirement for older people. And we’re beginning 

to see models of—like that, for probate judges, continuing legal 

education. Much of the role of these multidisciplinary centers, in 

addition to direct service to victims, is, in fact, public education. 

Many of the abusive situations we come upon as clinicians are 

situations in such that the victim and the abuser are so isolated 

that it’s not recognized by the abuser that their behavior is nonnormal. 

And isolation plays a major role here, Senator. You know, if a 

child doesn’t come to school, or comes to school with a black eye, 

there’s a modern-day equivalent of a truant officer who makes a 

phone call. In our society, older people may be retired and their social networks may shrink because of bereavement. And, ultimately, 

the network comes to only involve these two individuals, the abuser 

and the victim. And I tell the residents that, for that annual physical, that you may be the only person the victim sees in the course 

of a year. And that may be true of a whole number of legal and 

mental health and other providers. So, education is critical. It can 

be done by centers. 

Other members, testifiers, may have comments. 

Senator BLUMENTHAL. Well, I think that is a—that’s a very helpful observation. And, as you know, in a number of States, there are 

requirements for certain background checks as part of that certification process. And I wonder if members of the panel could comment on the efficacy of those background checks, or some system 

of checks, for care providers, people in positions of trust, and people 

who, similarly, have a responsibility. 

Dr. LACHS. I’m happy to say something about it. I mean, I’m a 

tenured physician at a good medical school. And when I started 

working in my nursing home, I had to have a criminal background 

check. I don’t know the data on the efficacy; others can probably 

speak to that. But, I can tell you that I’ve testified in criminal and 

civil matters where those were not done, and the results were hideous. 

Senator BLUMENTHAL. And I think one of the problems—if I can 

just interject—is that very often those background checks relate 

only to the State where that person is working. And so, he or she 

may have committed a variety of very serious crimes in other 

States, but the background check may not identify them. 

Ms. QUINN. Could I go back to the question about education? Because, in all but three States now, a wide range of professionals are 

required, mandated by State statute, to report suspected elder 

abuse to Adult Protective Services—healthcare providers, social 

services, law enforcement, anybody who would come into contact, 

in a normal course of business, with older people. But, we haven’t 

had the resources to develop the core trainings that could be sent 

out across the country so that States could train all those different 

professionals on what the requirement—just as they do in child 

abuse—what the requirements are, what the indicators are, where 

to report, what happens when you report. 

Senator BLUMENTHAL. Thank you. 

20 

My time has expired. And, unfortunately, like others in the committee, I have another hearing. I very, very much appreciate your 

help in this critical topic. 

Thank you very much. 

The CHAIRMAN. Thank you, Senator Blumenthal. 

Senator Wyden. 

Senator WYDEN. Thank you, Mr. Chairman. 

And I don’t want to make this a bouquet-tossing contest, but I 

think your contribution, the legislation, and the fact that you always use this committee as a bully pulpit to layout how important 

it is that we address these concerns, is a huge public service. I 

want to thank you. 

And I know we’re going to really benefit from having Senator 

Blumenthal on this committee, given his long record on these 

issues, as well. 

And, to the witnesses, a lot of you, I know, have been toiling out 

at the grassroots level for years and years. And I think that’s why 

I want to ask you the following question. 

I was co-director of the Gray Panthers for many years, and ran 

the Legal Aid Office for the Elderly. And we were working on these 

issues then. And, sort of over the decades, I think it’s clear that 

we have seen this problem grow, despite the fact that a number of 

useful bills have passed. I know Senator Kohl’s predecessors on 

this committee have been interested in this. And I think we’re 

going to go forward again with some very constructive suggestions. 

Clearly, bringing the first responders into this earlier is going to 

be of enormous benefit. I think trying to beef up prosecutions will 

be useful. 

But, the question I want to ask—and we can just go down the 

row; I’d be interested in your response—is, What, in your view, 

needs to be done so that, 10 years from now, we’re not having a 

hearing that essentially revolves around the same issues—that 

we’ve seen another growth in the problem, we’ve seen the 

scamsters, you know, still at it, and we sort of relitigate the ground 

that we’re dealing with today? 

So, why don’t we just go right down the row. And I’m particularly interested in some of the ideas you have that don’t just go to 

the question of additional funding. Obviously, we need adequate 

funding. But, just go down the row and give me your sense—you 

get to offer the idea that is most likely to make a difference so that, 

10 years from now, we can look back and say that, ‘‘On our watch, 

under the leadership of Chairman Kohl, we really got it right and 

made a big difference.’’ 

Start with you, Ms. Connolly. I know you’ve been at this for 

years, and we appreciate it. 

Ms. CONNOLLY. Thank you, Senator Wyden. 

Dr. Lachs, during his testimony, said ‘‘research and multidisciplinary teams.’’ And I would echo that and add to that list, also, 

Federal leadership. This has been an area where a few people have 

been toiling in the trenches, but there hasn’t been much high-level 

Federal leadership. And the bully pulpit makes a big difference, 

whether it’s in Congress or in the Executive Branch, because where 

the Administration leads, often the rest of the country follows, and 

it could make an enormous difference. 

21 

And that doesn’t necessarily require additional dollars, although 

also, I think, in a time of budget austerity, which we are in now, 

really we can’t afford not to start doing a better job with elder 

abuse, because all the indications are that it costs us countless billions of dollars a year. We really need to start looking at that issue 

better. Start making it all of our issue. 

Senator WYDEN. On the research question—then I’ll just go right 

to the row—but since you touched on it, I think it’s pretty obvious 

that financial exploitation can end up having seniors, who previously have been in their home, have been able to be in the community, have ended up in public housing, have needed public assistance. Any sense on two measures: How many seniors have actually been forced into public programs by elder abuse? And second, 

how much this has cost taxpayers? 

Ms. CONNOLLY. We had a little discussion about that earlier. And 

I don’t believe that we have any data on those numbers, Senator. 

And that goes back to the research issue, and the dire paucity 

of research. It’s really a huge issue in the field. We don’t know 

what works and we don’t know what successful interventions even 

look like. And that goes for the cost-saving aspect of interventions 

as well. So, it’s really a problem. 

And also, given that we have a very tattered safety net, one 

that’s full of holes, and very scattershot systems that are all over 

the place, we really need to take a good, hard look at, What are 

the needs of an Adult Protective Services and an ombudsman program and the legal services and other services across the board. 

How do we work better together, and more efficiently, by having 

resource centers, as Ms. Quinn testified to, and technical support, 

to really help everybody do their jobs better and to have all those 

systems talking to one another? 

Those are not incredibly high-cost measures. That’s just being 

smart about how we address this problem. And we haven’t really 

been smart about it, because we’ve lacked that leadership. And it’s 

extremely different from State to State. You have a different set of 

laws and a different set of responsibilities across the board. And 

that’s also an impediment to the data collection. 

These are issues that are very difficult, but not insurmountable. 

Our colleagues, for example, in the child abuse and domestic violence field, are way ahead of us, in terms of getting a better handle 

on how to put together both the safety net and the knowledge to 

inform our practices. 

Senator WYDEN. So, Ms. Connolly comes down on the side of research. 

Why don’t we just go right down the row. And—10 years from 

now—you want to make a difference today that’ll pay off then. 

Ms. BRANDL. The question is a challenging one, given that the 

population is aging and we live in such a youth-orientated culture. 

So, how do we sort of change—really address ageism and the 

youth-orientated culture to put more focus on this issue? 

And I’m going to agree with what I think the panelists here have 

already said. I completely agree with MT, that Federal leadership 

is huge. What happens here in D.C., what happens in government, 

this committee hearing, in and of itself, raising awareness is 

hugely important. And that needs to happen. 

22 

I also agree with Mark and what others have said about a multidisciplinary approach, that we really—what we have found, with 

the Office on Violence Against Women’s Abuse in Later Life Program, is it really is law enforcement, prosecutors, court personnel, 

advocates, the aging system, Adult Protective Services, and others 

working together. These cases are much too complicated for one 

system to address the issues on their own. And, frankly, it’s more 

cost effective if we’re sharing the load and having a multidisciplinary team come together, figure out smart, innovative ideas to 

respond to cases and intervene, and begin to think about prevention strategies in the community, as well. 

So, I think it’s the high Federal level, as well as really reaching 

folks on the grassroots level to give them more training, more information about what to look for and how they can respond and how 

to work better together. 

Dr. LACHS. Senator, I’m going to come down on the side of centers. And I want to respond to your comment about addressing this 

in a way that’s not purely a resource issue. And I’m going to liken 

this problem to something that we’ve seen in Medicare, something 

I’m also familiar with, as a geriatrician. You know, we’ve discovered that lots of problems in safety with patients, and readmissions, come from a problem called ‘‘care transitions.’’ We found out 

that the real problem with healthcare, particularly for older people, 

is when they move from place to place, from physician to physician. 

That’s the reason, we think, that many patients are readmitted unnecessarily. 

The more I do this, the more I have come to view elder mistreatment and the interventions we need as a care transition problem, 

people move from system to system, from housing to law enforcement to any number of venues, and no one has ownership of the 

entire case or the whole body of information. 

The center model, I think, really obviates that and makes someone take ownership in a way that decreases the inefficiencies of 

having multiple providers and a record that doesn’t sit in any one 

place. I think the center model really offers great hope, not only as 

a strategy for fighting the indignant situation we find older people 

in, but also as a way of doing it in a way that may be very cost 

effective. So, centers. And there’ll be some research, obviously. 

Senator WYDEN. What you’ve described is almost the elder abuse 

equivalent of the medical home. 

Dr. LACHS. Very good. That’s right. 

Senator WYDEN. Wouldn’t you say that’s almost the analogy? 

Dr. LACHS. I think that’s right. I think, again—so, over the last 

5 or 10 years, we’ve figured out that, you know, rates of Medicare 

readmission from hospitals—— 

Senator WYDEN. Yeah. 

Dr. LACHS [continuing]. Are 25 percent, nationally. I sit in these 

multidisciplinary conferences, that I’m describing to you, that are 

new, and I see people, sort of—ears perk—that say, ‘‘You know, 

wait a second. I heard about that client when they came through 

the housing system or the protective service system.’’ And, you 

know, there certainly shouldn’t be duplication of resources. I think 

we need some uber knowledge of how these individuals are traversing through the system. So, I think that offers great hope. 

23 

There are some very important research questions in there. But, 

that’s how I would respond to your question, very specifically. 

Senator WYDEN. I’m going to keep Chairman Kohl in charge of 

the uber knowledge. 

[Laughter.] 

I’m way over my time for y’all. Your suggestions—you get to 

make a difference today that pays off 10 years from now. 

Ms. QUINN. Well, I will echo what’s been said before. Certainly, 

Federal leadership. I would like to commend Assistant Secretary 

for Aging, Kathy Greenlee, who has really stepped up the game, in 

terms of leadership around elder justice, elder abuse issues. We 

certainly need more research, certainly endorse and—APS leads 

and is part of many multidisciplinary teams, certainly need more 

education of the public, of professionals, of responders. 

We have to reduce the isolation of older people. That is one of 

the key—absolute key prevention and intervention responses. And 

the—my concern about that is that the level of community services 

is decreasing. And that—putting community—in-home, communitybased services, is a major way to reduce isolation: home delivered 

meals, chore/housekeeping, that kind of thing. 

And I have to say, I think we really have to pay attention to the 

people who are the boots on the ground in the fight against elder 

abuse, and that is the overwhelmed, totally underfunded, totally 

without a national infrastructure system of Adult Protective Services. We really need to figure out how to build their capacity, how 

to get them well trained. If you want to work at Starbucks, you 

have to go through 40 hours of training before you make your first 

latte, but we will send an APS person out, in some jurisdictions, 

because they don’t have any money, right out of college and hope 

they learn on the job. So, this is just not acceptable. They’re making life-and-death decisions concerning these really frail and vulnerable people, and they really need some help. 

So, thank you. 

The CHAIRMAN. That’s good. 

Ms. BROWN. You know, we asked ourselves the same question 

when we were doing this work, because, as we looked back in past 

efforts, we saw many of the same types of recommendations and 

issues, again and again, that we’ve heard here today. And these are 

not new issues. So, we asked ourselves, What is the thing that 

might make the difference? And I really think I agree, that Federal 

leadership is a big part of it, both on the congressional side and 

having commitment and the willingness to be proactive on the administration side, as well. 

Senator WYDEN. Mr. Chairman, thank you for the extra time. 

The CHAIRMAN. Thank you very much, Senator Wyden. 

And we thank this panel very much. You really represent as 

much expertise as there is in this country on this very important 

subject. And we appreciate your coming here to Washington to give 

us the benefit of your knowledge and your experience. 

Thank you so much. 

[Whereupon, at 3:30 p.m., the hearing was adjourned.] 

(25) 

APPENDIX 

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Æ 


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