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91–381 PDF 2004

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

(

SPECIAL COMMITTEE ON AGING 

LARRY CRAIG, Idaho, Chairman 

RICHARD SHELBY, Alabama 

SUSAN COLLINS, Maine 

MIKE ENZI, Wyoming 

GORDON SMITH, Oregon 

JAMES M. TALENT, Missouri 

PETER G. FITZGERALD, Illinois 

ORRIN G. HATCH, Utah 

ELIZABETH DOLE, North Carolina 

TED STEVENS, Alaska 

RICK SANTORUM, Pennsylvania 

JOHN B. BREAUX, Louisiana, Ranking 

Member 

HARRY REID, Nevada 

HERB KOHL, Wisconsin 

JAMES M. JEFFORDS, Vermont 

RUSSELL D. FEINGOLD, Wisconsin 

RON WYDEN, Oregon 

BLANCHE L. LINCOLN, Arkansas 

EVAN BAYH, Indiana 

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) 

(1)

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. 

2

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:] 

3

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 coinVerDate 0ct 09 2002 13:15 Feb 02, 2004 Jkt 000000 PO 00000 Frm 00007 Fmt 6633 Sfmt 6633 C:\DOCS\91381.TXT SAGING1 PsN: JOYCE
4

cided 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.

5

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. 

6

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:]

7


91381.001
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91381.002
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91381.003
10

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 underfunded 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. 

11

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 

12

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 

13

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 

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tunately, 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 seisVerDate 0ct 09 2002 13:15 Feb 02, 2004 Jkt 000000 PO 00000 Frm 00035 Fmt 6633 Sfmt 6633 C:\DOCS\91381.TXT SAGING1 PsN: JOYCE
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mic 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 

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crete 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. 

44

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 Gov- ernors 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. 

45

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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 

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cided 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 

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tion 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 

51

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 existVerDate 0ct 09 2002 13:15 Feb 02, 2004 Jkt 000000 PO 00000 Frm 00055 Fmt 6633 Sfmt 6633 C:\DOCS\91381.TXT SAGING1 PsN: JOYCE
52

ence 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. 

53

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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