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The Elder Justice Act (EJA) of 2009

The EJA of 2009 has been included in the Patient Protection and Affordable Care Act (thehealthcare reform legislation). It provides federal support and funds to expand the fight againstelder abuse, neglect and exploitation.

What are abuse, neglect and exploitation per the EJA?

The Elder Justice Act defines an elder as anyone 60 years old or more. It defines elder justice,as efforts to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect andexploitation; and protect elders with diminished capacity while maximizing their autonomy recognizing an elders rights, including the right to be free of abuse, neglect, and exploitation.This recognition of the right to be free of abuse, neglect and exploitation is key to understandingthe purpose of the EJA.

Abuseis the knowing infliction of physical or psychological harm or the knowing deprivation ofgoods or services that are necessary to meet essential needs or to avoid physical orpsychological harm. In other words, abuse is when someone hurts an elder individualphysically or psychologically (striking him or her, rape, verbal threats, etc.) or denies the elderperson goods or services he needs to avoid harm (such as denying him or her food ormedicine).

Neglectis defined as the failure of a caregiver or fiduciary to provide the goods or services thatare necessary to maintain the health or safety of an elder; or self neglect. Self-neglect isfurther defined as an adults inability, due to physical or mental impairment or diminishedcapacity, to perform essential self-care tasks including a) obtaining essential food, clothing,shelter, and medical care; b) obtaining goods and services necessary to maintain physicalhealth, mental health, or general safety; or c) managing ones own financial affairs.

This means that if a caregiver (paid or unpaid, professional or family, volunteer, hired or court-

ordered) doesnt provide food, medicines, clothing, shelter or medical care needed to keep anelder healthy and safe, the caregiver has neglected the elder. If an impaired elder fails to carefor herself (for example, she fails to take her diabetes and heart medications) or doesnt pay herbills or protect her assets (for example, she leaves the unopened bills in the mail box or on thekitchen table and her utilities are turned off as a result), this may be self-neglect.

Exploitationis defined as the fraudulent or otherwise illegal, unauthorized, or improper act orprocess of an individual, including a caregiver or fiduciary, that uses the resources of an elderperson for monetary or personal benefit, profit, or gain, or that results in depriving an elder ofrightful access to, or use of, benefits, resources, belongings, or assets. This means themanipulation, conning, or stealing from an elder individual; this includes a child or caregiver whoappropriates an elders money or property for his own or who persuades the confused or

dependent elder to give him the money, house or car.

Stats on Elder Abuse, Neglect and Exploitation

State reports indicated that 65% of elder abuse victims were women, 42% were 80 years old orgreater, and 89% of offenses occurred in the elders home or involved elders living in a privatehome, as opposed to those living in a care facility. Data on the alleged perpetrators of abuse,exploitation and neglect indicated 52% of the perpetrators were female, 75% were less than 60

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years old, 32% were adult children and 21% were other family members. The other 47% of theperpetrators were a combination of professionals (banks, insurers, investment firms, doctors,non-family caregivers), neighbors, acquaintances and strangers.

It is generally believed that these numbers vastly under-represent the actual frequency ofabuse, neglect or exploitation of vulnerable adults. Because so many of the perpetrators are

well known to their victims, and many of them are actually the victims children or other familymembers, elderly victims are often unwilling to report abuse or exploitation to the authorities.The victims dont want to send their own children to jail and they dont want to initiate familyconflict or scandal. Victims are ashamed or are embarrassed by what has happened and wantto keep it secret. Elderly victims may also be dependent on the perpetrators for care, food,shelter, transportation, financial management, safety or companionship and will not risk losingthat assistance by reporting the crime. Victims may fear the perpetrators and are afraid offurther harms if they call the police. Elderly victims with cognitive impairments may not realizethat they have been robbed or their property transferred. They may not be able to clearlycommunicate, or even remember, physical assaults or theft or other exploitation, and may notbe believed even if they try to tell someone. The bottom line is that many perpetrators get awaywith their crimes.

How Will the Elder Justice Act Help?

The Elder Justice Act creates an Elder Justice Coordinating Council and Advisory Board andtrial forensic centers to improve the investigation and prosecution of crimes against elders. Itprovides grant money for education, advancement and increased compensation of long-termcare providers; it also provides grant money for long-term care facilities to develop andimplement electronic health record (EHR) technology, and additional funding for APS programsaround the country; furthermore, it provides grant money for long-term care ombudsmanprograms and training. It creates a new federal right providing a civil alternative to criminalprosecution as a response to abuse, neglect or exploitation.

What are the reporting requirements?

Report to the State Survey Agency (SA) http://www.4fate.org/html/Agency_Directory.pdf and toLocal Law Enforcement (LLE) entities in your area any reasonable suspicion of a crime.Multiple individuals may file a single report inclduing information about the suspected crime.The National Consumer Voice for Long Term Care http://www.theconsumervoice.org/ offersombusdman, and other groups of concerned citizens who advocate for quality long-term care,services and supports and quality of life for residents and consumers in their locality, state orregion sometimes self-identify as "citizen advocacy groups" (CAGs) nationwwide.