Pubdate: Sun, 15 May 2016
Source: Boston Globe (MA)
Copyright: 2016 Globe Newspaper Company
Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340
Website: http://bostonglobe.com/
Details: http://www.mapinc.org/media/52
Author: Kay Lazar

THE UNTOLD COST OF THE OPIATE EPIDEMIC: ELDER ABUSE

Reports of suspected elder abuse in Massachusetts have surged over 
the past five years, according to state figures - a troubling 
increase that law enforcement and elder advocates say is fueled in 
part by the opioid crisis and addicted adult children exploiting 
parents and other relatives.

Since 2011, abuse reports have climbed 37 percent, with more than 
1,000 additional cases reported each of the past five years to 
protective services offices. The Executive Office of Elder Affairs, 
the agency that tracks and investigates abuse, recorded nearly 25,000 
cases last year, but the state's numbers do not delineate how many 
involved opioids.

As those drugs tighten their grip on Massachusetts, more adult 
children addicted to opioids are moving back in with their elderly 
parents, Middlesex District Attorney Marian T. Ryan said. Retired 
parents, with their monthly Social Security and pension checks, 
become easy targets for financial, physical, and emotional abuse.

As an example, Ryan said that in the past month, her office has 
handled about 10 cases involving grandchildren who allegedly stole 
money, jewelry, and silver from unsuspecting elders. Often, the items 
"were pawned by grandkids to buy drugs," she said.

Ryan is advising police, firefighters, and emergency medical service 
crews responding to calls to look for unusual bruising on elders' 
wrists and forearms, often signs of a struggle. Checking the 
refrigerator may also yield clues about whether there is sufficient 
food in the house, she said. And a quick survey of other rooms may 
reveal dark secrets.

Ryan's office recently prosecuted a case that stemmed from an alert 
visiting nurse inquiring about holes in a bedroom ceiling. It turned 
out they were bullet holes. An older woman, bed-bound because of a 
leg injury, was subjected to terror - and plaster raining down on her 
- - when her grown son would fly into rages and shoot a gun into the 
ceiling above her.

Opioid addiction has cut a wide path through Massachusetts, often 
inflicting harm on the very young and old. Those on the front lines - 
doctors, judges, and drug counselors - have increasingly reported 
opioid-addicted parents so focused on their next score that they 
neglect or abuse the children in their care.

Elder abuse can take many forms, but is legally defined in 
Massachusetts as physical, emotional, sexual, or financial 
exploitation of residents age 60 and older. It also includes neglect 
by a caretaker for failing to provide essentials such as food, 
clothing, and shelter.

Specialists say the number of abuse reports is rising as the 
population ages and more elders, particularly those who are frail, 
remain at home instead of moving to a nursing facility.

The true extent of abuse in Massachusetts and nationwide is difficult 
to pinpoint, but a recent New England Journal of Medicine review 
estimated that 10 percent of the elder population has suffered abuse. 
Abusers are most likely to be adult children or spouses who struggle 
with substance abuse and mental or physical health problems, the 
review concluded.

Michael Woronka, chief executive of Action Ambulance Service in 
Wilmington, said emergency medical service workers typically have not 
been trained to hunt for signs of trouble in a household when 
responding to calls. Woronka, a 30-year veteran of the industry, 
operates ambulance services in a large swath of Eastern 
Massachusetts, including Essex, Middlesex, and Suffolk counties, and 
in Berkshire County in the western part of the state.

"This training [by Ryan] is causing us to pause now,' he said, "and 
forcing us to say we need to be open to the more social and 
psychological side of the situation."

Concerned that the scope of elder abuse and neglect may be larger 
than reported - specialists say fear and shame often keep elders from 
speaking up - Ryan recently increased training sessions for EMTs, 
police, and firefighters to help them spot signs of trouble.

Too often, Ryan said, her office has found that emergency calls for 
injuries from seemingly routine trip-and-fall accidents turn out to 
be cases of elder abuse perpetrated by a family member.

"When you peel back what happened," Ryan said, "the fall happened 
when they were punched, kicked, or pushed."

Often elders feel trapped in such dangerous situations, said Betsey 
Crimmins, a senior attorney at Greater Boston Legal Services, who 
specializes in elder abuse cases. Crimmins said elders may be afraid 
to speak up for fear their son or daughter, who might take them to 
medical appointments, will be prosecuted, and the parent will end up 
in a nursing home.

Crimmins launched an elder abuse prevention task force in 2014. She 
and other specialists assumed elders would most urgently seek rescue 
from financial exploitation.

"When we asked the elders in the meeting [about what they needed help 
with], they all said opioids, and my eyebrows shot up," Crimmins 
said. "They identified an issue no one in the room thought to touch."

Over and over, they heard about adult children who were addicted to 
opioids moving back with their parents and dealing drugs out of the house.

Crimmins said several groups in Massachusetts, including local 
councils on aging and law enforcement, are working on creative 
approaches to address elder abuse. But she said the services are too 
fragmented and lack a central entry point to connect them.

Alice Bonner, secretary of the state's Executive Office of Elder 
Affairs, said her agency is working to address that issue.

The agency is "proactively taking steps to prevent and reduce elder 
abuse by partnering with protective service agencies and other 
partners in law enforcement, health care, elder services, financial 
services, and other sectors to protect vulnerable elders who are 
living in the community," she said in a prepared statement.

The agency recently hired a new regional manager for its protective 
services program to upgrade and standardize training for workers, 
according to elder affairs officials. It also is working to reduce 
the length of time it takes to investigate suspected abuse cases, a 
source of chronic complaints, and to improve the hot line for the 
public to report abuse.
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MAP posted-by: Jay Bergstrom