The sobering reality of 'elder abuse'

ProPublica and PBS's 'Frontline' news program have undertaken a joint investigation into allegations of neglect, assault - even murder - of senior citizens in care facilities. Their report makes very worrying reading. Here's an excerpt.

ProPublica and PBS "Frontline" have identified more than three-dozen cases in which the alleged neglect, abuse or even murder of seniors eluded authorities. But for the intervention of whistleblowers, concerned relatives and others, the truth about these deaths might never have come to light.

For more than a year, ProPublica, in concert with other news organizations, has scrutinized the nation's coroner and medical examiner offices, which are responsible for probing sudden and unusual fatalities. We found that these agencies -- hampered by chronic underfunding, a shortage of trained doctors and a lack of national standards -- have sometimes helped to send innocent people to prison and allowed killers to walk free.

. . .

Because of gaps in government data, it's impossible to say how many suspicious cases have been written off as natural fatalities. However, the limited evidence available points to a significant problem: When investigators in one jurisdiction comprehensively reviewed deaths of older people, they discovered scores of cases in which elders suffered mistreatment.

An array of systemic flaws has led to case after case being overlooked:

• When treating physicians report that a death is natural, coroners and medical examiners almost never investigate. But doctors often get it wrong. In one 2008 study, nearly half the doctors surveyed failed to identify the correct cause of death for an elderly patient with a brain injury caused by a fall.
• In most states, doctors can fill out a death certificate without ever seeing the body. That explains how a Pennsylvania physician said her 83-year-old patient had died of natural causes when, in fact, he'd been beaten to death by an aide. The doctor never saw the 16-inch bruise that covered the man's left side.
• Autopsies of seniors have become increasingly rare even as the population age 65 or older has grown. Between 1972 and 2007, a government analysis found, the share of U.S. autopsies performed on seniors dropped from 37 percent to 17 percent.
  

Dr. Michael Dobersen, a forensic pathologist and the coroner for Arapahoe County, Colo., said he worries about suspicious deaths in nursing homes. "Sometimes, if I don't want to sleep at night, I think about all the cases that we miss," Dobersen said. "I'm afraid we're not looking very hard."

With the graying of the baby boom generation, such concerns will only grow in urgency. Within a few years, nearly one-third of all Americans will be over 60.

In a handful of locales, coroners and medical examiners have begun to view older Americans as a vulnerable population whose deaths require extra attention. Some counties have formed elder death review teams that bring special expertise to cases of possible abuse or neglect. In Arkansas, thanks to one crusading coroner, state law requires the review of all nursing-home fatalities, including those blamed on natural causes.

But those efforts are the exception. In most places, little is being done to ensure that suspicious senior deaths are being investigated.

"We're where child abuse was 30 years ago," said Dr. Kathryn Locatell, a geriatrician who specializes in diagnosing elder abuse. "I think it's ageism -- I think it boils down to that one word. We don't value old people. We don't want to think about ourselves getting old."

There's much more at the link.

With so many American families placing their older members into care facilities, in the expectation that they'll be well looked after there, this report makes extremely worrying reading. It's even more so for those approaching retirement, who must plan for their old age, and now have to worry whether or not they can trust the advertisements for facilities claiming to offer top-notch care to their customers. For someone like myself, who's partly disabled, this is an even more important consideration.

Kudos to ProPublica and Frontline for conducting this investigation. I think they've performed a valuable public service by doing so.

Peter