A Safe Haven for Elder-Abuse Victims

The frail old man was living with his son but collecting cans on the city streets and turning them in for cash to survive. The son was pocketing the old man’s Social Security checks every month, giving back nothing -- except verbal abuse. The old man was worthless, possessed by the devil, the son told him.

Social workers at the local senior citizens center knew of the situation but didn’t have the means to help. Then over the winter the son decided he was moving to North Carolina. The old man was at his mercy. He had no choice but to go -- or he’d end up on the street.

This time, there was a way to help. The social worker referred the soon-to-be-homeless man to a new emergency shelter for abused elderly people, one of the first in the nation.

The Hebrew Home for the Aged at Riverdale, a sprawling and historic facility in the Bronx, recently started a comprehensive program, including temporary housing, for elderly victims of abuse and neglect from northern New York City and Westchester County.

The old man was among the first clients admitted. He arrived in shock, nearly speechless and distrustful of everyone around him. He was discharged two months later, confident and stronger.

“We supported his choice to go back with his family, but he’s a different person now,” said Emily Brooks, a social worker at the Hebrew Home who worked with the 74-year-old client. The man, whose name Brooks did not reveal to protect his privacy, is living in North Carolina with his son, but now his Social Security checks are deposited directly into a bank account to which only the father has access.

“Some people think physical abuse is so much more inhumane, and we see many cases that really are,” Brooks said. “But at the same time emotional abuse can be really detrimental and horrific.” Victims of this abuse can be just as impaired and unable to function as someone who is regularly beaten and starved, she said.

The need to combat elder abuse, neglect and financial exploitation has long been recognized, but not nearly enough is being done, says Dan Reingold, head of the Hebrew Home, about 15 miles up the Hudson River from downtown Manhattan.

Reingold said it would help if government agencies could at least agree on national standards for defining abuse and neglect -- crimes that will likely increase as the baby boomer generation ages.

In fact, public awareness and programs for abused children and spouses are much further along than what is available for the elderly.

“In the early 1970s, this country recognized and encouraged the reporting of domestic abuse and child abuse, and people realized then we had an epidemic on our hands,” Reingold said. “Now if a child comes into a hospital with suspicious injuries, hospital workers must report it to the government. But if an elderly person comes in, they can look the other way.”

By the 1980s when legislation started to be enacted, elderly abuse was often trivialized as “granny bashing.”

“We’ve made a lot of headway,” Brooks said. “But we’re no way near where women’s advocacy and child abuse are. It’s all part of family violence, but regular shelters aren’t set up for older people.”

There are virtually no safe havens -- emergency short-term housing -- for elderly victims of abuse, according to Bob Blancato, national coordinator of the Elder Justice Coalition, which has been advocating federal legislation aimed at helping the elderly.

“As attention gets more focused on the growing problem of elder abuse, neglect and exploitation, you see different levels of response in communities around the country,” Blancato said. “This [program in New York] is a progressive example of what can be done.”

The Hebrew Home has been coordinating with local law enforcement in training officers to recognize abuse when they are called to take someone to the hospital. Part of the training is evaluating the veracity of explanations, such as, “Mom fell out of bed,” when an adult child or caregiver explains bruises.

It’s still not mandatory for police to report suspected abuse, but authorities increasingly are trying to train officers not “to take such an explanation at face value,” Reingold said. Even if an officer determines there is abuse, usually the only place to take the victim is a hospital emergency room.

Between 1 million and 2 million Americans older than 65 have been criminally mistreated by someone who is supposed to be protecting or caring for them, according to a 2003 report by a National Research Council panel.

In recent years, as the nursing home in the Bronx became more involved with the problem of abuse, the leaders decided to go the next step and start a shelter. With round-the-clock drop-off care for older people already in place, the nursing home was a good location for an emergency shelter, Reingold said.

The Harry and Jeanette Weinberg Center in Baltimore gave the Hebrew Home $1 million to start the shelter program and nearly $2 million more was raised through donations. Additionally, the home found community partners to provide support. The main goal is to get the victims out of the abusive environment and then help them find another place to live or a way to return home with support services.

“A lot of these people have been [treated dismissively], not allowed to make decisions,” said Brooks, who has worked with the seven people who have so far come through the shelter. “By and large the people who come to the shelter have been able to make their own decisions. They may be impaired, not because of dementia, but because they’ve lived with mistreatment for so long.”

As part of the program, the Hebrew Home has hooked up with the local doormen’s union to train them to spot abuse. At first the doormen were reluctant to take on such policing responsibilities. But their union supervisors acknowledged that they already informally were watching out for the “old ladies in the building and knew if the son was beating them up,” Reingold said. Now the Hebrew Home regularly sends a lawyer and nurse to the union hall for training sessions.

On the sprawling campus of the nursing home, which serves 900 clients, there is no way to spot clients who are there because of abuse. The staff protects their identity.

Reingold pointed out that nursing homes often have the built-in expertise to help these clients but not always the extra funds. Ultimately, the Hebrew Home in the Bronx plans to shelter 25 to 30 abuse victims in the facility at any given time. It costs about $25,000 for a two-month stay, with many of the costs picked up through government funding. Reingold says a lot of the success of such a program depends on linking law enforcement, health and social services in a given community.

“If you can link up in New York, well, it’s so much easier in a small community,” he said. “But our goal is not just to set up a shelter in the Bronx. We want to create a national model that can be replicated in every community in this country.”