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March 28, 2024

Elder Justice in 2024

David Godfrey, JD
The PDF for this issue which includes footnotes and endnotes can be found at here.

Elder Justice is a complicated multidisciplinary issue. The majority of abuse of adults is committed by family, friends, and caregivers. The relationship between the survivor of abuse, and the perpetrator of abuse shapes what is needed to create elder justice. Erica Costello, Director of the Commission on Law and Aging, and I attended Innovative Elder Justice: New Ways of Using Law, Medicine and Technology to Address Abuse and Financial Exploitation in an Aging Society, at Yale Law School on February 16, 2024. The program examined the state of the art on Elder Justice and reviewed promising practices for the future.

United States Senator Richard Blumenthal opened the program with remarks about elder abuse and federal action.  Bipartisan support is essential to success in Congress, and elder abuse is a deeply bipartisan issue. He recently participated in a hearing by the United States Senate Special Committee on Aging on artificial intelligence, voice cloning and scams to financially exploit older adults. He talked about the need not just for reporting, but for oversight and investigation.  Senator Blumenthal spoke of the important leadership role that the federal government can take in supporting states in updating laws and practices to prevent abuse and intervene when abuse happens, and  how the Federal government can support the states and the state courts in guardianship reform.

There were several reoccurring themes through-out the day.


Someplace between 70% and 90% of perpetrators of abuse, neglect, or exploitation are known to the adult who experiences the act of abuse.  Often the abuser is a family member, close friend, or caregiver.  The relationship between the person being abused and the abuser creates barriers to reporting, intervention and remediation.  A real fear of a loss of a social relationship or a needed caregiver means many adults won’t report abuse, and if asked about it will deny what happened.  Reporting is embarrassing. Many adults are fiercely independent.  Adults will tolerate abuse to live the they want to live, with relationships with those they want relationships with.

Prevention is Needed

MT Connolly said, “our biggest failure is a lack of prevention.”  We need to inform both older adults and those around them on what is abuse,  neglect or exploitation; how to prevent it, and what to do when it happens.  We know the majority of abuse is perpetrated by family, friends and caregivers. Prevention needs to focus on changing the behavior of this group. We need to provide supports and services to family members and caregivers.  Caregivers are often untrained or undertrained, over worked, and unsupported. Prevention is helping caregivers be better caregivers.  Laura Mosqueda of the National Center on Elder Abuse said “we must go upstream with education” about abuse and exploitation.  With at least 70% of abuse being by a person known by the person experiencing abuse we need to focus prevention and intervention on methods that protect and preserve relationships and caregiving in the environment the person wants. Cathy Greenlee reminded the attendees that self-advocacy if often missing in prevention and response to abuse. The Restorative Justice Model offers promise for person centered resolution, that heals the relationships in ways that are driven by the survivor of abuse.

Abuse is Underreported

The speakers reported that someplace between 1 in 10 and 1 in 48 incidents of abuse are reporting and appear in the statistics.  There are various barriers to reporting.  Fear of stigma, embarrassment, loss of independence, loss of social connection or loss of caregivers lead to a refusal to report by many older adults. 

Reporting and Data are Difficult

Senator Blumenthal spoke of the difference between data from reporting, and data from oversight or investigation. To fully understand the issue, we need more than the data that is currently collected.  Data collection is hampered by states having widely varying laws on reporting and defining abuse.  The criteria for who adult protective services can help, and the definitions of abuse , vary from state to state, making it difficult to draw meaningful inferences from the reports. There is no Uniform or model law on adult abuse..

A major challenge is funding is hard to get without data, and good data requires funded research.  It is long past time to break this paradox.

Promising Practices

Restorative Justice is social services based intervention that brings together the person who is experiencing maltreatment, and the persons who have caused it, to seek resolution and healing in a way that the older adult wishes.  This approach has been slowly expanding over the past 15 years and shows great promise.

Medical Legal partnerships bring a multidisciplinary approach to improving quality of life of persons receiving health care.  Elder focused medial legal partnerships, like the one at Yale, consistently show positive outcomes.

There was a discussion of the increased use of technology and artificial intelligence to spot anomalies that are indicative of abuse, neglect or exploitation.  Systems are being developed to train a wide array of professionals to ask questions, that lead, often indirectly, to a person who can be helped.

The closing speaker was David Owen, a writer for The New Yorker, with a personal narrative of his mother being financially exploited in a classic lottery scam.  His touching first-hand account illustrated how well-meaning people with strong families are manipulated by criminals looking to steal their life savings.

The program was offered without charge to attendees, made possible by the Oscar M. Ruebhausen Fund. I sincerely hope that this is the first in a series of these programs.

David Godrey, JD

Washington DC

David Godrey, JD, is an author, trainer, and consultant. He retired as Director of the ABA Commission on Law and Aging in Washington DC. Prior to joining the Commission, he was responsible for elder law programming at the Access to Justice Foundation in Kentucky. Mr. Godfrey earned his B.A. with honors at Rollins College in Winter Park, Florida, and his J.D. cum laude from the University of Louisville School of Law in Kentucky. He served on the board of the National Academy of Elder Law Attorneys – and was named a Fellow of the Academy in 2019.

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