One of the many roadblocks to an effective elder abuse response is the lack of holistic, intensive, wraparound services for victims. Elder abuse cases are extremely complex, and usually encompass many disparate, interlocking arenas of a victim's life. In addition to the deleterious impact of elder abuse on a victim's physical health, victimization profoundly affects the older adult's legal health. Victims of elder abuse may be facing eviction, foreclosure, consumer debt actions, or be the subject of a guardianship proceeding. Victims may have missing, inappropriate or exploitative advance planning documents. Poor physical and legal health, in turn, creates increased vulnerability to abuse, and an insidious cycle sets in, in which older adults are prone to re-victimization and their needs become ever more complex.
The aging body and brain, the specific legal issues and tools most relevant toward the end of life and our culture's assumptions and stereotypes around growing old coalesce to create a maelstrom that allows elder abuse to fester undetected. All of these factors must be addressed in order to restore victims' safety, independence and dignity. This complex confluence of factors requires a multidisciplinary approach to prevention and intervention that is both trauma-informed and specifically tailored to the needs of older adults.
With confidentiality as our watchword, attorneys are accustomed to working alone. To respond effectively to elder abuse, lawyers must reach out, working closely with medical practitioners to ensure legal remedies are appropriate and effective. Legal professionals can create best practices for integrating medical-legal partnerships into our work, complete with appropriate procedures for obtaining client consent and maximizing client capacity, which benefit our clients and enhance the impact of our legal work.
Elder Abuse Shelter
Our experience with this model of elder abuse prevention and intervention began in 2005, when we founded the Harry and Jeanette Weinberg Center for Elder Abuse Prevention at the Hebrew Home at Riverdale. Elder abuse is most often perpetrated by family members, which means home is often the most dangerous place when abuse is imminent or ongoing. However, typical emergency housing options such as homeless or domestic-violence shelters are often ill suited to older adults. Elder abuse victims often have medical needs – physical, cognitive and psychological - that cannot be accommodated in shelters, and the culture of shelters and the range of their services generally cater to a far younger demographic. Long-term care facilities are optimally positioned to fill this gap in elder abuse prevention and intervention services. Equally important, elder-abuse victims need legal advocacy that is far more complex than a long-term care facility is typically able to provide.
In response to this unique set of needs, the Weinberg Center has created a holistic service method that provides acute elder abuse victims with a safe and secure environment, a full continuum of medical, psychological, therapeutic and social services, and a tailored legal action plan created and executed by the Weinberg Center's attorneys. The multi-disciplinary Weinberg Center staff team works with Hebrew Home professionals to determine optimal placement, security and services for the client based on each individual's specific needs. The team creates a care plan for the client, including a discharge plan that will ultimately, if appropriate, enable a return home. The care plan is developed collaboratively by doctors, psychiatrists, social workers and attorneys, with the goal of improving physical, emotional and financial and legal security for the client. The legal team plans and executes all appropriate legal action, which can include procedures related to obtaining restraining orders, guardianship, orders of protection, assistance with Medicaid and financial planning, housing, negotiation and prosecution of abusers. Petitioning for guardianship may also be considered.
Additionally, RiverSpring Health, the healthcare system that operates the Hebrew Home, has integrated elder-abuse prevention and intervention throughout all of its services. Every new patient or client is screened for elder abuse at intake, and the Weinberg Center provides follow-up legal and social services support as needed. These services are coordinated with each person's medical service plan.
Lasting Legal Solutions
Legal and medical vulnerabilities are both risk factors and repercussions of elder abuse. To create lasting legal solutions, it can be helpful for attorneys to work with medical professionals to address victims' needs holistically. As Americans continue to age, and the field of elder justice continues to expand, the medical-legal model, as evidenced by early adopters like the Weinberg Center, has tremendous potential to help victims recover well-being and access justice.