Experts urge focus on abuse of elders outside of nursing homes

May 17--Kathy Greenlee and Derek Schmidt run in different political circles, but they have a similar message on elder abuse: We need to do more to stop it from happening outside of nursing homes.

Schmidt, a Republican who is the Kansas attorney general, is joining other attorneys general in asking the federal government for more authority to investigate elder abuse outside of care facilities. Greenlee, a former Obama administration official, is using her new position with the Center for Practical Bioethics to enlist community groups and financial institutions to keep an eye out for it.

"Most abuse happens in the community, because that's where most of the people live," Greenlee said. "I have talked to people who make the mistake of thinking that the only abuse occurs when you're in a nursing home or another congregate setting, and that's not true."

Greenlee said one in 10 Americans over 65 who live at home are abused physically, emotionally, sexually or financially.

Federal regulations only allow state Medicaid Fraud Control Units to go after suspected abuse in health care and nursing facilities, even though Medicaid also pays for in-home caregivers who can be abusers.

As president-elect of the National Association of Attorneys General, Schmidt co-wrote a letter to Tom Price, the new secretary of the U.S. Department of Health and Human Services, asking that the fraud units be turned loose to investigate and prosecute elder abuse wherever it occurs.

Schmidt said the Medicaid Fraud Control Units are a "force multiplier" that is especially important to smaller states because the federal government picks up a large portion of their costs.

He helped push through stiffer penalties for elder abuse in Kansas in 2014 and set up a new fraud and abuse division within his department. But the state-funded division has only two prosecutors and one officer. The Kansas MFCU has slots for four prosecutors, six or seven officers and two or three research analysts.

"It's a potent tool, and we just want to be able to use it to the fullest extent we can," Schmidt said.

Greenlee, who served as assistant secretary for aging under President Barack Obama, is now looking for elder abuse solutions outside the government.

She is speaking at the Jewish Community Campus in Overland Park on Thursday and said she wants to discuss how faith-based organizations can keep seniors engaged with the community. If they become socially isolated, it increases the chance that they will be abused.

"This is what I think pastoral care is for older people," Greenlee said. "To remain engaged."

Greenlee said she's planning to have Adult Protective Services workers from both Missouri and Kansas at the presentation to help explain what they do and how community members can report suspected abuse.

Seniors who live at home are vulnerable to abuse from paid caregivers or family members.

"Family caregivers are still the backbone in the long-term care system in our country," Greenlee said. "We need family caregivers to continue to do the work. But we cannot be naive in thinking that all families are functional and healthy and supportive of older people. That's not true."

Greenlee said that when she worked as the ombudsman for long-term care in Kansas state government from 2004 to 2006, she saw family members steal money from older people to buy things like boats. She also saw family members hoard an older person's money to bulk up the future inheritance even as the senior suffered.

She said that since joining the Center for Practical Bioethics in November, she's contacted banks and investment firms to talk about how to spot financial abuse and intervene on behalf of their customers.

"I would say I've seen progress with that community coming to the table," Greenlee said. "That's an entire multilayered industry that can be deployed as an asset on behalf of people to help provide protection, but it's very complicated. ... I think some of them have their eyes open, and some don't."

It will take more than banks, churches and synagogues to protect elders from abuse, Greenlee said. There's a pervasive "age-ism" in society that she said tends to keep older people from being integrated in communities. That's dangerous.

"If older people are hidden and not seen, elder abuse will be as well," Greenlee said.

Andy Marso: 816-234-4055, @andymarso

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