The first comprehensive federal legislation to combat abuse, neglect, and financial exploitation of the elderly was introduced in the Senate last month.

Sens. John Breaux (D-La.), chair of the Senate Special Committee on Aging, and Orrin Hatch (R-Utah), ranking minority member of the Senate Judiciary Committee, introduced the Elder Justice Act to address pressing social and medical issues that are often ignored.

"Seniors are abused physically, sexually, and psychologically in our country every day. They also are victims of financial exploitation and neglect. The perpetrator may be a stranger, an acquaintance, a paid caregiver in an institution, a corporation, but far too often it is a spouse or a relative," remarked Breaux when he introduced the bill (S 2933), according to the Congressional Record.

Reported cases of elder abuse have risen more than 300 percent from 117,000 cases in 1986 to 470,000 cases in 2000, according to Heather Stowe, an expert on elder abuse at a conference on family violence at George Washington University last spring. Yet, only about one in 14 cases is reported to the authorities, said Stowe.

Breaux commented, "A single episode of maltreatment can cause someone living a productive life to spiral downward and result in depression, serious illness, or even death," according to the Congressional Record.

Compared with other family violence issues such as child abuse and violence against women, "elder abuse has not received sustained federal attention and resources," said Breaux.

The measure would establish an Office of Elder Justice at both the Department of Justice and Department of Health and Human Services (HHS) to develop a national strategy for combatting elder abuse. Initiatives would focus on prevention, training, treatment, evaluation, and research and would be coordinated at the federal, state, and local levels, according to the "Elder Justice Proposal." This proposal gives a detailed description of the Elder Justice Act.

To facilitate research activities, the new offices would develop a series of grants, studies, and demonstration projects that would be conducted by state, academic, private, and not-for-profit entities, according to the proposal. The offices would also be responsible for addressing the abuse, neglect, and exploitation of seniors living independently and in residential care facilities.

The General Accounting Office report titled "Nursing Homes: Many Shortcomings Exist in Efforts to Protect Residents From Abuse," released in March, found that most alleged incidents of sexual and physical abuse were not reported promptly to law enforcement officials and that few allegations were prosecuted. In addition, the report noted that there was no federal law requiring background checks of nursing home employees, according to the abstract.

The Breaux-Hatch bill calls for these initiatives:

• FBI criminal background checks for employees of long-term care facilities.

• Demonstration projects addressing shortages of staff in long-term-care facilities.

• Incentives to attract more health care professionals into positions serving seniors.

• Grants to educate and train law enforcement officers and prosecutors about elder abuse.

• Forensic training of geriatricians and new forensic centers to better detect elder abuse.

• Five new centers of excellence that would specialize in elder abuse, neglect, and exploitation. The centers would promote development in the field through expertise, research, clinical practices, training, and dissemination of information.

• A national resource center in the HHS Office of Elder Justice for consumers, families, providers, advocates, regulators, law enforcement, policymakers, and researchers.

Kenneth Sakauye, M.D., chair of APA’s Council on Aging, told Psychiatric News, "I commend the senators for introducing this bill, which focuses national attention on the issue of elder abuse, neglect, and exploitation. In my state of Louisiana, the department that was dedicated to elder abuse has been closed for about four years due to a lack of funds. Cases of elder abuse are being handled by the state section that deals with child abuse."

He continued, "As a clinician specializing in the treatment of the elderly, I have been aware of the lack of evidence-based models of care. I applaud the bill’s provisions that would fund new grants, studies, and demonstration projects on prevention, detection, and treatment."

Judith Crossett, M.D., chair of APA’s Committee on Access and Effectiveness of Psychiatric Services for the Elderly, told Psychiatric News, "There is a significant need for multidisciplinary training in how to clearly recognize issues of elder abuse and neglect and balance patients’ rights with risk of harm and competency determinations."

Breaux commented, "If we can unlock the mysteries of science and live longer, what do we gain if we fail to ensure that Americans also live better and longer lives with dignity?," according to the Congressional Record.

At press time, the bill had not moved out of the Senate Committee on Finance, and it was unlikely that it would see action in the 107th Congress, said Joy Cameron, Breaux’s legislative assistant.

The text of the Elder Justice Act can be accessed on the Web at http://thomas.loc.gov by searching on the bill number, S 2933. "Elder Justice Proposal of 2002" is posted on the Senate Special Committee on Aging Web site at http://aging.senate.gov/elderjustice/bill.pdf. ▪