Elder Abuse: Another COVID-19 Evil
In the summer of 2019, my 90-year-old grandmother was placed in an assisted living facility. My grandmother had been diagnosed with dementia and my mother, her sole caregiver, felt guilty about placing her mother in a nursing home. It was a difficult decision for our family, but we knew it was for the best.
You think that you will be able to take care of your parents when they get a certain age," my mother explained. "But we had to do what's best for her no matter what."
In her new home, my grandmother's communication and mental capacity have improved due to new friends and environment. But this isn't the case for all nursing home residents, especially those who serve low-income communities.
The 2019 Profile of Older Americans published in May 2020 by the Administration on Aging (AoA), found that the 85-and-older population of African Americans make up 18.9 percent of the poverty in the United States compared with 7.3 percent of non-Hispanic whites and 11.7 percent of Asians. In addition, Forbesmagazine reported that in 2019 that 14.9 percent of African Americans earned lower wages than Whites.
This wealth disparity impacts retirement savings and care later in life.
A 2015 study by the National Institute on Minority Health and Health Disparities titled, Deficiencies In Care At Nursing Homes And Racial/Ethnic Disparities Across Homes Fell, 2006–11,noted: that "Despite the increased use of nursing homes by minority residents, nursing home care remains highly segregated. Compared to whites, racial/ethnic minorities tend to be cared for in facilities with limited clinical and financial resources, low nurse staffing levels, and a relatively high number of care deficiency citations."
Lisa Nerenberg, executive director of the California Elder Justice Coalition, said that nursing home facilities with limited resources have seen a rising number of COVID cases.
"There's poorer care in facilities that have less affluent residents and more residents of color generally and that's translated to COVID," Nerenberg said.
The pandemic only made conditions worse for residents who were cut off from family and loved ones because of social-distancing requirements.
The grandparents of Samantha A. Wallace have dementia and are in a facility in Orlando, Florida. The senior care facility follows strict guidelines to assure the safety of residents. This includes social distancing and 14-day quarantining when necessary.
According to a 2009 study published in the Industrial Psychiatry Journal, the lack of communication from family and friends has a covert effect on the minds and functionality of elders, especially those with Alzheimer's or dementia. In their limited visits, the Wallace family listens for cues of distress from their loved ones.
"Because we know them so well, we look for how they sound," Wallace said. "There have been times when we've said, 'No. We want them to go to the hospital.' If they sound faint or weak, we want to know what's happening."
One way Samantha's mother, Carolyn Wallace, has managed to keep close eyes on her parents is to build relationships with the staff. She has an open line of communication with their personal care nurses to stay on top of their care. "When you have a relationship with a particular nurse or a [certified nurse assistant] on the different shifts, you'll know if they're telling you the truth," she explained.
And even though a few COVID-19 cases happened at the nursing home, the Wallace family were kept informed on how each case was handled and whether the facility followed proper protocol to protect healthy residents.
Karyne Jones, president and CEO of the National Caucus and Center on Black Aging, based in Washington, D.C., has been building programs for the elderly in African American communities since 1970 to keep them vital, thriving, and independent. She's noticed that the number of fraud cases has increased among the elderly since the pandemic, which left many people unemployed and cash strapped.
"[There's] a lot of fraud that's coming in by telephone. They'll call and say, 'You know, we represent a certain company, and we can help you with this or that, and just give us your credit card,'" Jones noted. "There's so many scams, and so many people take advantage. Unfortunately, people don't know where to go to report it."
The biggest culprit on elder abuse, however, is not strangers, Jones pointed out, but family members. Caregivers might "take over their finances because they have dementia and are incapable of taking care of themselves."
"They're in their house. They know where their checkbook is. They know where the credit cards are," Jones said.
Nerenberg agreed. Familial caregivers can often "end up neglecting the person," she said.
Jones and Nerenberg's observations are on point. A study by the National Care Planning Council found that 90 percent of elder abuse cases are perpetrated by family members.
The elderly population is among the most fragile members of society, and the COVID-19 pandemic has highlighted the disparities between African American communities and others. Below are organizations with more information on Black seniors.
The Centers for Disease Control and Prevention released Preparing for Covid-19 in Nursing Homes at the beginning of the pandemic that lists nursing home regulations.
If you're looking for a list of safe care facilities and nursing homes, visit the AARP's long-term scorecard for Nursing Homes and Medicare.gov.
To report any type of elder abuse, the National Adult Protective Services Association can guide you to the help you need.
If you suspect elder fraud, the Institute on Aging has created a help line to crack down on fraud cases.
This article was written with the support of a journalism fellowship from The Gerontological Society of America, The Journalists Network on Generations, and the The Commonwealth Fund.