Fireside Chat on Elder Justice and Caring for Older Adults
Laura Borth, MS, RD, Policy Analyst, Elder Justice Coalition
September 27, 2023
As we look to the future of elder justice, it’s essential to address the hurdles that have hindered progress. The annual Fireside Chat held by The National Center for Elder Abuse (NCEA) and the Elder Justice Coalition (EJC) featured passionate conversation from Bob Blancato, National Coordinator of EJC, Dr. Laura Mosqueda, Director of NCEA, and Nicole Howell, former Health Policy Advisor with U.S. Congressman Bill Pascrell. The panelists discussed the challenges of gaining congressional support for the Elder Justice Reauthorization and Modernization Act (S.1198, H.R.2718) and persistent issues related to long-term care facilities. Below are key takeaways of their conversation.
Nursing Home Reform
Nursing homes play a crucial role in providing residential care to approximately 1.3 million ailing older people. Yet, the quality of resident life and care has long been both a concern for residents and a health policy issue for society. Among the challenges in long-term care, maintaining adequate staffing to meaningfully support residents is key. Minimum staffing standards are essential to high-quality care provision for residents. Greater transparency and accountability of facility operations is equally important, as are mechanisms to address long-standing issues of staff burnout. Staff recognition and supportive work environments can be bolstered through initiatives like the nursing home worker training grants promulgated in the Elder Justice Reauthorization and Modernization Act that address enhancing staff training, compensation, career development, and retention.
Funding, Framing, and Bipartisanship
The most significant roadblock to elder justice has been the continuing challenge of funding for the Elder Justice Act (Act), which was established as part of the Affordable Care Act of 2010. While the Act aimed to ensure the safety and well-being of older adults, it has often struggled to secure the necessary financial support. However, the pandemic shed light on the urgency of providing proper care and living conditions for long-term care residents, and the need for funding to secure these goals.
Funding for the Act isn’t just an expenditure; it’s an investment in the safety and dignity of our older population. By reframing the conversation as “elder abuse prevention,” we can evoke a stronger sense of exigency and commitment. Federal monies allocated during the pandemic to address deficits in nursing home care were wisely used, underscoring the necessity of a sustained and well-supported effort. The Act was designed to be bipartisan, intended to appeal to constituents across the political spectrum. Localizing and humanizing the issue can encourage greater resonance and garner broader, support for the Act. Educating policymakers and the public about the challenges faced by older adults and caregivers can go a long way in securing support for meaningful change.
Education and Data Collection
Initiatives to educate policymakers and the public must be inclusive, embracing diverse and historically underserved constituencies. Outreach requires a nuanced understanding of the perceptions and concerns of different communities. There is a critical need for tailored research and data collection within minority and tribal communities to better recognize, track, and respond to incidents of abuse. This knowledge will inform culturally sensitive education and training to better respond to the needs of the growing diverse older cohort and facilitate a more comprehensive, representative approach to elder justice. Education remains a powerful tool in driving change, both at the federal and local levels. By sharing stories and data with policymakers, we can shape policies that improve the quality of life for older adults. A case that was recently brought to our attention is illustrative. An older veteran experienced a sweetheart scam, where a young woman moved in with him and fleeced him out of his life savings. He was willing to testify before the Senate committee to share his story. These accounts of abuse can educate, prompt us to identify potential allies, and amplify the call for change.
Innovation and collaboration are promising routes to transforming care for older adults. As demonstrated during the pandemic, novel initiatives were undertaken by, among others, area agencies and nutrition providers to forge partnerships with the business community. This relationship serves as a model for the types of relationships that can be leveraged to better support older people. On the horizon, we will be seeing strategies such as artificial intelligence to advance abuse prevention efforts, but recognize that innovations must be applied responsibly and ethically.
Elder justice within facility settings is a challenging arena that requires sufficient funding, collaboration, and a focus on quality outcomes to create supportive and healthy environments for older adults and providers. Through education, coordinated efforts, commitment, and compassionate care, we can create a future where older adults can thrive and are protected from abuse and neglect.