'This is what it's all about'

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James M. Berklan
James M. Berklan

One line, more than any other, hit home during my discussion with Carol Silver Elliott on Wednesday.

“If we're really in the business of taking care of older adults, this is what it's all about.”

The essence of eldercare. Here it was.

Elliott is passionate about the SPRiNG Alliance, a network of 14 long-term care providers that have made caring for abused elders a focal point. (SPRiNG stands for Shelter Partners — Regional, National, Global.) Elliott's Jewish Home Family in Bergen County recently became the latest provider, and first in New Jersey, to offer free care for abused elders.

We're talking a bed, meals, personal services and programming free for up to four months. It's the least that can be done, Elliott feels.

“The opportunity to potentially save someone's life is not insignificant,” she said. “The first time I opened this at Cedar Village [in Cincinnati], I said I didn't know why everyone doesn't do this.”

Jewish Home Family's SeniorHaven has hosted one abused senior so far, and none too soon, Elliott believes.

“I feel quite confident we saved this woman's life, and for us, as an organization, that's something that really resonates — not just with staff but with the board and community as well.”

The fact that there has been just one abused person served thus far is part of Elliott's appeal to fellow providers to take up the cause.

“We're not talking about serving hundreds of victims,” she explained. At Jewish Home Family, “we're talking about an anticipated admission rate of maybe three a year.”

While she understands their concerns, she discounts fellow providers' worries about possibly harming their bottom lines with free care.

“We're all committed to making census, but I don't think having one [free] person in your building a quarter, or two a year, will make that much difference in your financial well-being.”

If the abuse victim's stay can be billed to Medicaid or is eligible for rehab, “of course we bill,” Elliott added. Otherwise, agreements have been forged with medical directors, pharmacy providers and others for free care — including ambulette drivers who might be needed for transfer to other facilities if hers is full.

“It sends a message to the community, and also to referral sources,” Elliott says in a rapid-fire cadence that takes over when she discusses the topic. “They see you in a different light when they see you out there walking the walk, and not just talking the talk. How do we turn our backs on a population that is the most vulnerable, yet least likely to get what they need?”

The first elder abuse shelter in the country in a long-term care setting opened about a dozen years ago in the Bronx, NY, at what is now known as RiverSpring Health. That has grown into the SPRiNG Alliance, whose members openly share ideas and resources, monthly by phone and once a year in person.

“All the shelters are really working off the same sheet,” Elliott told me. “We share protocols, policies and materials. We're all in this together. There's nothing territorial about this.”

There can't afford to be. Estimates say there are at least 3.5 million victims of elder abuse annually. RiverSpring takes in about 12 victims per year, while Elliott's Cincinnati location averaged five. “We haven't even scratched the surface," she noted.

While the conversion rate for those suffering domestic abuse from initial identification to reporting to a shelter is 70%, the rate is just 10% for older abuse victims, Elliott explained. Whether it's physical, emotional, sexual, neglect or some other form of abuse, usually there's “a level of financial exploitation” involved, she added.

Helping the abused is an uphill battle because older adults find it very hard to come forward with claims. That's partly because their children or grandchildren are often the abusers, creating embarrassment or humiliation, Elliott observed.

Abuse victims arrive at the LTC shelters only after an intervention by authorities or some other group. Planning for discharge begins as soon as the victim arrives. Often, there's another adult child in the area who knows nothing about the mistreatment and takes in the victim. Others relocate to assisted living facilities or quarters away from the abuser.

Elliott emphasized that most long-term care providers could easily offer abused adult services — and should. Members of the SPRiNG Alliance are always willing to answer questions and offer advice, she offered.

“Honestly, the most important thing is the willingness to make it work, and staff committed to it,” she said. “The irony is, this is a very small piece of the puzzle, with a very big impact.”

In other words, the essence of senior care.

Follow James M. Berklan @JimBerklan.


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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.