The voices of Urban Institute's researchers and staff
June 17, 2014

Casey Kasem and elder abuse in the United States

June 17, 2014

Casey Kasem, the voice behind American Top 40, passed away on Sunday at the age of 82 after a highly publicized family conflict over the quality of his medical care. People like Casey Kasem often seem ageless to their audiences, while behind closed doors, they battle declining physical and mental health and increasingly rely on loved ones for daily care and important end-of-life decisions. News sources report that Kasem’s suspected cause of death was sepsis from an ulcerated bedsore, possibly a sign of neglect or improper care.

Was Kasem a victim of elder abuse? Though we don’t have an answer yet, his high-profile case underscores the importance of recognizing the signs of vulnerable adult abuse and understanding how this form of abuse is defined, processed, and treated nationwide.

What is elder abuse?

Yet even defining elder abuse can be complex. There is no uniform definition of elder abuse, and terms differ from jurisdiction to jurisdiction. But the National Adult Protective Services Association classifies the following eight types of mistreatment as elder abuse or vulnerable adult abuse:

  1. Physical abuse
  2. Emotional abuse
  3. Sexual abuse
  4. Neglect
  5. Self-neglect
  6. Isolation
  7. Abandonment
  8. Financial or material exploitation

How big is the problem?

Although Kasem’s story was plastered over newspapers and tabloids, according to the US Department of Health and Human Services, for every case of elder abuse documented, as many as five may go unreported, often because vulnerable adults are afraid to report abuse by their caregivers. Abuse can also go unnoticed by the victim because of his or her deteriorated mental or physical state, or because friends and family members are unsure of the signs of vulnerable adult abuse and are worried about the consequences of filing a potentially unsubstantiated report.

In an effort to grasp a more comprehensive understanding of this problem, Urban Institute researchers are conducting a national survey of Adult Protective Services (APS) agencies to learn about the types of cases they investigate, the data they collect, and the challenges they face. This research will bring us closer to an appreciation of the scope of elder abuse in the United States.

Elder abuse as a criminal justice issue

Our study also addresses how elder abuse, mistreatment, and neglect fit into a criminal justice framework. Are elder abuse cases treated as civil or criminal matters? Is law enforcement involved in addressing elder abuse?

It was only recently that laws came to recognize the criminal nature of elder abuse. The Elder Justice Act, enacted in 2010 as part of the Affordable Care Act, is the first elder-related federal law to provide significant funding for research and practice specifically targeting the criminal justice system’s role in combating elder abuse.

Those who witnessed a similar evolution of efforts and investments to combat domestic violence see the recognition of the criminal nature of elder abuse as a step forward. Until recently, law enforcement was considered a last resort because elder abuse was thought to be caused primarily by caregiver stress rather than by criminally violent tendencies. Changes in this attitude are apparent in the Elder Justice Act, which, for example, requires immediate reporting to law enforcement of abuse committed in long-term care facilities.

But much work still needs to be done, particularly at the state and local levels, where there are still too few comprehensive criminal statutes that address elder abuse. With elections on the horizon and Casey Kasem’s legacy on our minds, it is important to recognize the pressing nature of elder and vulnerable adult abuse as a criminal justice issue, a public health issue, and ultimately, a human rights issue for which we all are responsible.

If you think someone you know may be a victim of elder or vulnerable adult abuse, neglect, or exploitation, visit The National Adult Protective Services Association’s website to learn how to make a report.

An elderly woman who has suffered abuse by a relative watches "I Love Lucy" on a television inside her room at Cedar Village retirement community in Mason, Ohio. (AP Photo/Al Behrman)

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Comments

Is there any information on elder abuse of DNR agreements that have been made when the patient lives in nursing homes or receives hospice care?

Most APS cases wind up thrusting people into guardianship where the problems may actually continue. Guardianship, once a good law, has created a feeding frenzy for court-appointed fiduciaries. When they finish billing a ward's estate to death, they put the ward on Medicaid at public expense. This is an ironic twist because one of the purposes of the law is to avoid a vulnerable person becoming a public charge.

Wow, what a shocker! This peaks to the vital importance of the need for a Living Will by all of us!