End-of-Life Choice, Palliative Care and Counseling

Elder Abuse – A National Tragedyby Chris

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By Ashley Carson Cottingham
National Field Director

On June 15, World Elder Abuse Awareness Day, we take time to acknowledge that an estimated 2.1 million older Americans fall victim to elder abuse, neglect and financial exploitation each year. At Compassion & Choices we work diligently to protect older adults by upholding their rights at the end of life, sometimes when they are no longer able to speak for themselves. And this year we became proud members of the Elder Justice Coalition in Washington, D.C.

Elder abuse occurs on a regular basis, affecting some of the most vulnerable members of our society. What’s even worse is that for every reported case of elder abuse, neglect and exploitation, experts believe there are five that go unreported. We must put an end to it.

Our work has exposed a form of elder abuse that is rarely discussed. It occurs when an older adult’s expressed wishes at the end of life are ignored, and as a result they are subjected to unwanted and invasive medical treatment. We believe this unwanted treatment absolutely constitutes elder abuse.

For example, when 92-year-old Marjorie Mangiaruca received full cardiopulmonary resuscitation including a tracheotomy in violation of the clear terms of her Do Not Resuscitate Order and consequently endured a long, slow death in the hospital, that was elder abuse. Right now, Compassion & Choices is helping her daughter bring this case to court in Florida.

When 85-year old William Bergman was dying of mesothelioma and moaned in pain with each breath while his daughter pleaded with doctors to prescribe more effective pain medication – and they did not – that was elder abuse. Compassion & Choices won a court judgment to that effect, the first of its kind, in 2001.

Our client Margaret Furlong went to the hospital at age 82 armed with her advance directive, which explained her personal wishes for treatment. She presented the document to the admitting doctors and relied on it to prevent invasive rescue procedures if she collapsed. Sadly, when she had a cardiac arrest, medical staff began a series of unwanted procedures to restart her heart and lungs, and she later awoke in the intensive care unit. When she pulled on the tubes, they tied her hands. When she squeezed her son’s hand and tried to tell him she wanted the machines turned off, they ignored her pleas. After ten days tethered to machines, Margaret’s condition continued to decline, and doctors finally agreed to disconnect life support. No one should have to endure this type of abuse in their final days.

For World Elder Abuse Day 2013, the United Nations’ Secretary General, Ban Ki-moon’s message states, “We owe it to older persons and societies at large to fight ageism in all its forms, and enhance the dignity and human rights of older persons everywhere.” Compassion & Choices couldn’t agree more.

The time is now to end elder abuse, neglect and exploitation. As a nation we must dedicate the same type of attention and resources toward this national tragedy as we do toward eradicating child abuse and domestic violence. Older Americans deserve to live their golden years free of abuse, and according to their rights and end-of-life wishes