San Diego County District Attorney Summer Stephan once said "Our civilization will be judged on how we treat our youngest and our oldest members." Indeed, if that's true, what does it say that, according to Public Policy Polling, "One in five over the age of 65 are subject to elder financial exploitation, which is the most prevalent form of abuse—and is growing in frequency and severity." Elder abuse is everyone's concern – but perhaps the first step is to understand not only the problem but to find a model for addressing this epidemic.
Check out this recorded webinar as Philip Marshall returns to address this very issue by:
- Sharing an overview of his Upstandership™ model of elder justice,
- Discussing practical, real world applications of the model,
- Exploring how this model can inform justice professionals work.
Justice Clearinghouse Editors (JCH): What inspired you to develop this model?
Philip Marshall: My advocacy for elder justice is directly related to the sad circumstances surrounding my grandmother, Brooke Astor. As you may know, she was a New York City philanthropist who was a victim of multiple forms of abuse and financial exploitation by her son, Anthony Marshall, who was my late father.
After my hard-learned experience in helping save my grandmother, I looked for a practical model to help other people—especially those who are actively engaged in supporting seniors—to stand up to alleged or actual abuse.
I discovered that for individuals to stand up and act, they need to know that their own community has their back. This goes to the heart of realizing our social compact, the agreement between individuals and society to restore justice by stopping injustice.
So, I started exploring ways we can cultivate community concern and capacity to serve proactively to save our seniors and their circles of support. I was looking for a model that promotes personal responsibility to stand up to injustice, because unfortunately, far too many crimes against all segments of society are not reported.
When it comes to seniors, only one in 23 cases of elder abuse are reported, and one in 43 cases of elder financial exploitation are reported, as estimated in a groundbreaking New York study, Under the Radar: New York State Elder Abuse Prevalence Study. The severity of abuse varies—but all forms of elder abuse pose a serious threat to seniors.
Beyond the fray of the news cycle every day, my grandmother’s case brought attention to “getting people talking about the needs of the elderly,” as described in a 2006 New York Times editorial titled “The Brooke Astor Effect.”
Speaking about abuse, and speaking out when there is abuse, is critical—as our silence protects perpetrators, not their victims. Today, victims of these crimes may be strangers. Tomorrow, they may be our loved ones, or perhaps, in the future, we may be victimized. Seniors and society deserve more. I can’t stress this enough: To be complacent about elder justice is to be complicit in elder abuse.
We must stand up to help seniors and their communities affected by abuse.
Speaking about abuse, and speaking out (when there is abuse),
is critical—as our silence…protects perpetrators, not their victims.
Let me step back and define elder abuse (which, here, does not include fraud).
If you don't fix on the figures, such as my grandmother’s wealth and her longevity, she fits the profile of all too many elder-abuse victims—at first glance, she had fewer risk factors, but it doesn't take many for damage and suffering to occur. As a victim, she was a woman with cognitive impairment and was subject to undue influence. She lacked social support as a result of being deliberately isolated, and her only child, my father, was emotionally and financially dependent on her. The abuse she suffered began when her cognition was impaired by Alzheimer’s disease. According to the Alzheimer’s Association, more than 5.7 million Americans are living with the disease, which also directly affects the 16.1 million Americans who are unpaid caregivers for those with dementia.
One way to describe elder abuse is that it is a power imbalance in a trust relationship. Elder abuse involves an intentional act, or failure to act, by a caregiver or another person in a relationship involving an expectation of trust. Abuse causes or creates a risk of harm to an older adult.
Elder abuse includes many forms: financial exploitation, psychological abuse and manipulation, deprivation, neglect (including self-neglect), isolation, abandonment, restraint (physical and chemical), and physical and sexual abuse. Frequently, there is co-morbidity with seniors poly-victimized and re-victimized—as happened to my grandmother, and as happens to millions of seniors every day.
Forms, frequency, and duration of abuse may be “enhanced” and escalated, especially where there is an intimate, long-term relationship between victim and perpetrator, as typically happens, especially with hybrid financial exploitation, when various forms of abuse are strategically delivered, in tandem with coercion, to advance a perpetrator’s desires and thievery.
Among all forms of abuse, hybrid financial exploitation is perhaps the most entrenched and intractable because it is characterized by mutual dependency between the elderly person and the perpetrator. It is the most difficult for Adult Protective Services to investigate, and carries with it the most draconian outcomes for the victims who are most likely to be appointed a guardian.
This means that elder abuse is a chronic form of injustice— approximately one in 10 seniors over the age of 60 living at home are subject to abuse. One in five over the age of 65 are subject to elder financial exploitation, which is the most prevalent form of abuse—and is growing in frequency and severity. Seniors are not safe, but it’s safe to say that elder abuse is a national health epidemic.
Elder abuse is different from other forms of domestic violence given the likely increasing vulnerability of seniors, their possible cognitive impairment (including Alzheimer’s disease), a great amount of their collective wealth being easily accessible to abusers, along with many other factors.
As stated by Mark Blyth, a professor of political economics at Brown University's Watson Institute, “80 percent of all financial assets are owned by baby boomers.” In short, elder abuse impacts at-risk, vulnerable older Americans, and we need to stand up for them, individually, and as a community.
Elder abuse is a chronic form of injustice—
approximately one in 10 seniors over the age of 60 living at home are subject to abuse.
Permission to Act
Reflecting on my grandmother’s sad circumstances before I acted, I wonder how many trusted family, friends, neighbors, and professionals share a similar situation yet do not know what to do, or who to turn to. Before I took action on my grandmother’s behalf, I was filled with angst, frustration, and a sense of impotence as I watched her world, which spanned the globe and a century, become so diminished and compromised by her son.
With the help of her staff, one January evening I was able to gain access to my grandmother without alerting my father. I visited her for what I thought might the last time. On my way out, visibly shaken, I embraced her attending nurse. We realized we were actually embracing an opportunity to talk, because another nurse had just arrived to begin her shift.
With my grandmother asleep, we three spoke at length, shared sad stories, concern, support—and, above all trust. This was the signal moment that spurred me to act—to decide to stop being a bystander and become an “upstander.”
But it took me—or I should say “us”—six months of planning and gathering an “A Team” together before I was able to act, when I petitioned the courts for a guardianship, which was subsequently awarded, for my grandmother.
While elder abuse is the betrayal of trust, elder justice is the provision of trust through relationships and responsibility. The term “trust” has many meanings, but two are vitally important when it comes to addressing any social injustice—and Upstandership™.
When someone says “I trust you,” to a person in a position of responsibility, they mean it in two ways: they trust that person’s morals and they trust that person’s technical ability to achieve something—for instance, piloting the plane you are on. You need both forms of trust to realize social justice. To quote Nassim Nicholas Taleb, “In the real world it is hard to disentangle ethics on one hand from knowledge and competence on the other.”
So, to address social injustice we need a model that combines personal/professional responsibility with community “response ability”—or the ability to respond—otherwise our agency will be diminished and matters will get worse.
I am compelled to explore ways to help citizens and their circles of support to stand up to injustice and to explore ways we can serve and save our citizens at all “skin in the game.”
Initially, I explored and incorporated aspects of the concept of “bystander intervention” that, while helpful, has three drawbacks: It has negative connotations associated with the “bystander effect,” or not helping; it typically informs acute, but not chronic, forms of social injustice; and it does not apply a strengths-based approach to realizing our social compact between society and self.
One in five over the age of 65 are subject to elder financial exploitation
which is the most prevalent form of abuse—and is growing in frequency and severity…
JCH: You talk about Upstandership™ in terms of elder abuse. How could the theory of Upstandership™ be applied to other forms of violence—ie: animal abuse, child abuse spousal abuse.
Philip: The beauty of Upstandership™ is it can be applied to all forms of chronic or acute injustice. It has helped me frame my work in addressing abuse, however, elder justice is in its infancy compared to other realms that define our social, legal, and moral obligations. As noted by the National Center on Elder Abuse, “…knowledge about elder abuse lags as much as two decades behind the fields of child abuse and domestic violence.” So, I need your help. The truth is, we need to help each other.
Other realms of social justice are much more advanced and, as such, provide many more resources that can be used to explore Upstandership™. In fact, we all have so much to learn from, and with, each other when it comes to justice.
Elder abuse is a systemic problem that needs systems-based solutions with justice professionals working together at all levels, community- and country-wide. And, while elder justice is “new,” it’s coming of age. Here, elder justice can help complete, not compete with, other causes—mindful of Hegel’s claim, paraphrased, that, “the conflict is not between good and evil but between goods that are each making too exclusive a claim.”
This said: as a model, Upstandership™ is evolving, thanks to input from professionals. I also welcome hearing about other models that can help us realize justice.
When it comes to abuse, we seem to be wending our way alphabetically, starting with animal abuse, then child abuse (with case law on animal abuse informing its development), then domestic abuse (or intimate partner abuse), and now elder abuse—which frequently needs to be seen through the lens of domestic abuse, more.
In addressing abuse in the context of an expectation of trust, to date our national priorities are indicated by our federal funding levels on abuse and neglect, with child abuse receiving over 91%; domestic abuse, 7%; and elder abuse, 2%.
To help justice professionals understand its application in everyday practice, let me describe the eight steps of Upstandership™ that are articulated on their own terms and then in relation to each other.
JCH: How can justice professionals apply the concept of Upstandership™ in their everyday practices?
Philip: To help justice professionals understand its application in everyday practice, let me describe the eight steps of Upstandership™ that are articulated on their own terms and then in relation to each other.
As a preliminary, we must gain attention since daily displacement activities keep us away from this place, here and now—attending to our communities, ourselves, and our future selves.
Lack of attention to anything of importance is typically due to a dependency or an addiction. Here, it starts with our dependency on social media and its dopamine-infused instant gratification—over delayed gratification that, in part, is informed by our fear of the future, especially when it comes to aging.
Awareness fosters our connection with issues. Awareness is achieved by publically (re)framing social issues, developing narratives, and sharing stories to facilitate personal, trans-professional, and communitywide communication—aided by cognitive and social scientific findings—toward discourse and change through shared solutions.
Awareness is abstract (or even counterproductive, as it may “normalize” pathological patterns) unless personally relevant, rooted in shared values, and seen through the lens of humanity.
To foster greater awareness the FrameWorks Institute has done so much to reframe social-justice issues—including aging, demographic change, and elder abuse.
Through its Strategic Frame Analysis™, the institute maps the gaps between expert and public understandings of issues, and then identifies more effective ways of reframing critical issues to inform everything from policy to practice.
When we know we begin to notice. Through knowledge, we acknowledge alleged or actual injustice, victims and their needs, others in victims’ circles of support, contextual dangers, concern for safety, and community concern and capacity.
Through personal knowledge, or gnosis, we acknowledge our personal and/or professional responsibility to act, realizing that to be complacent about justice is to be complicit in abuse; and our silence protects perpetrators, not their victims. This compels us toward action.
Action happens when we report, refer, or intervene. Reporting of actual or alleged criminal acts (such as abuse) may be mandated or permissive. Acute situations demand professional first responders, such as law enforcement and Adult Protective Services. However, many circumstances are brought to light by inadequate, circumstantial evidence. Even if evidence is available, it may be insufficient to arrest injustice. As frustrating as it may be, premature action without a plan and community resources, may be inadequate to help. It may be dangerous, too. Sometimes, circumstances may get worse before becoming better.
With uncertainty and the risk of harm and failure at hand, action is realized through the relationship between Upstanders as trustors, those who place their trust (and confidence) in their community who, as trustees, serve and save. Our action balances between our personal responsibility and our community’s collective “response ability,” cradled in trust.
Critically, toward achieving action, our responsibility must be articulated with our collective “response-ability”—our ability to achieve coordinated community response—through policy and protocol, community connections; supportive services; and legislative acts that permit, or mandate, us to act.
We need to know when we choose to act, our community has our back—otherwise, our agency may be diminished and victims (primary and secondary) may be placed at greater risk.
Justice is achieved by a survivor-centered response to address offender accountability with victim safety, trauma-informed care, restitution, and resiliency through parallel justice, transformative justice, and other means—starting with first responders (local law enforcement and Adult Protective Services).
At first, I did not recognize the full meaning of “elder justice.”
When my petition for my grandmother’s guardianship was granted, I did not realize elder justice: I helped my grandmother and those trying to help her. I only realized elder justice when I, and many others, brought some of my grandmother’s perpetrators—my father included—to justice.
In so doing, I understand better Reverend King’s claim that, “True peace is not merely the absence of tension, it is the presence of justice.”
It is through victim-defined advocacy, UpstandershipTM comes full-circle, becoming whole, too—with victims, who command our attention.
In the webinar, we will test drive UpstandershipTM through the lens of elder justice.
Please take time to consider how—or if—these steps inform your work to empower both society and self to stand up to social injustice—and, more so, to let me know how you, as Upstanders, help realize our shared goals every day.
In the spirit of UpstandershipTM, I am now actively seeking your professional constructive criticism and suggestions toward developing and deploying this model for all realms of social justice.
Click Here to Watch "Achieving Upstandership: How It Can Help Each and All of Us Realize (Elder) Justice."