When Marie-Therese Connolly describes suspicious-looking bruises on the elderly, she sounds like a forensic expert on CSI.
Bruises on the neck, head, inner thigh, genitalia and soles of the feet are often inflicted and can be telltale signs of elder abuse, one of the most hidden problems in the nation, she says.
"If we can help people understand how to tell the difference between an accidental bruise and an inflicted bruise, that's a beginning," says Connolly, director of Life Long Justice, a Washington, D.C., non-profit group dedicated to protecting the elderly. "Advancing forensic knowledge is important so social and protective services workers, physicians, emergency room personnel and prosecutors know what to look for and what kinds of questions to ask about injuries."
Perhaps no one has done more to address the problem and bring about change. In naming Connolly, 54, a 2011 MacArthur Fellow in September, the MacArthur Foundation announced that "she is a leading voice to prevent the suffering of older adults and ensure that elder abuse becomes a priority on the national agenda."
The $500,000 grant is allowing the former Department of Justice attorney to write a book on the subject and continue her work crisscrossing the country giving speeches and working with a handful of university and other programs to push for change.
"It's a big help," she says. Since leaving her job and moving into an advocacy role three years ago, she has not drawn a salary.
"The fact that a respected entity like the MacArthur Foundation decided this is an issue worth investing in is a real game-changer," Connolly says. "It is an epidemic and will only become bigger as the 77 million Baby Boomers age."
Most cases not reported
Preying on the elderly comes in many forms: physical, sexual and financial. It happens at home, in communities and in nursing homes. One in 10 healthy adults over 60 are victims, according to phone surveys done by the National Institute on Justice. Among adults with dementia, a study by the University of California-Irvine shows that 47% who are cared for by family members are abused or neglected. As many as 96% of cases go unreported, Connolly says.
"She wants people to know we're morally responsible to take care of the people who took care of us," says Laura Mosqueda, a physician and director of the program in geriatrics at the University of California-Irvine School of Medicine.
"She really single-handedly, through the power of intelligence, persuasion and personality, launched the conversation on the issues."
Connolly says most people ignore elder abuse.
"I can't think of another issue that affects more people in this country where less is being done," she says. "Programs for child abuse and domestic violence are decades ahead."
One reason for the lag: Mistreatment of the elderly can be hard to detect because the elderly often bruise and fracture more easily than young people, so we don't ask questions we otherwise might, she says. The elderly also might not report abuse because the abuser is nearby or they fear being sent to a nursing home if they complain about a caregiver.
Nursing homes are another area in which Connolly is well-studied. She says some people would rather be abused at home than be sent to a nursing home.
She started working in the elder-justice field in the late 1990s, cooordinating the Department of Justice's Elder Justice and Nursing Home Initiative, created in response to reports of serious problems in California nursing homes. She developed legal strategies and ways to use data to prosecute cases of neglect and abuse.
Also, while working in the Department of Justice, she embraced forensics and research. "We know little about how best to detect, respond to or prevent elder abuse,'' she says. So she organized the first forum on elder abuse forensics and, with the National Institute of Justice, launched what she says is the only grant program to fund elder abuse research. Among other things, it paid for the bruising studies.
Connolly conceived of and helped draft the Elder Justice Act, the first federal legislation to address elder abuse. It was signed into law in 2010 as part of the Affordable Care Act but awaits funding. Without the money and implementation, there can be no new programs or infrastructure at national and local levels.
"She's tireless and a shining star for these causes,'' says Risa Breckman, an assistant professor of geriatric social work at Weill Cornell Medical College.
Connolly stepped up her fight for funding in March. She testified before the Senate Special Committee on Aging, saying, "Elder justice has never been assigned true priority on the national agenda with resources to match. And the fallout from this deficit are evident everywhere.''
Sen. Herb Kohl, D-Wis., chairman of the Special Committee on Aging, replied in an e-mail about future funding for elder justice:
"There's no doubt that spending must be reined in, but protecting seniors -- a vulnerable and rapidly growing segment of our society -- from abuse is a fundamental responsibility. At the heart of the bipartisan elder justice initiative are needed resources for the state agencies that provide the front line response to physical abuse and complex cases of senior financial exploitation."
'Hooked' on the law
Connolly almost did not study law. She wanted to follow her parents into medicine. Both came to the United States to practice at the Mayo Clinic in Rochester, Minn. She planned to follow her mother's path into psychiatry but changed her mind while taking a law school class in mental health at Stanford.
"I began to learn about the countless riveting, impossible, shameful and heartbreaking issues at the intersection of public health, vulnerability and the law," she says.
She earned her law degree from Northeastern University School of Law. Understanding law, she thought, would allow her to help change policy. "I was hooked,'' she says.
She met her husband, a lawyer who also helps the elderly, through mutual friends. They were married in 1989. Dan Kohrman is a senior attorney with the AARP Foundation. They have three children, Fiona, 21, Nathan, 18, and Gabriel, 16.
Despite busy careers, Connolly found time to teach workshops at her children's school on writing and poetry, and her husband coached soccer. At home, conversations at the breakfast table can be intense at times.
"We work on different aspects of advancing civil rights and justice for older people,'' she says. "I learn a lot from his perspective.''
Kohrman was one of the litigators in a class action filed by people with mobility and disability problems against the California Department of Transportion, which delivered a $1.1 billion settlement.
"A lot of what we talk about is why is it in America we have great respect for our elders but we're not doing a lot to protect them when they grow old and frail," Kohrman says.
At the March Senate hearing, actor Mickey Rooney, 88, testified about mistreatment by family members. Connolly cited the case of Ruby Wise, whose son Chris Wise was prosecuted in 2010 for neglecting her. She died covered in feces and bedsores, weighing 72 pounds at a home they shared in Seattle. Her son used earplugs to block out her screams and moans for help. He was convicted of manslaughter.
"We are all looking down the barrel of aging,'' Connolly says. "But our culture is not enthusiastic about embracing it. We need to focus, not just on the clubs and cruises aspect of aging, but also the frailty and incapacity pieces of it, and have the conversations to prepare ourselves, both in our personal lives and as a nation."
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