{"id":410,"date":"2015-08-05T15:09:36","date_gmt":"2015-08-05T22:09:36","guid":{"rendered":"https:\/\/keck.usc.edu\/news\/a-crusade-against-elder-abuse\/"},"modified":"2023-11-19T12:06:22","modified_gmt":"2023-11-19T20:06:22","slug":"a-crusade-against-elder-abuse","status":"publish","type":"post","link":"https:\/\/keck.usc.edu\/news\/a-crusade-against-elder-abuse\/","title":{"rendered":"A crusade against elder abuse"},"content":{"rendered":"\n \n \n\n\n\n\n\n\n\n
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\n\n \n Press Release<\/span>\n\n\n\n<\/div>\n \n \n
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A crusade against elder abuse<\/h1>\n\n\n<\/div>\n \n \n
\n Diane Krieger<\/span>\n \n August 05, 2015<\/span>\n <\/div>\n \n \n
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Laura Mosqueda fights for increased funding of federal research and maintains a focus on prevention and early detection of neglect and beatings<\/h3>\n

Laura Mosqueda, a leader in the study and prevention of elder abuse, has seen things you wouldn\u2019t want your grandmother to know about.<\/p>\n

On house calls with Adult Protective Services workers, she\u2019s seen frail, demented seniors in appalling circumstances \u2014 victims of neglect, starvation, beatings, occasionally even rape. Instead of averting her eyes, the USC-trained geriatrician has directed her unflinching attention to these horrors and forced the medical community to look, too.<\/p>\n

A year ago, Mosqueda joined USC as chair of the\u00a0Department of Family Medicine<\/a>\u00a0and associate dean of primary care at the Keck School of Medicine of USC. It was a homecoming in many ways for the Keck School graduate (MD \u201987) and lifelong member of the Trojan Family.<\/p>\n

\"USC_Keck_Laura_Mosqueda_crop1\"
Laura Mosqueda, MD, FAAFP, AGSF<\/figcaption><\/figure>\n

\u201cI\u2019ve been going to Trojan football games since I was 8,\u201d said Mosqueda, a Los Angeles native whose parents studied medicine at USC. Her mother, who passed away in 2013, was radiologist Gloria Frankl MD \u201955, a noted pioneer in mammography. Mosqueda\u2019s father is Harold Frankl MD \u201955, former chief of gastroenterology at Kaiser Sunset and longtime volunteer faculty at Los Angeles County+USC County Medical Center.<\/p>\n

Mosqueda came to USC after 16 years at the University of California, Irvine, where she co-founded the nation\u2019s first Elder Abuse Forensics Center \u2014 a hub for legal, medical, law
\nenforcement and social services strategies to improve the investigation and prosecution of elder abuse cases. That center served as the model for the USC-based\u00a0Los Angeles County Elder Abuse Forensic Center<\/a>, where Mosqueda continues to work with fellow Keck School geriatrician and center director Diana Homeier.<\/p>\n

Boosting USC\u2019s leadership in the field is the National Center on Elder Abuse, which Mosqueda directs. Supported by a three-year, $2.2 million federal Administration on Aging grant, the center is the nation\u2019s only clearinghouse on elder abuse.<\/p>\n

Across USC, Mosqueda has been building interdisciplinary bridges around the study of elder abuse, reaching out to faculty in social work, law, education, business and the USC Davis School of Gerontology, where she holds a joint appointment.<\/p>\n

How did you get into this field?<\/h2>\n

When I was doing my fellowship in geriatrics, I saw a patient who had a huge welt on her arm. She told me her daughter had hit her with a telephone, so I reported it to Adult Protective Services as a suspected case of elder abuse. When the patient came back to see me a few weeks later, nothing had changed. So I marched into APS. I was really mad. And that\u2019s when I learned that I was a part of the problem. APS workers are often in difficult and dangerous situations with little assistance from the medical community. They are true heroes, yet few people know they even exist. Inadequately staffed and so underfunded, they have very limited time to spend with the people they are trying to help. This experience spurred me into action, going on house calls with APS workers and police, and learning all I could.<\/p>\n

Why is this an issue for the medical community?<\/h2>\n

One of the most common problems in evaluating and prosecuting elder abuse cases is the medical piece. The vast majority of APS workers have little or no medical training. They are not lifting up shirts and looking for wounds. They\u2019re social workers. When I went out on house calls with them, I would see somebody all bruised up, and I\u2019d say, \u201cThat person was beaten.\u201d What I would hear time and time again, even from police, is: \u201cThey\u2019re old. They bruise easily.\u201d Well, that\u2019s true. But you shouldn\u2019t see bruising on the face, the head, the neck, the soles of the feet, the torso. You shouldn\u2019t see multiple bruises and large bruises without a reasonable and believable explanation.<\/p>\n

We did the first studies on bruising in older adults. Now we\u2019re able to tell emergency department personnel, paramedics and primary care physicians what to look for. On the other hand, we\u2019re really careful not to over-accuse. Older people do bruise easily.<\/p>\n

Why would someone harm the elderly?<\/h2>\n

The vast majority of abuse is not done by bad people. It happens when poorly informed folks who may lack caregiving skills either physically or emotionally can\u2019t handle the situation they\u2019re in. Take, for example, a sandwich-generation woman whose father-in-law with Alzheimer\u2019s disease moves into the house. She\u2019s already raising her teenage kids and running the household. Now she\u2019s got somebody following her around, saying: \u2018What time is it? What time is it?\u2019 Finally she just loses it: She hits or starts screaming, doing things that are absolutely abusive and should never happen. But that woman doesn\u2019t need to be locked up \u2014 she needs help. Of course, there are some people with serious pathology who are abusive, and they do need a date with the criminal justice system.<\/p>\n

What kind of safety net is there for the elderly?<\/h2>\n

In California we have assisted living. It\u2019s the wild, wild West: There are very few standards. When people have good circumstances \u2014 enough money, caring family \u2014 even then it\u2019s really difficult. Start chipping away at any one of those things, and it can become a real disaster.<\/p>\n

Why hasn\u2019t this been fixed?<\/h2>\n

We live in a society that\u2019s fairly ageist. We fear and resent growing old. We mock the elderly. It\u2019s so painful, but I hear it all the time: \u201cWell, they\u2019re old and demented so it\u2019s not such a big deal if they\u2019re abused because they\u2019ll forget.\u201d I hear it from elected officials, from the public. It\u2019s incredible.<\/p>\n

Yet America itself is getting older.<\/h2>\n

That\u2019s why something has to happen now. People over 85 are the fastest growing segment of our population. These are the people most likely to have chronic conditions. Half of them have a dementing illness and half of those people will be abused or neglected. We don\u2019t have a workforce that is prepared in terms of numbers or education to care for these \u201cold-old,\u201d as we sometimes call them. We\u2019re not prepared and we know it\u2019s coming. We don\u2019t have sufficient policies or protections and don\u2019t enforce the ones we do have well enough. We\u2019re already seeing it with the flourishing of grandma scams. It\u2019s only going to get worse.<\/p>\n

Is there a link between financial abuse and physical decline in the elderly?<\/h2>\n

Emotional and financial abuse has a very direct impact on health. You see this clear decline in people\u2019s physical health after they get scammed. They start to withdraw, they\u2019re less likely to go to doctor\u2019s appointments. They get deconditioned. Because older adults have less physiologic reserve than younger people, the tipping point is much finer. They just don\u2019t have same capacity to bounce back.<\/p>\n

In an ideal society, how would we address these issues?<\/h2>\n

It starts with a health care system that provides person-centered holistic care. It involves understanding brain aging and the needs of caregivers. Those most vulnerable to abuse and neglect tend to have chronic illnesses.<\/p>\n

While we\u2019re providing medical care and linking people to community-based services, we also need adequately funded systems to intervene and help in cases of abuse and neglect. We need a compassionate, empathetic approach. That\u2019s the kind of thing that will prevent abuse.<\/p>\n

What is the potential of technology mediating these needs?<\/h2>\n

Huge! It\u2019s already very helpful in monitoring for falls and medication management. It also can help caregivers interact with the medical community.<\/p>\n

What about surveillance technology? Cameras on caregivers might eliminate some of the abuse.<\/h2>\n

I think it would be a very, very good thing. When people have put in so-called granny-cams, we have seen some awful things. But you have to be careful of the rights of the caregiver and elder privacy rights. We have to start weighing out these ethical issues.<\/p>\n

How do you stay focused?<\/h2>\n

You eat the elephant one bite at a time. While we\u2019re keeping all these big issues in mind, we\u2019re pushing on policy and asking the federal government to fund more research. We need to keep the focus on prevention and early detection and recognize that this is a public health issue. There are people suffering right now whom we can help. That\u2019s why it\u2019s so important for me to still go on house calls with police, to practice medicine and understand what we can be doing today.<\/p>\n\n\n\n<\/div>\n <\/div>\n\n\n <\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":87,"featured_media":411,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"advgb_blocks_editor_width":"","advgb_blocks_columns_visual_guide":"","footnotes":"","_links_to":"","_links_to_target":""},"categories":[6],"tags":[529,57],"class_list":["post-410","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-press-release","tag-department-of-family-medicine","tag-recent"],"acf":[],"yoast_head":"\nA crusade against elder abuse<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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