Defend our older citizens

Americans have been quick to recognize that women and children deserve special protection by the state. But the elderly have been left to fend for themselves. Families - long the traditional support systems of the elderly - are now often absent in elder care because of the unprecedented mobility of modern life.

As a result, millions of older Americans are suffering from violations of basic human rights at the hands of family members, financial institutions, paid care givers, and healthcare professionals.

Earlier this fall, Sen. John Breaux (D) of Louisiana and Sen. Orrin Hatch (R) of Utah introduced a bipartisan bill to protect the interests of the elderly. The Elder Justice Act is the first of its kind to address the estimated 5 million cases of elder abuse in the US each year. The victims are often women, the culprits are likely to be their caretakers, and the range of abuse - physical, sexual, psychological, or financial - is likely to be easily overlooked by the police and other law- enforcement authorities.

This isn't just an American problem. A spectacular example of elder abuse made international news last year in the case of Dr. Harold Shipman of Hyde, England. It was discovered that 15 of the elderly women who died under his care had been poisoned. The physician is now in jail.

While important attention is needed to regulate and investigate instances of abuse under the care of health professionals, elders need basic education about their rights under the law.

Few people understand the distinction between a power of attorney and a guardianship. The former merely delegates an agent to carry out routine fiscal chores, such as paying bills and depositing pension checks. But without a third party to act as an advocate for the elder's interests, power of attorney can be aggressively transformed into an instrument to totally control an older person's life.

The power of attorney has been called "a license to steal." It can also be a license to grossly degrade an older person's quality of life. Usurpation of power by an agent who has a stake in the elder person's will can create a nightmare of conflict of interests. Guardianship is the legally proper method of establishing full control over a dependent person. But many elders are reluctant to pursue it, as establishing a guardianship can be expensive and involve up to four lawyers.

There is abundant evidence that elder abuse is a huge and growing problem in the United States. It will take enlightened social legislation like the Elder Justice Act, and a generation of education and inspired leadership, to bring to elder care the attention it deserves.

• Lawrence Cranberg is an affiliate member of the Texas Geriatric Society and chairs the committee on elder rights for the Austin chapter of the American Association of University Women.