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COVID-19 has forced us to face the fact that in mere days or hours we can go from autonomous, free-acting agents to having strangers become the guardians of our bodies and selves. These strangers may be called upon to judge the value of our lives against those of others as they triage scarce resources or to predict our quality of life against the potential risks and rewards of treatments. The sudden annihilating onset of the disease denies many the chance to choose for themselves how they want to spend their final hours and with whom. It separates patients from loved ones, depriving both sides of mutual comfort, reassurance, and the easing of fears and suffering.
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With the COVID-19 epidemic spreading across the globe, people everywhere are getting a crash course in public health. Terms like “flattening the curve” and “herd immunity” are daily being added to our vocabularies. Since its beginnings during a cholera epidemic in the 1850s in London, the field of public health has evolved dramatically, yet some of the advances that are particularly germane to COVID-19 are not getting much attention. That includes public health’s focus on social justice.
In the thirty-something years I’ve worked in the field of elder abuse prevention, I’ve seen abuse framed and re-framed as a medical syndrome, a caregiving issue, domestic violence, and a public health epidemic. The Elder Justice Act (EJA), enacted in 2010, enshrined abuse as a matter of social justice and individual rights. Although the new frame has been widely embraced, the EJA is narrowly focused and fails to address the myriad other threats (besides abuse) to older Americans’ rights. I wrote Elder Justice, Ageism, and Elder Abuse (Springer, 2019) to explore these threats and what our field can do about them.
The United Nations General Assembly established the Open-Ended Working Group on Ageing (OEWGA) in 2010 with a mandate to consider the existing international framework for the human rights of older persons and identify possible gaps and how best to address them. This included exploring the feasibility of new “instruments and measures,” which range from aspirational memos to binding U.N. conventions (a type of treaty). The goal is to strengthen the protection of human rights of older persons. ...the group has focused on particular human rights topics as they apply to older persons, including equality and non-discrimination; violence, neglect and abuse; autonomy and independence; long-term and palliative care; and social protection and social security The first session of the OEWGA took place on February 15, 2011. In subsequent annual sessions the group has focused on particular human rights topics as they apply to older persons, including equality and non-discrimination; violence, neglect and abuse; autonomy and independence; long-term and palliative care; and social protection and social security. Future topics will likely include access to justice, health care, and housing. Because these subjects are viewed as overlapping and interdependent, the deliberations are not siloed. By far, the most repeatedly debated issue is whether there is a need for a specialized, binding convention on the rights of older persons. Virtually every participating non-governmental organization (NGO) and many nations have argued that existing human rights instruments fail to recognize older persons as clear rights holders in all aspects of human rights laws. Other nations, including the U.S., argue that existing instruments cover older persons adequately and that all that is needed is better implementation strategies. Participation does not require you to stick your head out. You can observe or put your name in the cue to deliver comments (called “interventions”)...You will find tremendous professional benefit from participating, both in terms of learning about U.N. processes and experiencing the diversity of international aging advocacy. Which way the pendulum swings in this debate will depend to a large extent on NGOs that advocate for or serve older persons. NGOs have played a major role in the Working Group’s discussions and can participate via a fairly simple credentialing process. The process harkens back to the creation of the Convention on the Rights of Persons with Disabilities, the success of which depended heavily on the voice of NGOs. NGOs overwhelmingly favor a convention but lack the critical mass necessary to make U.N. member states heed their call. Numbers really do count. There are countless U.S. NGOs that would never consider playing a role in U.N. affairs, let alone even try to understand the working of such a complex organization. However, it is easier than you think. Participating organizations have developed materials that explain the issues and can assist in learning U.N. procedures (see below). Becoming familiar with them will well equip you to be an expert advocate for a convention. The next step is to have your organization accredited to attend future meetings. The Working Group posts instructions. Accreditation is granted to organizations (not individuals) and only have to be accredited once. The application asks for information about organizations' competence and the relevance of their activities to OEWGA's work. If your group serves or advocates for elders, you probably qualify. The UN Secretariat reviews applications using standardized criteria, which include equitable geographic distribution. The OEWGA, by motion and vote, makes accreditation final. If approved, your organization can register up to five representatives to OEWGA meetings. Participation does not require you to stick your head out. You can observe or put your name in the cue to deliver comments (called “interventions”). Written submissions are also usually invited on specific topics that the Working Group plans to address. You will find tremendous professional benefit from participating, both in terms of learning about U.N. processes and experiencing the diversity of international aging advocacy. The meetings provide the opportunity to hear from and meet representatives from NGOs around the world and make new contacts with both U.S. and international advocates and leaders. Yes, there is the expense of traveling to and visiting New York, but if that challenge can be met, your organization can make a difference. As Woody Allen has said: 80 percent of success is showing up. And yes, at the U.N., they do spell “Ageing” with an “e"! Resources
About the AuthorCharles P. Sabatino  The author is director of the American Bar Association Commission on Law and Aging which has participated as an accredited NGO in the meetings of U.N Open-Ended Working Group on Ageing since 2012. He specializes in health law, long-term care planning, and improving access to legal services for older adults. He is an adjunct professor in elder law at Georgetown University Law Center and a past president of the National Academy of Elder Law Attorneys.
Usually the focus is on “how to make whole that which has been broken.” Apology, forgiveness, compensation, mediation and restitution are major parts of these discussions.
About the authorJohn Dussich
By Georgia Anetzberger, PhD, ACSW A friend of mine died last year. I’ll refer to her as “Jenny”. Some of us might ask ourselves, “How was it that Jenny didn’t become a victim of elder abuse?” By most accounts, she should have. After all, towards the end of her life Jenny was the embodiment of many established elder abuse risk factors. For self-neglect, these included frailty, functional limitations, living alone, and lack of a primary caregiver. For elder mistreatment, these included physical disability, impairment, or frailty along with advanced age. Yet, Jenny managed to reside alone in her home of decades until age 89, when she elected to move into a hospice facility for her final weeks. She was able to live life on her own terms, because Jenny also possessed protective factors from elder abuse, the most important of which are described below. How was it that Jenny didn’t become a victim of elder abuse?” By most accounts, she should have. When I learned that Senator Pan, Chair of the Senate Budget Health and Human Services Subcommittee, had scheduled the informational hearing “The State of Long-Term Services and Support for California Seniors," I thought, maybe we "doom-sayers" had turned a corner in achieving legitimacy! What else could it mean when you had advocates and State officials who provide many of the services utilized by older adults coming together at the request of the Legislature? I choose to believe the November 15th hearing is a sign that the State Legislature is poised to address long-term services and supports (LTSS) as a priority and an indication of much-needed political will.
To our readers.
Our June 15 post, UNPACKING UNDUE INFLUENCE by Mary Joy Quinn, has continued to generate requests for advice on specific cases in which undue influence is suspected. While we welcome comments, we are unable to consult or advise on specific circumstances or cases. In response to the high level of interest in this topic, we are providing the following resources.
In March 2017, CEJC's National Elder Justice Advocates Academy hosted "Building an Elder Justice Movement State by State," a panel featuring representatives from five state elder justice coalitions* at the annual conference of the American Society of Aging in San Francisco. As is often the case, the planning and lead-up turned out to be as engrossing as the event itself. Georgia Anetzberger, Iris Freeman, Paul Caccamise, Risa Breckman, and I used the opportunity to catch up on how our groups were coping with the unnerving setbacks and threats to elder justice we're witnessing and to marvel at unforeseen opportunities.
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