- older americans are victimized every day. - my son is very, very abusive, and when he drinks, it's hell on wheels. - the typical perpetrator, 90% of the time, it's a family member. - and this activist is trying to push elder abuse out of the shadows. - it is very difficult to tell a parent what to do when the person who is hurting her is her child. - any one of us can be a victim, and any one of us can be a perpetrator. - the consequences can be tragic and heartbreaking. - do you love your son? - yes, i do. - also "inside e street," how magnets are treating depression. - at some point, she was not interested in life anymore. after successful treatment with tms, there was a significant change. - "inside e street" is made possible by...

- auto and home insurance from the hartford, helping to make a difficult time a little less difficult for drivers 50 and over. information about our program, including how to find an agent, is available at hartfordautoinsurance.com. - from the heart of the nation's capital and around the country, you're "inside e street" with lark mccarthy. - elder abuse. chilling words describing acts that would be unthinkable to most of us. yet, as you'll learn in this broadcast, the elderly are most likely to be victimized in their homes by a relative. elder abuse comes in many forms-- physical, sexual, psychological, financial-- and as the population of elder americans grows, so does the incidence of abuse. one in 10 healthy adults over 60 are victims, and among adults with dementia, 47% of those cared for by family members are abused or neglected.

public awareness has been slow to develop, and few local governments are equipped to deal with the problem. but in orange county, california, a coalition led by researchers at the university of california, irvine medical center is way ahead of the curve. - 10-4. do you have a description? - when i go into a house where i believe anlder haseen abused - 10-4. do you have or ibeg ab,on? i get angry. of the anaheim police department. she specializes in elder abuse. - not only do i get angry, but i'm motivated, cause my job is to go in and protect that elder and make sure that nothing ever happens to them again as far as being abused. so i want to put the perpetrator in jail, and then i want to get that elder to a safe place. - so we'reonna go ahead and we'll go ahead and get started with the elder abuse forensics center meeting. - hill is a key member of orange county's

elder abuse forensics center, a first-of-its-kind group that brings together doctors, social workers, police, prosecutors, and others to fight elder abuse. - supposedly, she was taking care of him, but when he gets in, he's got, like, different stages of sepsis, and i don't understand all this stuff, t... - the typical perpetrator, if there is on would, a lot of times, be family members. - kerry burnight is a gerontologist at the uc irvine medical school and a co-director of the forensics center. - 90% of the time, it's a family member, oh, it's just a person at a nursing home, but in fact, because the vast majority of older adults live at home and are cared for by family members, that is--family members are the perpetrators. - the need for organizations like the forensic center has never been greater. - think of it as a horrible perfect storm, because never in the historyof s have we had so many older adults.

it is a staggering tsunami of all of us aging. the other part is the economics of it-- economic instability, so that these perpetrators, these family members, are seeing the older adult as somebody who has resources or a home or-- and then the last part is that we're subsequently cutting social services, so a lot of the services that could serve older adults and help protect them are really going by the wayside. - do you know when these photos were taken? - dr. laura mosqueda is a geriatrician at uc irvine and a co-director of the center. - i think what everybody needs to understand is that any one of us can be a victim, and any one of us can be a perpetrator of abuse. we just don't think it can happen to us, but it can. we also just don't think we would ever haul off and hit anybody or yell at a loved one, but we all can get driven to that point. and i think once we understand it and really believe it,

then we can also protect ourselves. my medical practice is where i can combine the science of what we understand, some of the studies that we've done and that others have done, with my clinical, hands-on practice. [knocking on door] - come in. - i look at a variety of tell-tale signs, and it actually begins from the moment i walk in the room. what is the body language of my patient with a family member there? what is the behavior and interaction like? and then i'll ask my patient questions. have you been in a position where you are feeling threatened or anybody's hurting you or you're afraid of anybody? - no. i haven't. - but physical marks can be the most revealing. - how can you differentiate a bruise from a bruise inflicted from elder abuse? and what we found is that you can't. we have found that in bruising--aging, in absence of abuse, you'll have bruising on your extremities. with abuse, we see it on the neck, on the genitals,

on the bottoms of the feet, on the ears, and those indicators are saying, "no, this doesn't just happen. "it isn't just--you're not just bruised because you're 90. "you're bruised because you've been forcefully held down or beaten or molested." - but elder abuse is not limited to physical violence. - at first, i thought only physical abuse was devastating, but the more years i've been in this and seen the kinds of cases, the psychological abuse of saying, "you will never see your grandkids again," "nobody cares about you," "you don't do what i say and you're going to nursing home" can be every bit as debilitating. similarly, the neglect of simply not having your needs met, about lying in your own urine and feces until decubitus ulcers fester on your back, this is not an uncommon scenario, and it's not limited to just certain lower socioeconomic status. we go into multi-million-dollar homes and see these

devastating cases of elder abuse and neglect. - and we need to know what these people saw at the home health care... - ted burnett is an orange county prosecutor specializing in elder abuse. - the neglect is often caused because they want the money, and if they spend it on the elder, then the money won't be available when the elder finally passes, and you often even hear people say when you talk to them, "i was gonna get the money anyway, so that's why i took it early," when they take money, or when they're neglecting the person because they don't want to eat away at the inheritance. [telephone ringing] - adult protective services. good evening. michael speaking. - if you are worried about your next-door neighbor, worried about your aunt or your mother, you can call adult protective services regardless of where you are in the nation and say, "i am worried for these reasons." - have people tried to help her with this before? - we can't be afraid to make that phone call to social services or to law enforcement

to report alleged abuse, because better to err on the side of caution and make that report and protect somebody and allow them to live a life of dignity than to bury our head in the sand and pretend that nothing is happening. - 10-4. - joining us now is marie-therese connolly, an advocate for elders and a leading scholar in elder abuse issues. she's the director of lifelong justice, and in 2011, she received an award from the macarthur foundation, an award commonly called a genius grant. welcome and congratulations. - thank you so much. - i should point out that you are commonly called "m.t.," so that's what we're gonna call you today. - that sounds great. - all right, m.t., right after you won the award, you said you hope that this will be the beginning of the attention we need. what is the attention we need? - elder abuse has been sort of a lost issue. it has not received the priority it deserves or requires

in order to advance what we know and our responses to the problem. it took a very long time to pass the elder justice act, and still there's no funding or implementation of that law, and it hasn't really been an issue that has gotten very much attention at the national level. - you've called this an epidemic, and that you can't think of any other issue affecting so many people where so little is being done. what do you mean by that? - well, i should explain. there's a lot being done in a lot of communities where people are really trying to grapple with it, because it's an issue that has an impact on millions of people nationwide, but they're reinventing the wheel again and again. families and communities and providers, health care providers, law enforcement folks like we just saw, there are not very many communities that have that kind of-- that kind of an amazing forensics center to respond. - what are they doing right that you'd like to see

more communities doing? - well, they're really pioneers, because they have developed a very multidisciplinary program. when they're looking at a particular case, they can say, ok, how do we best address it, and which one of the people around the table or which teams of people are best suited to do something about it? is this a case where there should be prosecution? is this a case that should be primarily a health care response? should adult protective services get involved? should there be a guardianship? etc. looking at the situation and communicating with one another, but you also develop the lines of communication that allow them to be more effective in how they respond to other situations. - you've made the comparison, and so have others, that we are decades behind in dealing with elder abuse, especially when you mpare it, say, to domestic abuse and child abuse.

are you just talking about awareness or in terms of how those issues are dealt with? when you say that we're decades behind, what's the alarm bell that should be ringing for us? - well, let me give you a couple of examples. in terms of federal legislation, the child abuse prevention and treatment act was enacted in 1974, and the violence against women act was enacted in994, and it took until 2010 to pass the elder justice act, and still we haven't seen either funding or implementation. - all right, so let's focus on that now. you helped write it, right? lofty goals. what is it supposed to do? - well, it's supposed to do a number of different things. it's supposed to elevate the issue to the national agenda. and so one of the things the elder justice act does is to create what's called an advisory board, which is comprised of the leading experts in the country, and then also something called the coordinating council, which is folks from the different agencies-- from the department of justice, from the department of...

- so all those are good things. you like those things. but you're saying-- but it was never funded, or limited funding, i guess we should say. - no funding. no funding appropriated. - here's what the administration on aging said, that the resource center for-- will help adult protective services systems, agents, and staff, across the nation to respond more quickly and to intervene more effectively, and she says that it's got $200,000 a year, roughly, to operate. - that's right. right. so yes, it has about $200,000 a year, and the national center on elder abuse has about $500,000 a year, and that's a pittance compared to other resource centers addressing other issues, and really not enough to do what people out there on the front lines and in various communities and families need. - we've been getting the overview, and as you know, it is such a personal issue affecting so many individuals, so we would like to play for you some excerpts from an orange county elder abuse support group

and then to get your reaction. we're gonna hear from ruth. she's a woman in her seventies. she lives with her 52-year-old son, and she says she's been repeatedly abused by her son. let's take a look. - when it escalated, how did that happen? how did it escalate? - he was drinking. and i think when he drinks, sometimes, there's drugs involved, too, but i can't prove it. he came in and i was-- i was probably a little loud, too, because i was angry at him, and so he came at me. and he had a knife and said, "i can slice your throat." many other times, he's accused he's going to break my neck or he's gonna toss me out. i just--i'm learning how to just kind of tolerate it. - when you hear her say, "i'm learning to tolerate it,"

- one of the really complicated things about elder abuse is that it often involves parents and their adult children, and often it's adult children who have either substance abuse or mental health issues. and so the parents love their children, and they're put in this untenable situation-- do you throw your child out and face the prospect of him or her likely being homeless? parents don't want to prosecute their children, and so it really sets up this impossible situation. and then also if the adult child is a caregiver, then-- - they're dependent. - they're dependent on them, and so then they're scared that if they throw the kid out, that maybe they'll have to go to a nursing home. they'll lose their independence. and often there's also an element of shame. so it's very, very complicated, and--

- because from the outside, we would look at that and say, "kick him out. get rid of him." but we should say that at one point, she actually did, so let's listen to a little bit more of ruth's story. - how did the abuse affect you? - for a while, i crawled into a shell. a friend helped me get david out of the house, and he gave him a one-way ticket to leave town. i made the mistake of letting him come back about 8 months later. he was in a no-win situation, and the mother came out in me, and i didn't want him sleeping on the street, so i let him back in. that's the worst mistake i could've made in my life. - and you have heard that story before, haven't you, m.t.? - again and again. - let's talk about the case of ruby wise of seattle, because i know you're gonna deal with this in your book that you're writing. a horrifying case where literally,

this elderly woman was left to rot by her son. - that's right. ruby wise lived with her adult son, and as her care needs got greater and his care for her did not meet those care needs, she literally rotted to death. and she was moaning and crying, crying out for help for weeks, and the neighbors closed their windows and her son put in earplugs. it's really--it's a very complicated case in some ways... - but he was convicted. we need to point out he was actually convicted of an offense in her death, and one of the things you said when you testified about this case that as a nation, we are wearing earplugs. - that's right. - what should we be doing? - we've learned in the last couple of years just how prevalent the problem is. one in 10 people living at home are--become victims of abuse, neglect, or exploitation,

and when you're looking at people who have dementia, the numbers go way up. it's one in every two people who have dementia... - and it bears repeating there's all kinds of abuse, and the psychological can be just as devastating as the physical in so many respects, so we should just go over that again. the many types of abuse. - that's exactly right. there's physical, sexual, and psychological abuse, and then there's neglect, and then there's financial exploitation, and it also should be pointed out that it can happen in all kinds of settings. it can happen at home. it can happen in facilities. it can happen in community settings. - well, your work in this area has been recognized by this grant--$500,000 with no strings attached-- because of the work you've already done, so tell us what you plan to do with your genius grant from the macarthur foundation. - well, i hope to continue doing the work that i've been doing. as you mentioned, i'm working on a book,

and so i hope to finish that, and we're also launching a not-for-profit entity that will be focusing on these issues and advancing [indistinct]. called lifelong justice, and continue to work with colleagues nationwide, really trying to build bridges between and among people who are working in the realms of policy and research and practice. - when you got the news, what were you doing? do you remember exactly? ok, tell us what were you doing. - i was sitting in my home office and i was between conference calls, and i was absolutely flabbergasted, and continue to be sort of blown away and humbled. - so we have one more thing from ruth that we would like-- and it really has to do with love, the very thing that you were talking about

and how complicated and emotional an issue it is, allyhen the very thing that you're talking aboutut a parent and an adult child. - do you love your son? - yes, i do. as much as he's full of so much hate, but i can't give up the love that i do feel for him. - what does she need to do to help herself? what does ruth need to do? - i think she needs to make sure that she has a safety plan inlace and she needs to... i'm sorry. - she needs to make sure that-- - it's so difficult, isn't it? - it is. it's very difficult because-- because it's very difficult to tell a parent what to do when the person who is hurting her is her child, and she needs to take care of herself,

but she needs to ultimately make the decision about how to do that. - at least she is getting the support, right? she's on the road. she is on the road, and she's there with so many others, is what she needs to understand. - right. there are millions of people who are being victimized by this problem, and so--one of the things that i-- one of the things that's important to know is that elder abuse is not a problem without a solution, and so as family members, as citizens, one of the things that we want to do is kind of think about it in advance. and so don't--don't let older people in your life become isolated, and don't confuse isolation and independence. independence is good. isolation is not good. and then talk about issues. talk about planning for incapacity, planning for old age, and then see something, say something.

if you see a problem, say something about it, reach out, and that's where we have a lot of work to do, because the systems that we have in place right now are not adequate to respond to the needs of people who are addressing this problem right now. - thank you so much for joining us. it's been our privilege and we wish you much success. we're counting on you to help solve this problem. - well, thank you so much for addressing this problem. it's so important to be shining a light on it. - in a moment, one more thing. how magnets can ease the blues. - thank you. marie-therese connolly. - we appreciate it. - thank you, lark. - we want your ideas and feedback. so follow us on twitter @insideestreet. re-tweets are welcome. for more information on elder abuse, go to insideestreet.org. - one more thing. treating depression when conventional therapy doesn't work. since the food and drug administration approved transcranial magnetic stimulation, or tms, in 2008, some 5,000 people of all ages have been treated in the u.s.

for those afflicted with debilitating depression, who don't respond to conventional drugs or don't tolerate electroshock therapy, tms has emerged, at least for some, as the treatment of last resort. - this has to be tight but not too tight. - in 2008, 84-year-old effie vasiliades fell into the depths of depression. - the suffering is unbearable. how can i tell you? i've been to hospitals and doctors and nurses and, you know, psychotherapists. - effie's depression was triggered after her husband suffered a stroke. 20 years earlier, when her mother died, she was able to manage with antidepressant drugs, but when her husband died, her world turned very dark. antidepressants alone could not conquer her blues. - i was still depressed. it wasn't going away. i could see that i wasn't any better, because i cried all day with no reason. i never felt suicidal but i was hoping to die

by god's hand; that would be easier for me. - she had developed anxiety. depressed moods. she was not optimistic anymore. she was fearful of going out. - dr. oscar morales runs the tms clinic at mclean hospital, a psychiatric facility outside boston. - do you want to stand up and we'll head on in. - effie had heard about tms and dr. morales on tv. despite her age, effie was deemed a good candidate for tms, and began her first series of 5-day-a-week treatments in the spring of 2011. - the tms stimulator allow us to deliver huge amounts of electricity to the coil using magnetic fields that cross the skull, go through the brain, and then induce an electrical stimulation, activating tissue. if it is depression, we target the left prefrontal cortex.

- that's the part of the brain that controls mood. 7 months after she began tms treatments, effie was in the maintenance phase, about two sessions a month. - so this is going to be 37 minutes treatment. any question before we start? - no. - are you comfortable? - i'm very comfortable right now. - it's starting now. - ok. a woodpecker. [machine clicking] - yes, sounds like a woodpecker. she has a very fascinating story. at some point, she was not interested in life anymore. after successful treatment with tms, there was a significant change. effie was ready to travel. i went to greece. we stayed 3 weeks. i took a very long trip up in the mountains. it's a breathtaking area i had never seen. i came from there and i just wanted to see it. it was beautiful. - one note of caution. not everyone who's experienced tms treatment

has had the life-changing results effie had. we should also say tms is not cheap-- $8,000 to $10,000 for a 20-session treatment. and at this early stage, many insurance companies won't pay. but the good news, according to dr. morales-- tms has fewer side effects than antidepressant medications. next "inside e street," the challenge of finding an encore career in tough economic times. - you can build out your plan over a 3-year process and add those little pieces in so that when you're ready to make the career change, you have it all together in order to do that, so you're not just blindly jumping into a new field. - strategies for the next chapter. thanks for joining us. i'm lark mccarthy. see you next time "inside e street."

- "inside e street" is a production of aarp, in association with maryland public television. - "inside e street" is made possible by... - auto and home insurance from the hartford, helping to make a difficult time a little less difficult for drivers 50 and over. information about our program, including how to find an agent, is available at hartfordautoinsurance.com. - to purchase a dvd of "inside e street," order online at insideestreet.org or call 800-873-6154. please include the show number.

>> today we'll be doing a variety of brain fitness exercises, as well as movements that will help strengthen our driving skills. so let's get started. keepdriving.com is dedicated to helping older adults maintain their driving independence using cognitive training, exercise, nutrition, and community. explore keepdriving.com today. "sit and be fit" is a creation of mary ann wilson, registered nurse, teacher and recognized leader in the field of fitness and healthy aging. mary ann consults with a team of medical and exercise specialists to bring you a fun and eff