Acerca de

As a new member of the EAIME team and someone who feels drawn to helping to solve some of the challenges of elder justice at community and policy levels, I was thrilled to have an opportunity to get to know Marie-Therese (MT) Connolly, a self-described policy wonk completing a book about the elder justice movement, her work in the field of elder justice is renowned.  A lawyer, writer, and researcher, MT’s work has been recognized with a MacArthur Foundation Fellowship...and has deeply informed the RISE model, the advocacy-based, harm reduction program that is at the heart of EAIME’s Elder Service Connections partnership with Maine’s Adult Protective Services team.  I’m incredibly grateful that MT was able to take time for the thought-provoking discussion that follows. 

 

Our conversation began as MT shared her enthusiasm for the work that EAIME is doing. 

 

MT:  Because it’s your day-to-day work, it might be harder to see from the inside just how unique your approach is in cases referred to you by APS: You can stay involved with clients longer than APS, allowing more opportunities to build trust. You can work not only with clients,

but also, if they wish, with others in their lives, including people alleged to have harmed them. You can work with them on the relationships they care about. And your work is part of a larger research study. This work is possible because EAIME is a very special organization with a

leader who is a true visionary.  Patty [Kimball, EAIME’s Executive Director] isn’t afraid to try new things, to collect data about new ways of doing things, and to ask hard questions about whether those new ways are effective.  And if they aren’t working, she’s not afraid to go back and make changes or start again.  You may not realize it, but this is different from what happens in many organizations, which often operate based on good intentions, fervent beliefs, or inherited systems. But not evidence. Gathering data and trying to identify and validate assumptions promotes credibility – and EAIME is doing this, measuring the impact of the work, including, critically, from the perspective of the older adults you serve. That’s the reason for the work after all.

 

Kathryn:  As I listen to you describe this process, I’m struck by how similar this is to the work that I did while working in the software field – we’d build things incrementally, test each piece with users, get data and feedback, and then iterate through that process until we had a product that met users’ needs.  It’s a combination of design thinking and agile development , in software-geek terms. 

 

MT:  Exactly!  If software engineers built whatever they thought their customers needed and just put it into the market without understanding whether or not it actually solved people’s problems or addressed their needs, they’d be missing an integral step. If you’re building something for certain customers, then you want to find out what those customers think of the resulting product. That’s what EAIME is trying to do. And it’s very rare in the elder justice field.

 

Kathryn:  And data from our customers was at the heart of building a good product, just like data from EAIME’s clients is fundamental to developing effective services. 

 

MT:  EAIME is incubating ideas – like the RISE model –that drive innovation and challenge the ways that we’ve provided supports and services to elder abuse victims for the past half-century. The direct services that you and your colleagues provide, and the data that you collect, give the research team information to analyze that hopefully will inform future practice.  In fact, we’ve modified the approach based on feedback along the way. And as I think about this, the process is iterative at the client level as well... EAIME’s advocates can build longer-term relationships with clients than APS workers can. Over the course of those interactions, the clients’ own wishes and needs often evolve, along with what they want from you, the advocates. And you can be nimble enough to change alongside them.  

 

Kathryn:  What surprised me most when I started this job is that much of the work that I do is about building trust – in order to help facilitate change, I need to understand the trauma behind an individual’s hoarding; the complex family dynamics that contribute to abuse; the fears of losing independence that lead to self-neglect.  So I go into a new case with a “problem” – let’s say hoarding – and as I develop the foundation of trust and respect with a client, a larger story often unfolds, completely changing the course of the intervention, sometimes multiple times. 

 

MT:  Wouldn’t it be great to find ways to capture data about what steps you take to build trust with clients and how that trust can help you better help them? So you learn what works not just at one moment but at several moments over the course of your work with them? 

 

Kathryn:  It would...there are so many things that I think that that data could tell us.  And speaking of things that data should tell us:  the data around elder justice tells a clear and troubling story, that even though one in ten older people are victimized, the vast majority of elder abuse stays hidden.  Why do you think there is so little attention to – and investment in – elder justice? 

 

MT:  Ageism is a leading culprit, both at personal and societal levels. Our psychic fear, loathing, and shame about aging inhibit our ability to think about it, prepare for it, and find joy and meaning in getting older.  Something similar is going on at a societal level. Although we’ve invested huge resources to live longer, we’ve done much less to meet the needs of our aging society. We have a hard time even acknowledging the practical aspects of aging, much less that many older people are victimized. Elder justice is at the furthest outpost of aging, at the intersection of two things people don’t want to see:  old age and abuse. 

 

Kathryn:  That happens to “other” people... 

 

MT:  Yes, we see both as “other” – undesirable and not us. Ageism fuels abuse when we see older people as less fully human, as less “worthy” of being treated well. The way we’ve segregated our society by age makes the problem worse. Research shows that when young people have positive interactions with older adults, they – not surprisingly – have more positive views about older people and aging. But young people spend much less time with older people than they used to, with predictable results. There are also other reasons to reduce our rampant age-segregation: Older and younger people have so much to offer each other and can have a profound positive impact on one another’s lives, health and well-being. We just need to do a better job with age desegregation!

 

Kathryn:  That seems like one of the things that Age-Friendly Communities [a World Health Organization program sponsored in the US by AARP to build livable communities for people of all ages] can help with. 

 

MT:  Age-Friendly Communities are great and another place where Maine is leading the way.  [Maine has more than 70 communities involved in the Age-Friendly network, and the state itself has age-friendly designation.]  Because I believe that age-segregation and ageism lead to more elder abuse, I also believe that Age-Friendly initiatives can help prevent it, and are a critical tool in advancing elder justice.

 

Kathryn:  So, with the Baby Boomer generation entering their older years, and more people being vulnerable to elder abuse, what do you think is imperative for us – as elder justice advocates – to do now so that we can be best prepared to serve that rapidly-growing population? 

 

MT:  You’re doing it. We desperately need good intervention and prevention research. It’s the biggest gap in the field. Said another way, we need to know what works to address elder abuse or to prevent it in the first place. We just don’t know. But in this project, you and your colleagues are out there trying to learn more about what kinds of services, methods, and relationships are most effective to give everyone – older people, their families, communities and service- Providers – better tools for a better old age. 

 

Older people want to be able to care for themselves, and family members want to be able to help care for them.  But caregiving can be very challenging. We don’t have adequate social infrastructure to help people get care at home. Nor do we have a long-term care system that people trust. We need better options. 

 

Also, older people who are victimized by someone they care about often want help mending relationships that have been breached or help for the person who harmed them, like job counseling, mental health or drug treatment. In that sense, getting help for that other person could be a form of preventing future harm.

 

Kathryn:  I agree.  Elder abuse doesn’t just come out of the ether, and it doesn’t just affect the person who is harmed.  It’s intergenerational, and I’m hopeful that sometimes our advocacy can help to interrupt that cycle.

 

MT:  Yes! I believe it has that potential. The conflict in the cases you’re seeing can drive legacies of strife that divide families across generations...there’s cumulative harm, but also, thankfully, the opportunity for repair and healing can ripple on too.  Most people want to do

better but sometimes need help to do so.  The punitive, carceral approaches often don’t achieve that end. Nor are they designed to reduce the harm experienced by the people involved.

 

Kathryn:  Having restorative justice approaches as a tool in our toolbox has been incredibly helpful.  [Restorative justice is a process that seeks to heal what has been broken by seeking direct accountability for one’s actions and, when appropriate, reintegrating relationships where

there has been division.]  

 

MT:  Restorative justice means different things to different people and in different contexts. And using restorative approaches in the context of elder abuse cases requires lots of careful consideration and adaptation. There’s no one cookie cutter approach. And using it in conjunction with the other RISE methods is critical. But thanks to Patty’s deep experience with this approach, and bringing on Kelsey Park [a restorative justice expert], EAIME is committed to using restorative approaches in elder abuse cases in a rigorous, thoughtful way.  And again, also to collecting data around that aspect of the work to learn more about its impact.  That’s so unique. 

 

Kathryn:  For me, in the field, I don’t always realize that what we’re doing is on the bleeding edge. 

 

MT:  Oh, it is.  The country is watching what’s happening in Maine -- there’s excitement about EAIME’s work and the research around it. It’s incredible to see direct service providers like you deeply committed to asking and collecting data about the impact of your work. That’s rare. There’s also increasing interest in finding ways to adapt the RISE model to other systems, like criminal justice, guardianship and financial enforcement. So I’m hopeful such expansion is on the horizon!

 

There’s just so much potential in this work for improving lives and systems...not just in Maine, but across the country. Being pioneers, creating new programs and studying them, is hard and sometimes messy work. It requires creativity, courage, humility, persistence, flexibility and vision from everyone involved. Which is why I’m so grateful to both EAIME and Maine APS. But if you want to change things, you have to start somewhere. It's been such an inspiring process. I'm eager to see how our work together helps drive more positive innovation in the field. 

​