How does a 78-year-old woman starve to death in her own home?

This one calls out for something, something real, something dramatic, something substantial, something to make a difference. Yes, there is elder abuse in the world; friends of mine have devoted themselves to the cause; it is an international cause, in fact (see the International Network for the Prevention of Elder Abuse); but what is so shocking is how this happened. About a mile from my own home here in Albany, this woman starves to death in her own bed in a home she shares with her daughter.

Let's not try anybody right now: let's just look try to find the social realities that surround this case. What has been reported is that a 47-year-old woman shared a home with her mother, and, according to the Albany Times-Union of Saturday, April 26th, "At some point, and for reasons that remained unclear Friday, she stopped feeding her mother enough to keep her alive." So, here are a couple of ideas on that:

• Nobody noticed the older woman hadn't been seen around for a while? Maybe not a call to the Elder Abuse Hot Line (New York State Adult Abuse Hotline: 1-800-342-3009, press option 6 [options six?]) but couldn't somebody have been gotten into the loop? Maybe -- maybe -- all it would have taken would have been a phone call -- to the local Office for the Aging or Department of Social Services -- to have a case manager become involved.

• How does an older adult -- apparently confined to home or even to bed -- not get into the community-based long term care system? How does a person reach the point where they cannot feed themselves and not have an aide? Don't people know to call for help? Isn't that what the blue pages in the telephone book are for? [They still have the blue pages, don't they?]

• Why do we in the aging services network not know about our (potential) clients unless they throw themselves at our faces. Shouldn't we have a way of knowing these things?
  

Shouldn't the care system be a true cradle-to-grave network where a person is never far from (life-sustaining) help when needed? This is a tough nut to crack: how do we track somebody through their lives so that we are there when they need us? Is there to be some eye-in-the-sky that all-knowingly sees people, tracks their records, determines when they need aid? It's important to every person that the needy not fall through the cracks, so important that this question needs to be asked.

We've done a pretty good job at getting all people into some parts of the social services system, either through a type of default, this is how it's done mechanism or through global awareness. The Social Security system nets people seemingly from birth; all people age 65 and over seem to know to get into Medicare. Why can't we get people into the aging network of services before they starve to death?

There are so many people who are slipping through the cracks, in one form or other, that we need to reexamine what it is we are doing with our service system and why we miss people who are truly in need. We should know where the elderly are, we should know whom among them need support, and we should be able to offer that support. Forget arguments of costs of community based long term care versus nursing homes or other residential facilities. This is a question of basic morality: people should not be abandoned to starve in their own beds, and if they do they've been abandoned by all of us.