As a geriatric medical specialist, I am all too familiar with the telltale signs of elder abuse, which is disturbingly common among American seniors.
So as an alarmed citizen, I have referred former President Joe Biden to the Adult Protective Services Division of Delaware’s Department of Health and Social Services as a likely elder-abuse victim — naming Jill Biden, Dr. Kevin O’Connor and former Biden chief of staff Jeffrey Zients as possible perpetrators.
The news of Biden’s advanced prostate cancer diagnosis, the release of audio from special counsel Robert Hur’s 2023 interview and the revelations of Biden’s cognitive decline from the new book “Original Sin” make it clear to me that we’re seeing something even more malevolent than a political and media cover-up: The former president was, and likely still is, being victimized.
Elder abuse is an intentional act or failure to act by a caregiver or another trusted person that causes or creates a risk of harm to an older adult.
As this case tragically demonstrates, it can happen to anyone, committed by anyone.
Visible bruising and other injuries from physical violence are obvious forms of abuse.
Non-violent actions — like deprivation of food, causing weight loss, or intimidation, causing social withdrawal and personality changes — are also defined as abusive behavior.
A more sinister type of elder abuse, however, involves the exploitation of an elderly individual for the abuser’s financial, personal or — in this case — political gain.
It seems apparent that those closest to Joe Biden, people upon whom he was and remains dependent, usurped the power and authority of his office for their own benefit, while professionals who had a duty to protect him failed to do so.
Who can forget Jill Biden’s gushing praise of her husband’s humiliating performance during the presidential debate?
What was behind her insistence that he run for office when she, above all others, had to be aware of his failing cognitive capacities and declining physical health?
Is she a loving spouse or a master manipulator, using his dependency on her to control his decision-making? If the latter, she is engaged in elder abuse.
What kind of medical professional could fail to recognize the profound deterioration of the president’s physical and intellectual capabilities?
How could a physician issue a clean bill of health for someone so obviously suffering from dementia, condoning the pursuit of another four-year stint in the most cognitively challenging job on the planet?
How could any clinician fail to diagnose prostate cancer when it was still in an early, potentially curable stage?
Either Dr. Kevin O’Connor failed to practice medicine at the professional standard of care, or he has actively participated in a cover-up — in which case he, too, was involved in elder abuse.
The case against him is even more egregious since O’Connor, above all others, had a professional duty to protect his patient.
Which person — or indeed, how many people — on the president’s staff used his autopen to sign official documents, including the dozens of presidential pardons in his final days?
Surely, they recognized the same limitations that Hur saw when he de facto acknowledged Biden’s lack of cognitive capacity.
But even if they blinded themselves to the truth, the Justice Department’s website specifically defines as elder abuse the use of a senior’s signature to execute monetary and other transactions the individual doesn’t understand.
Shame on Jeffrey Zients and all other staff members who literally stole the authority of a compromised, vulnerable old man for their own purposes.
The referral I filed to the state of Delaware did not recommend Hur for investigation, but I find his actions both questionable and concerning.
He declined to press criminal charges against Biden for illegally retaining classified documents, because he found the president to be “a sympathetic, well-meaning elderly man with a poor memory.”
As a trained attorney, however, Hur must have been aware that the American Bar Association recognizes the legal concept of “undue influence” as it relates to elder abuse: the intentional use of social influence, deception and manipulation to gain control of the decision-making of another.
Hur came to his conclusions regarding Biden’s lack of capacity in October 2023, but failed to sound the alarm — despite being fully aware that the complex orders and documents being issued in the president’s name exceeded his cognitive capabilities.
Didn’t he have a duty to do so, under his profession’s stated standards?
In our system, the final determination of whether an elder has been the victim of abuse is made by a state’s Adult Protective Services agency, following its investigation of a credible allegation.
We can only hope that the state of Delaware will function as it should — and give the former president the attention and scrutiny his tragic situation deserves.
Elaine Healy, MD, FACP is a practicing geriatric physician and certified nursing-home medical director.