The capacity to be Harper Lee

In February, the author Harper Lee stunned the world with the news that, in July, she will publish “Go Set a Watchman.” It’s Lee’s second novel, coming out decades after her iconic and transformative work “To Kill a Mockingbird.”

In the weeks to follow this news, more news was created.

Lee’s 88 years old, a resident at the Meadows, an assisted living facility in Maycomb, Alabama. Friends were concerned. They say she suffers from memory, hearing and vision loss. Her day-to-day affairs are under the close supervision of the same lawyer who discovered the long lost novel and negotiated its publication. Alabama’s Department of Human Resources initiated an investigation to determine whether she was the victim of elder abuse.

On April 6th, the Department’s letter to Lee’s attorney concluded she is not. The case is closed. But the conversation about how we investigate cases of alleged abuse and neglect should remain open.

In “Is Harper Lee Killing her own Mockingbird?” published in the Philadelphia Inquirer, I examine how we address questions of capacity and undue influence. They are among the greatest challenges in cases of alleged elder abuse and neglect.

I examine the challenge of person’s who have a notable change in their prior well-established habits such as judgments of trustworthiness and risk taking. I've seen these cases, a person who lived a life-time of frugal spending and investment suddenly begins sending money to people promising a large foreign lottery payout.  

For Lee, we can now be assured that her self as she wishes to be is being respected, not exploited. For all of us, this is an opportunity to reflect on one of the 21st centuries emerging challenges to our both our civil and private lives.

Changes in older adults’ cognition and their need for others to assist them with daily tasks together with accumulated life-time wealth make them easy prey to exploitation and abuse. And if they lose their wealth, they have limited, if any, ability to start over and recover their losses. As a result, family or the state has to step in and pay.

Living with cognitive impairment and frailty puts them at heightened risk of being treated as merely a means to someone else’s ends. We have an urgent public health mandate to advance the science and practice of capacity assessment.