M.T. Connolly is a leading expert on elder justice and author of “The Measure of Our Age: Navigating Care, Safety, Money, and Meaning Later in Life” (Public Affairs, 2023). A Justice Department attorney for 22 years, she helped write the Elder Justice Act of 2010, was the founding head of DOJ’s Elder Justice Initiative, worked with a team assembled to prosecute nursing home fraud, and co-wrote the 2014 Elder Justice Roadmap, shaping federal, state, and local research, policy, and practice. A MacArthur Foundation “genius” grantee, she also co-created the RISE model, designed to empower older adults, reduce harms, and promote elder justice. Our interview has been edited for clarity and length.
Gerson Galdamez: When we met, I was a first-year gerontology doctoral student at USC and around the lab we’d say: “M.T.’s working on an elder abuse book.” We all knew what a daunting task that was. Even though elder abuse feels like a niche issue, it’s actually a window into the broader world of gerontology and snowballs into many interconnected issues. What was the process of writing it and some moments of learning and shifting to what the book became?
M.T. Connolly: I love your description of elder abuse being a window into gerontology. But I more often use the term “elder justice” these days because it better reflects what we want as humans. The book started out as sort of an exposé about elder abuse— wonkier and really depressing. Then I thought about writing predominantly through the eyes of victims, which was less boring but still really depressing.
One problem with aging is that people are so scared of it. They’re scared to think about it, scared to live it, scared to talk about it — as individuals and as a society. That’s reflected in our families, our institutions, and our professions. And if that’s an issue with aging, it’s magnified tenfold when it comes to elder abuse. So, I decided to write about innovators who were changing things and doing more hopeful work.
Some advisors said “you have to pick a health lane, like medicine, law, finance, or policy.” But aging and elder abuse don’t pick lanes. They veer all over. Like life. So I wanted to write about characters who were doing pioneering work in several different lanes. Laura Mosqueda, a doctor, helps us see geriatric medicine, health systems, and prevention in action. Ricker Hamilton, a social worker, represents APS and social services. Page Ulrey, a prosecutor, shows us how the criminal law responds. Lauren Fuller, a Senate staffer, gives us a behind-the-scenes glimpse into how Congress operates. Alison Hirschel, a legal services lawyer, shows us ways to use the law in preventive and ameliorative ways. And Ron Long, a banker, reveals some ways that financial systems were responding to their older clients.
Then one editor told me, “Your characters are contra dancing; they’re not in the same story. But if you include your own story, you’ll have a narrative arc of your awakening consciousness.” I was reluctant, but he finally persuaded me.
The book also examines what we’ve done as a field and asks, “What are we trying to accomplish? And what’s the impact of our work?” We’ve inherited systems that weren’t built for the problems they’re being used to address and often don’t work that well. Storytelling is the engine, but it’s one thing to tell stories of real people and quite another to tell stories about policies and system. They’re hard to see but often play the role of the book’s “villains." I wanted to help readers understand what they’re up against. When I embarked on writing, I had no clue I was trying to do something so ambitious.
Gerson: I was struck by the role of story and emotion as navigators for the complex web of information in the book, mainly focused on the care of your father. How do you see storytelling as a means of achieving the goals of people who care about aging?
M.T.: Law and policy work can destroy your writing. The language is technical and wonky. I wanted to tell stories that showed how aging operates at lots of levels, in culture, systems, professions, communities, families, individuals, and consciousness. I also wanted to examine aging through several disciplines, like medicine, law, policy, finance and forensics. Trying to weave those things into one story was challenging.
Starting with caregiving seemed to make most sense because it touches tens of millions of lives every day. It’s a very intimate issue and also core to well-being and preventing mistreatment.
Writ large, storytelling is how we make sense of our lives. And sharing stories is how we connect with others at the deepest level. Listening, really paying attention to another person, is a sacred gift. I was struck by this during the pandemic: When things were so horrible in long-term care facilities — no personal protective equipment, tons of isolation, illness and death – some staff members asked residents to tell their stories because it was one healing thing they could do to say “I see and value you as a human being.”
Storytelling is also central to effective advocacy. Numbers, footnotes, and graphs aren’t what change hearts and minds. Stories do.
But telling stories well poses structural and mechanical challenges. What are the mechanics? Most media articles start with some kind of a story”hook”. In choosing what stories to tell and what details to include, you need to ask: What points are you trying to make? Who’s your audience? What stories will resonate for them? If people give you the sacred gift of their time, you want to honor that trust.
Gerson: You also mentioned giving pieces of yourself. Do you have to dig a little deeper for it to feel genuine?
M.T.: Yes. Writing about myself was initially a structural decision. But as I went along, I began to see how my own story—personal and professional— mirrored the bigger story I was trying to tell. Another piece of learning for me was that, ironically, vulnerability can be a form of strength. Sharing what we find confusing, shameful or scary can reduce its power over us, making it less scary and strengthening us in the process.
In using stories — whether as a writer, public speaker, or foundation person — you need to merge what you want to say with who your audience is. If you’re giving an APS talk to a bunch of bankers, or a financial regulation talk to a bunch of APS workers, it won’t seem relevant to them. You honor your audience by taking the time to understand who they are and what is interesting and relevant to them.
Also, reciting accomplishments — “We’ve done these 18 things. Isn’t it beautiful!” — is fundamentally pretty boring. You want to engage brains and emotions by wrapping your argument and ideas in story. And you want to tell those stories in prismatic ways so that different people can hear something in them. We live in a wildly diverse world, and too often stories are told in ways that target too narrow an audience.
Gerson: As you know, Archstone Foundation has shifted its approach to funding care teams, training, and technology to support integrated, equitable, and coordinated care. The need for that is palpable in your book, in which you write that “progress requires both substance and influence.” What can funders do to procure influence, and what aren’t we seeing in terms of what’s possible to move the needle?
M.T.: After what I learned in my research for the book and from the disappointments with the Elder Justice Act, I wanted to build something at the community level in a way that embodied certain ideas and values. In the book, I tell (the short version) of building RISE and test driving it in two randomly-selected counties in Maine. Our aim was to fill several huge gaps: a dearth of intervention and prevention data in the elder justice field, the void between binary systems, and systems that many people are scared to use. We also heard, “If you’re not going to help my family, how are you helping me?” We wanted to build something that addressed those gaps and along the way, ask the people we’re trying to serve what they think about the services.
I think it’s super cool that you guys are looking at teams, and would expand what we know about the impact of teams, and of how they’re composed and operate. Responsible policy makers want to know how the programs they fund are working. What’s the impact? We need to ask if programs and policies improve the wellbeing of the people being served in the way they define it. That’s the “substance” part of the equation.
With RISE, moving the needle was borne of carefully conceptualizing the intervention, rigorous research, continually asking “what’s the impact?,” and constant communication at all levels. We also focused on the “influence” aspect of change, by communicating with community partners as well as with thought leaders and law and policy-makers.
One reason I wanted to write the book was to better understand disappointments in my own work. I had big bully pulpits at the Justice Department and then during a stint at the Senate Aging Committee. It was miraculous to get a bill introduced with as many bipartisan cosponsors as we did in 2002, when the Elder Justice Act was first introduced. We thought the was going to sail through but we were wrong. It languished for eight years. No one came out against it, but no one put real political capital behind it either. That was a big lesson, and a tipoff there was something bigger going on that I didn’t understand. Which is why a central theme in the book is: “How does change happen?”
Translating evidence-based interventions and prevention measures into policy is hard and not something we’ve done well in the elder justice field. We need to have better tactical chops. It helps to have proposals that are supported by evidence and data about their economic impact. And it’s often smart to attach proposals to bills that are “moving” or issues that are getting attention in the culture. These days, loneliness, isolation, and mental health get more attention than elder abuse. And caregiving is finally garnering more political traction too. All those issues are inextricably entwined with elder justice.
Gerson: Any parting thoughts for gerontologists, geriatricians, social service providers, and other aging-specific folks facing mounting problems in aging systems?
M.T.: You’re doing incredibly important work, and we need more of you. You also bring a critical voice and set of skills to teams. Take care of one another because the work is hard, you’re operating in an environment of many broken systems, and the culture undervalues or just plain doesn’t see what you do.
It helps to consider the broader context. We are living longer lives than ever before but we haven’t kept up with that demographic reality. Part of our theory of change for RISE is to work with existing systems, not blow them up. Can we find better ways of doing things together? There’s a lot of hope in that. We’re trying to honor the good intentions behind what’s going on now while also building better tools and new options. To do that you need and lots of communication.
Finally, we need to reconceptualize aging. It’s not just an issue for old people, it’s an issue for all people. We’re all either older ourselves or older people in training. Any of us might become a caregiver or a care recipient in an instant. So, think ahead. Have the hard conversations. And remember that aging is not about “them,” it’s about “us.”
Gerson: And any parting thoughts for those who might not know anything about aging but will surely encounter it someday. Why should they pick up the book?
M.T.: One goal of the book is to help people navigate aging better themselves and with the people they love. We want to get old but not be old. We’ve paid more attention the quantity of years than to the quality of the time we have. This means we’re not only unprepared for aging’s challenges. We’re also often unprepared to take advantage of the most meaningful aspects of aging. In fact, writing about this for the last chapter of the book changed my own approach to life. I hope the book helps readers recognize the challenges sooner, navigate them better, and, also, crucially, not miss out on the things that matter, the things that bring them joy.
The most meaningful feedback I get from readers is that the book has changed how they see aging. One person told me: “I was really judgmental of my sister-in-law when she couldn’t take care of her husband after a decade of hard caregiving. I saw the situation differently after reading your book.” Another reader told me, “Before I felt like my life was winding down. Now I feel like I need to get going because there’s so much more I want to do! And in a good way.”
I hope the book helps transform how we think about aging—ourselves and as a culture. We spend so much worthless energy on fear and shame. But that ageism is useless and destructive. It’s bad for our health and bad for society. We need to recognize our long lives as a gift and focus more on what matters most in the precious time we have.
