RICHARD ROUTMAN: We Need to Talk About What's Happening to Our Elders

Alzheimer's and elder care demand our attention not just because millions endure them, but because the systems that are supposed to protect our most vulnerable are fundamentally broken. In light of the upcoming release of our documentary, No Country For Old People; a Nursing Home Exposé, August 1st on Amazon, my producing partner and today's guest host, Rick Mountcastle (whose work prosecuting Purdue Pharma was dramatized in Hulu's "Dopesick") and I are turning our focus on elder abuse. 

In this powerful episode, we're joined by Richard Routman, whose 14-year career at the Department of Health and Human Services gave him a front-row seat to nursing home neglect cases, pulls back the curtain on why elder abuse persists despite seemingly robust regulations. The reality is sobering: residents fear retaliation if they report mistreatment, staff worry about losing jobs if they speak up, and facility administrators actively obstruct investigations by altering records or instructing employees to "forget" incidents when questioned by surveyors. Meanwhile, the regulatory landscape remains fragmented between federal agencies, state surveyors, Adult Protective Services, and law enforcement—creating dangerous gaps where abuse reports disappear.

Most troubling is how money influences the entire system. The nursing home industry spends hundreds of millions annually on political contributions and lobbying, effectively buying themselves protection from meaningful reform. As Richard notes, ordinary citizens advocating for better care are "fighting with sticks" while the industry fights "with guns."

Yet this conversation offers hope through specific action steps. Every county has a Commission on Aging that citizens can join to question officials and advocate for improved oversight. Families should learn their rights regarding documenting care—in many cases, they can legally record conditions despite what staff might claim. Most importantly, Richard reminds us that cultural change starts with rejecting the ageism that treats elder abuse as somehow less urgent than child abuse.

Don't miss our documentary "No Country for Old People" launching on Amazon August 1st. Until then, remember that knowledge, community action, and love remain our most powerful tools against a system that too often fails those who built our world.

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