The stories are heart wrenching and often difficult to imagine, but the existence of elder abuse, neglect, and exploitation is very real. The National Council on Aging (https://www.ncoa.org/article/get-the-facts-on-elder-abuse) estimates that 1 out of every 10 Americans aged 60 or over has experienced some type of abuse.
Last week’s column explained the definitions of elder abuse in Pennsylvania and important factors in regard to the reporting of elder abuse https://keystoneelderlaw.com/elder-abuse-safeguarding-the-vulnerable/. Adult Protective Services (APS) is the program responsible for the investigation of elder abuse, neglect, and/or exploitation (ANE) and the coordination of services to meet an older adult’s needs and shield them from further harm. The pattern for providing protective services to adults is similar across many states even though every state has its own definitions and regulations for ANE.
Adult Protective Services is not the only resource available for older adults who have been mistreated. One critical element to understand is that APS has no authority enforce criminal charges in ANE cases. In situations where the abuse is severe and/or life threatening, law enforcement may also be involved. APS also does not handle scams or cases of fraud involving older adults. These situations are handled by the Federal Trade Commission and/or state Attorney General.
Situations appropriate for APS referral are those in which the victim has some type of relationship with the suspected abuser. When criminal and/or civil actions against an abuser are appropriate, Adult Protective Services will work with the authorities and legal counsel to pursue justice for the victim, in addition to arranging for necessary services.
An aspect of Adult Protective Services which isn’t well understood is eligibility. Older adults who are abused do not automatically qualify for protective services. Every state has its own eligibility rules. In PA, an “adult in need of protective services” is defined as “an adult who needs the assistance of another person to obtain protective services in order to prevent imminent risk to person or property.”
When making a report of suspected elder abuse, it is helpful to describe why you believe that the victim is eligible for services. Since this information might not be readily apparent, it can help the person receiving the report to properly classify it into 1 of 4 categories.
- Priority – Priority cases are ones which require immediate attention because the older adult is at risk of serious injury, serious bodily injury, or death. The report is shared with an APS caseworker right away so that an investigation may begin. Ideally, an in-person interview with the alleged victim occurs.
- Nonpriority – If there is no imminent threat of serious harm, a nonpriority report will be shared with a protective services caseworker during the agency’s normal operating hours or on the next business day. An investigation must begin within 72 hours of the report.
- Another planning and service area – If the potential victim is away from home when a local report is filed or does not live in the area where the report is made, a referral will be made to a protective services agency with jurisdiction over the area where the older adult is physically located at the time of the report. The new agency will then reclassify the report to one of the other 3 categories.
- No need for protective services – If the older adult is determined to be able to independently perform or obtain the services needed to sustain mental and physical health, OR there is not an immediate risk to health or property, then a report will be placed into this category. A separate caseworker will then review the report and this designation. The caseworker may agree and provide referrals to other organizations before closing the case, or the caseworker may change the category and proceed accordingly.
Placement into the last category does not necessarily mean that a crime has not been committed, or that civil intervention to stop the abuse, recover property, or seek damages for pain/suffering is inappropriate. Legal consultation may be advisable even when APS is unable to provide assistance. Of all forms of elder abuse, emotional abuse is the most difficult to charge as a crime.
There are several finer points which are critical to understanding the nature and scope of APS. Self-neglect is not a crime, but is included in definitions of elder abuse to allow for eligibility under APS guidelines. A report which involves an adult who lives in a care facility which is licensed by a state agency will be referred to that licensing agency for investigation. Finally, unless a court order has been issued under specific regulations, the initial assessment by APS and the receipt of specific services are voluntary.
Public attention, government policy, and funding for the protection of older adults from abuse, neglect, and exploitation are nowhere near the levels received by the social issue of child abuse. World Elder Abuse Awareness Day (https://eldermistreatment.usc.edu/weaad-home/about/ ) is held annually on June 15th. It was established in 2006 and recognized by the United Nations General Assembly in 2011 in response to the need to educate citizens of the global community about this problem.
Are your older relatives, friends, and neighbors at risk? Pennsylvania’s Elder Abuse Hotline is 1-800-490-8505. If you suspect that elder abuse is occurring and are hesitant to get involved, please remember this quote by Edmund Burke: “The only thing necessary for the triumph of evil is for good men to do nothing.”
Karen Kaslow, RN, BSN