This week, I sat down with one of Community Partnership on Aging’s outreach/social workers, Lynn to learn a little bit about Adult Protective Services. Lynn worked there as a social worker, advocate, and ran the Community Office on Aging for many years, and after retiring she couldn’t stay away from working with older adults. She is with us now serving the cities of South Euclid, Lyndhurst, and Highland Heights as one of our social workers.
Elyse: What is the goal of Adult Protective Services?
Lynn: The goal is to investigate allegations of abuse, neglect, and financial exploitation. There is also an agency that specifically works within nursing homes and another agency that exists specifically to protect the developmentally disabled.
Elyse: Is Adult Protective Services a federal program?
Lynn: Adult Protective Services is a state law. A law exists in every state, and is a little bit different in each one.
Elyse: How does Adult Protective Services define who they are protecting?
Lynn: In Ohio, it is defined as someone who is 60 or above and/or is cognitively impaired – someone described as vulnerable. All but nine states use age 18 and above – Ohio is one of the nine exceptions. Cuyahoga County accepts referrals age 18 and above as do some other counties, but services to those individuals occurs only under very specific conditions.
Elyse: Who refers people to Adult Protective Services?
Lynn: Anyone can make a referral. However, there are some individuals that are required to report signs of abuse, neglect, and financial exploitation. Those individuals are mandated reporters, and include people who work with the elderly – for instance, health care professionals, lawyers, and senior service providers.
Elyse: Do people ever call to report something that is happening to themselves? For instance, someone might call and say, “A family member is stealing money from me.”
Lynn: Not typically – almost 50% of reports are for self-neglect, so most people wouldn’t call and say, “I am neglecting myself.” The majority of referrals come from other professionals who are involved in the person’s life. The second most reported problem is neglect by others – it accounts for 25% of all calls.
Elyse: How does Adult Protective Services define “neglect” when it comes to adults?
Lynn: Neglect is defined by the National Adult Protective Services Association as the failure of an adult to provide goods or services necessary to avoid physical harm, mental anguish, or mental illness. This could mean failure to provide for him/herself or the failure of a caregiver to provide for an older person. Basically, the individual or caretaker is not meeting the person’s basic needs for food, shelter, physical healthcare, and/or mental healthcare.
Elyse: If someone calls to report abuse, what usually follows that report?
Lynn: Once a referral is accepted by APS, there is a 30-day investigation. It begins with looking at the individual, and then from there looking at the support system around that person – doctors, neighbors, friends, and families. When a decision is made as to how to proceed, the goal is always to keep the individual in the least restrictive environment possible. Less than 1% of individuals end up needing any kind of guardianship.
Elyse: It seems like people might be scared to call because they are worried a friend or loved one might get taken out of their home or put with a guardian, but it sounds like that is rare.
Lynn: 99% of the time the services are provided on a voluntary basis. Other times the individual refuses services but the situation isn’t serious enough to warrant going to court to take further action to mandate intervention. If someone is competent, they have every right to make a bad choice. If Adult Protective Services were to get a call that someone is living in squalor, and they have always lived in squalor and that is what they want, they are free to continue living that way, assuming they are competent. If Adult Protective Services were to find someone living in squalor, but saw a picture of them at their house and it is clear that they are behaving in a way that is not consistent with past behavior, APS would investigate as if the person is still able to make choices that are in his/her best interest. However, most of the time when APS investigates, the person is considered competent. Sometimes the person refuses any further involvement by APS and other times APS is able to introduce the person to a resource they didn’t know was available – for instance discounted transportation for seniors – and the problem is solved. Now, he or she can get to doctors’ appointments, and the self-neglect ends.
Elyse: Is there a checks/balances system in place as far as determining competency goes?
Lynn: If the competency of an older adult is in question, APS will determine whether guardianship needs to be pursued. If so, the Cuyahoga County Probate Court will conduct an assessment of their own and a physician’s statement will also be required as a part of the guardianship process.
Elyse: Are there any programs in particular that Adult Protective Services refers to that you want to highlight?
Lynn: One great program is the Representative Payee program. In this program, an older adult is able to operate independently in the community, but Social Security has appointed a person or agency to manage the individual’s finances. So, each month this payee would get the person’s monthly check, pay the individual’s bills and rent, and then give him/her spending money.
In addition, there is the Volunteer Guardianship program. Some folks in that 1% who do need guardians but do not have family to serve in this role. In these cases, the court needs to appoint a volunteer that acts in the best interest of the individual. Volunteers are typically retired attorneys, clergy, social workers or members of the community. An extensive training program is provided by the Adult Guardianship Program for all volunteers.
Elyse: Is there anything else you want to add as we end our discussion?
Lynn: There are estimates that say for every 1 case of abuse, neglect, and financial exploitation of the elderly and vulnerable that is reported, 23 go unreported. If you see signs of abuse, neglect, or exploitation, report it (see links to resources below on signs of abuse). The number to call is 216-420-6700. Referrals may be called in by anyone and can be anonymous. Referrals from persons who wish to identify themselves can also be made through the website: dsas.cuyahogacounty.us/adultscreening/