Coordinated Response Helps Prevent Abuse, Neglect, Exploitation

Helen is an 84 year old woman who was befriended by an acquaintance she met during a time in her life when she was most vulnerable and lonely. This "friend" developed a trusted relationship with her, promised to take care of her, and pay her bills. Instead she isolated her from her friends and family and swindled her out of her life savings. Helen was left with a housing eviction notice, credit problems, and emotional trauma. The ADS Elder Abuse Case Manager assisted her in applying for and obtaining affordable housing, linking with mental health support, referred her to legal support to address her eviction and credit issues, and supported her through the process of police interviews and trial. Now Helen has stable housing and ongoing emotional support. She is socially and physically active, thriving, and happy.

Helen's story is just one of the 260 elder abuse cases that Aging and Disability Services (ADS) case managers have served since February 2012.

Elder abuse is a growing problem in the United States, yet a largely hidden one. Although the public is becoming increasingly aware of the issue, many older adults hesitate to reveal incidents of abuse, neglect, or exploitation, especially when the abuser is a family member.

Reported cases are the tip of the iceberg. The majority of cases go unreported. As an illustration of this, a New York State 2001 study found that the elder abuse incident rate was nearly 24 times greater than the actual number of cases referred to social service, law enforcement, or legal authorities. According to Ageless Alliance, as many as 1 in 10 older adults and one-half of people with dementia are victims of elder abuse. Only 1 in 44 cases of financial exploitation gets reported.

June 15 is World Elder Abuse Awareness Day—an annual event launched in 2006 to draw attention to elder abuse as a worldwide public health and human rights issue.

In part, elder abuse is under-reported because of an older adult's fear of what might happen to them if they do report the incident. They may worry they'll be taken from their home and placed in a facility. They fear they might not be believed. Oftentimes, they fear that reporting the abuser's actions will get the abuser in trouble and result in them no longer being able to get the help they need in the home. This is because the abuser is oftentimes a family member of the victim.

One in 10 financial abuse victims will turn to Medicaid in their lifetime directly as a result of the monies stolen from them. Victims are four times more likely than non-abused older adults to end up in nursing homes. Victims have a mortality rate that is three times that of others in their age cohort.

Unfortunately, many health care, financial, law enforcement, paramedics, fire fighters, and social service professionals don't recognize the signs of elder abuse, neglect, or exploitation. When they do, often they don't know who to refer to or where to turn for help. Training for these professionals is an important step in bringing the abuse to light and helping the older adults in our communities.

Aging and Disability Services' Elder Abuse Case Management Program provides advocacy and social work support for individuals 60 years and older in King County who are struggling with abuse, neglect, or exploitation. The elder abuse case manager serves these older adults by connecting them to information and resources to address their needs, and works in coordination with law enforcement, Adult Protective Services, legal services, and other service professionals. Our goal is to support the individual as they navigate through these systems and provide support as they work to stabilize their lives.

In addition, Aging and Disability Services is partnering with Seattle Fire Department (SFD) and King County Emergency Medical Services (EMS) to improve Vulnerable Adult reporting by firefighters, emergency medical technicians, and paramedics. Since the start of the SFD/ADS partnership in September 2014, 182 Vulnerable Adult reports have been generated, with follow-up by a dedicated ADS case manager.

Preliminary data indicates SFD/EMS is doing very well at identifying and reporting residents in need of services. Only 13 percent of those reported were receiving formal services at the time. The SFD/EMS reporters get feedback from the ADS case manager regarding the disposition of the patient as well as efforts made to investigate the report and coordinate services. This feedback provides important training for first responders in recognizing and reporting situations of potential abuse and/or neglect.

Seattle Fire Department responded to a call from a 95-year-old woman who was living with her 97-year-old brother. Neither of them was receiving any assistance and they lived very independent lives. She had called 911 after he hadn't moved from his recliner in two days. He had not wanted his sister to call for help—both thought he just needed to rest and would get better. He was found to be very frail, dehydrated, and covered with pressure sores. Once at the hospital, it was determined he had had a stroke and would not be able to return home. The ADS/SFD Case Manager was able to meet both siblings at the hospital. Later, the case manager went to their home where she helped the sister start to plan for her future without her brother at home and get services in place. Had Seattle Fire Department not completed the Vulnerable Adult report on the brother, the 95-year-old sister might not have had services offered to her.

To learn more about the issue of elder abuse, visit these websites:

If you know an older adult whom you believe is a victim of abuse, neglect, or exploitation, contact Adult Protective Services at 1-866-END-HARM or your local law enforcement agency.

Contributors Kathi Church, Suzy Miller, and Karen Heeney specialize in supporting victims of abuse, neglect, and financial exploitation for Aging and Disability Services, the Area Agency on Aging for Seattle-King County. Read also Why You Should Wear Purple on June 15 (AgeWise King County, June 2014).