The elderly often won't say they need help Friends can call Social Services

Q & A

November 02, 1993|By Ed Brandt | Ed Brandt,Staff Writer

Edith Smith is 83 years old, lives alone, and is barely competent to take care of herself. If you're concerned about her situation, what do you do?

"Call the local Social Services department," says Handy D. Brandenburg, program manager of Adult Protective Services at the state Department of Human Resources. "She may be a victim of self-neglect."

Other forms of abuse include the physical, the exploitive and neglect by someone who is supposed to care for the elderly person. The exploitive is any action that involves misusing the vulnerable adult's money or property.

QUESTION: Your department is responsible for adults 18 years old and up. Of the abuse complaints you receive, how many involve the elderly?

ANSWER: About 65 percent of the calls involve people 65 years of age and older.

Q: What is a "vulnerable" adult?

A: This is a specific term under the law. This is someone who can't adequately take care of his or her daily needs.

Q: What part of the population is most vulnerable?

A: The elderly woman is, because she is often alone.

Q: What can be done for that person, or for anyone in that condition?

A: The local Social Services and Department of Aging departments have many in-home services available, including personal care, feeding, housekeeping and the like. The purpose is to see that the person is as comfortable as possible at home so that person can stay out of a nursing home.

This is good for the person and good for the public because of the high cost of nursing care.

Q: Is there a state law that mandates the reporting of elderly abuse?

A: Yes. Under the law, any health practitioner, police officer or human service worker, private or public, who believes that an elderly person is in danger or has been abused, must report their concerns to the local social services department.

Q: Of the four forms of elderly abuse you have mentioned -- physical, exploitive, self-neglect, and neglect -- which is the most prevalent?

A: Easily the largest -- 66 percent -- is self-neglect. Again, people in this category usually live alone and can no longer take care of themselves properly.

Usually, these people have outlived family support and friends.

They might have trouble walking, and, therefore, cooking. They develop bed sores and infections. They are often malnourished and incontinent, and frequently demented.

We get them out of that situation and into a home as quickly as possible.

Q: Do the elderly generally report their own abuse?

A: Rarely. The abused elderly person is often afraid to report abuse because the abuser is often a member of the family, or is someone charged with caring for that person.

The elderly person usually wants to protect the family member. The elderly person is usually dependent on the abuser and wonders what will happen if an incident of abuse is reported.

Actually, physical abuse is rare.

Q: Who generally reports a case of elderly abuse?

A: A friend, neighbor or relative.

Q: Does your department have police or subpoena powers?

A: No, but we work very closely with the police and the state's attorney's offices to see that the elderly are protected and the abuser punished.

Q: What happens if someone calls your agency for help?

A: If it is an emergency, we must investigate and take appropriate action within 24 hours by law. If it's not an emergency, we have five days.

Then we have 30 days to determine if the person is vulnerable -- can't take care of himself or herself -- and abused. If it is determined that the person is not vulnerable, that person can accept our help or tell us to take a walk. We can't force assistance on a nonvulnerable person.

Q: What happens in extreme cases, where people are incompetent and have no one to care for them?

A: Competence would have to be decided by a court. If the person is declared incompetent, there are various forms of guardianship, including public guardianship.

Heads of departments of social services are guardians of last resort for people from 18 to 65. Anyone 65 or over falls under the departments of aging.

The guardian protects the person's assets and sees that the person gets the proper care.

Q: How is the caseload running now?

A: We've been averaging more than 350 abuse referrals a month statewide, of which about 230 involve people 65 years old and over. As I said, however, I would estimate that's only one-tenth of the cases of elderly abuse.

Q: Are abuse reports on the increase, and if so, why?

A: Maryland had 4,284 reported cases of abuse of the elderly last year -- only slightly higher than the previous year.

But most cases go unreported. Various studies estimate that as many as 9 out of 10 cases of abuse go unreported. Some estimate an even higher ratio.

The reports are increasing in pace with the increase in the elderly population, which is the fastest growth area by far.

A lot of factors are involved in abuse of the elderly, including the breakdown of family structure and increasing longevity, but no one factor stands out.

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