Adult abuse and neglect referrals continue to exceed previous years

BATAVIA, OH — Referrals for elder abuse, neglect and exploitation in Clermont County have almost doubled since 2016 for a number of reasons:

In 2016, Clermont Senior Services handled 257 referrals. The agency expects more than 500 referrals this year.

“National research indicates that only one out of 10 cases of abuse is reported,” said Edna Burns, director of Home Care, Case Management and Adult Protective Services. “Based on the population of Clermont County, the number of cases would be so much higher if all cases of suspected abuse, neglect or exploitation was reported.”

Senior Services has served as exclusive contract provider for Adult Protective Services with the Clermont County Department of Job and Family Services since 2000.

Adult Protective takes calls at Senior Services at 513-536-4085, 8 a.m.-4:30 p.m., Monday-Friday. After-hours and holiday reports are received by Job and Family Services at 513-732-7173, and Senior Services is notified to start the process of investigation.

The Adult Protective Services team includes three full-time and one-part time investigators. Burns, a Registered Nurse, devotes about half of her time to managing Adult Protective.

“Adult Protective is the only state-mandated service in Ohio for this population,” said Cindy Gramke, executive director of Clermont Senior Services. “Meals, home care, adult day care, transportation… are critical, but not mandated.”

Abuse, neglect and exploitation cases have become more complex. Some victims face a combination of neglect, physical abuse, financial exploitation, psychological abuse, sexual abuse and abandonment.

Gramke said the complexity requires an interdisciplinary response from Senior Services, Developmental Disabilities, Mental Health and Recovery, Sheriff’s Office and township law enforcement, Probate Court, Prosecutor’s Office, Mercy Health – Clermont Hospital Geriatric Behavioral Health, and others. A Mobile Crisis Unit activates regularly and a 30-member team meets monthly to review cases and develop process improvements.

“We’ve got the right mechanisms in place,” Gramke said. “We move far more quickly for all the right reasons. The channels are far more open to really helping an individual.”

The Ohio Database for Adult Protective Services launched in 2017, connecting all counties. This allows for tracking of cases across county borders and collection of helpful stats for planning purposes. From July 1, 2017, through June 30, 1018, a total of 14,597 reports of abuse, neglect and exploitation were received for adults ages 60 and older statewide. A total of 4,490 individuals across the state were identified as in need of services, with 1,239 refusing services. That’s the big difference from Children’s Protective Services. Adults can refuse services.

“The people we are dealing with are not children,” Burns said. “An adult has a right to self-determination and we must respect this, even though we may not agree with their decisions and this may be frustrating to an outsider. We can’t just go in and make them do what’s best for them. APS Investigators must follow regulations, which may limit at the time what Adult Protective Service Investigators may be able to do.”

Additionally, family members are not obligated to care for their aging parents or grandparents or extended family members unless they are currently acting in the role of caregiver.  If a person has been acting in the role of caregiver and then stops this may be neglect.

Adult Protective becomes the advocate of the adult who is referred, not of the person making the referral. Adult Protective can refer to appropriate services, but cannot make the adult accept them. The agency can refer exploitation to law enforcement.

Burns said that 53 percent of Clermont County’s cases in 2018 were for self-neglect, with 25 percent for exploitation, and 19 percent neglect by others.

Exploitation comes in many forms and one of APS has seen recently is scams involving transfer of money. Scams may include the “sweetheart scams” where a person convinces a lonely senior that they are in love and bilks money from the unsuspecting person or the “get rich” scam. This year APS also have received more referrals involving homelessness or possible eviction, often with people running short of rent money.

“A lot of people may think of physical abuse, but self-neglect is prevalent because they don’t want to bother their family, have no family, or do not know how to navigate the system,” Burns said. “A lot of people in their 80’s do not want to bother anybody because they were self-sufficient for so long. We’ll find out about their situation when they fall and EMS goes in. Something happens that makes someone notice, and we get a report.”

Adult Protective investigates and evaluates the problem and comes up with a case plan for assisting the adult’s situation. Adult Protective Services, represented by Burns or one of the Investigators and assistance from the Assistant Prosecuting Attorney for the county will go to court for a protective order as a last resort. For example, a person with dementia who may be living in unsafe conditions without assistance from family or friends.

In some cases, either a guardian of the estate is appointed for financial decisions and a guardian of person to make decisions not involving money. Due to a need for guardians, a volunteer program has been started for guardians of person. Volunteers require online training and have support from Licensed Social Workers connected with Clermont Senior Services as needed. This program is separate from Adult Protective Services.

Under protective orders through court action, APS Director is sometimes appointed as a decision maker for placement and monitoring care of the person until a permanent guardian of person can be appointed by Probate Court.

“Our goal is to keep the adult in the least-restrictive environment, to keep the person in their home,” Burns said. “We try to keep our eyes on them through services they receive. Clermont Senior Services will host free trainings for community partners during the year. Everyone is pulling together to help this growing population in need of help.”