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Protecting Vulnerable Seniors: Adult Protective Services Promotes Quality of Life

June 02, 2016

When we hear of an older or disabled adult being abused, neglected, or financially exploited, we cringe. But our ingrained respect for personal privacy sometimes overshadows a common sense action step to protect the vulnerable person. Or, we don’t know what to do.

Lance* and his siblings had misgivings about their sister moving back in with their mom because of her history of drug abuse and bad relationships. Though her stay was intended to be temporary, the sister stayed on and on, month after month. In time, family members began to see that she was manipulating their mom out of her money and not providing adequate care. So they took a variety of steps to try to intervene. The close relationship of mother and daughter, however, was an added complication, and the siblings were stymied about how they could help and protect their mother, who had health issues and mild dementia.

Statewide network
Illinois has a social services and advocacy-based methodology vs. a law-enforcement approach for dealing with mistreatment of seniors and disabled adults. So, designated organizations across the state receive funding and authorization to investigate, assess, and follow up on reports of abuse, neglect, and exploitation. North Shore Senior Center has been part of this network since 1988 when legislation was adopted in Illinois to ensure funding for protective services.*

The Center’s service area for investigating reports of mistreatment or self-neglect* encompasses New Trier, Maine, and Northfield townships. When a report is made to the Illinois Department on Aging through the statewide 24-hour hotline, those cases that fall within the Center’s geographic region are live-transferred during business hours to the Arthur C. Nielsen, Jr. Campus in Northfield. Holly Lichtman, LCSW, supervisor of the Center’s Adult Protective Services (APS) program and her team of social workers and interns prioritize the reports. Highest priority is given to physical or sexual abuse or in cases where the senior’s assets are depleted due to exploitation. A social worker is on call at all times in order to investigate the most serious reports expeditiously, even in the middle of the night.

Responding to Reports
Once a report has been received by social workers, the Center is obligated to investigate for the next 30 days. The APS team must determine whether the report can be substantiated and what follow-up action is necessary. Holly commented, “It’s not really a voluntary program, because once we receive the report, our first visit is unannounced.” All investigations are confidential and include an assessment of the person within the environment. For example, the social worker looks for any physical signs of abuse, asks questions about living arrangements and caregivers, and finds out who is paying the alleged victim’s bills.

In some cases, the individual may not accept—may even refuse—APS services, but social workers might conclude that case management or other community-based services are appropriate. Thus, the APS social worker will refer the older adult and family to the appropriate services. The aim is to keep the victim at home and to ensure adequate support and protection. If the senior or disabled individual is unable to make decisions and a social worker has determined that the person still is at high risk of abuse, neglect, or exploitation, APS social workers provide counseling, continue to monitor the situation, and develop intervention goals to reduce the risk.

Types of Abuse
“We receive reports from doctors, home health care workers, family members, or even from victims themselves,” said Holly. “And each client situation is different.” The abuser, though, is most often the caregiver, whether a paid care provider or a family member. APS social workers frequently see cases of passive neglect and often can work with family members to improve care, such as suggesting an adult day program to help relieve caregiver stress. Other forms of mistreatment include physical abuse, sexual abuse, emotional abuse, confinement (i.e., restraining or isolating), deprivation of medical or other necessities, and financial exploitation

Professional Intervention is Vital
In mid-2015, after a series of reports—from caregivers, a cleaning lady, and siblings living nearby—that his mother was experiencing emotional abuse and neglect, Lance called the Center’s APS program directly. “Mother’s physical condition was deteriorating, and her dementia was worsening to the point she really wasn’t competent to make wise decisions. We had reached the end of our rope,” said Lance, “and Holly helped put the wheels in motion to improve the situation.” This included a series of visits—some unannounced—by social worker Jennifer Fryman and a report to the court system. The court then created a guardianship and ordered the eviction of the sister. In addition, Jennifer helped make arrangements for 24-hour caregivers.

Holly and her team are committed to promoting the safety, independence and quality of life for older adults and adults with disabilities. She has been with the Center for 16 years and views her work in the APS program as a wonderful opportunity to protect the most vulnerable adults by providing services to protect them and keep them in their own homes. “It’s gratifying to work with families who might not be aware of services that are available,” she said, “and to educate them about how they can provide better care or to assist them as they aim to protect a family member from abuse.”

When working with the victim, social workers directly and frankly discuss the situation and always respect the adult’s right to confidentiality. “We also value a person’s right to self-determination if that individual is decisionally capable,” said Holly. “We might believe the victim is making a bad decision, but that person has the right to make his or her own decisions. If the choice is to refuse services or do nothing to remedy the conditions, we have to understand our role as social workers and that we’ve completed the purpose of our involvement.”

Report and Support
You might be inspired at this point to join the effort to protect at-risk older and disabled adults. What can you do? Report a suspected case of abuse and/or financially support these important services.

Abuse and exploitation do occur in our community. The Illinois Department on Aging notes that “only about 1 in 14 cases [of mistreatment] is actually reported. This means that the vast majority of victims are suffering, often for years, when there is help available.”* 

So get involved if you suspect that an older or disabled adult in your family or community is being abused, neglected, or financially exploited. Call North Shore Senior Center at 847.784.6000 or the toll-free, 24-hour Adult Protective Services Hotline: 866.800.1409. Your report can be made anonymously if you wish, and all calls are confidential.

Lance commented, “Without protective services to shine the light on our dilemma, it never would have been resolved, and I don’t know what would have happened to Mother.” He continued, “Their response was very professional and impartial. They are not part of our family, so their intervention was absolutely pivotal in our being able to protect our mother. Hopefully, now, we’ll be able to give her appropriate care for the rest of her life. We could not have done this alone.”

The Center receives and investigates more than 260 reports of abuse each year. In addition, Holly and her team educate professionals and community residents about the APS program and other resources that are available. These services are funded in large part by the Center’s contract with the State of Illinois Department on Aging. However, philanthropic donations help to ensure the Center’s excellent record of responding professionally, effectively, and compassionately to reports of abuse in our community.

*Identifying details have been altered to protect privacy.
*Originally called the Elder Abuse & Neglect Act for adults 60+, the statute became the Adult Protective Services Act in 2013 to also include disabled adults ages 18 to 59.
*Although self-neglect is included in the list of APS concerns, sufficient funding from the State of Illinois has not yet been appropriated. Funding is expected in 2016.
*Illinois Department on Aging. 2/2014. Abuse, Neglect and Exploitation: How You Can Help. Printed by the State of Illinois.