Hot Lines Help Combat Abuses of the Elderly, but They’re No Cure-All

In Ocean County, N.J., an elderly widower who was confined to his wheelchair was regularly beaten by a longtime family acquaintance who said she was there to care for him.

A neighbor heard the old man’s screams and the sound of objects being thrown against the wall. He called a 24-hour county hot line set up to handle reports of abuse of the elderly. Social workers went to the house but were refused entrance by the woman.

They called the police, who found a battered old man in his mid-70s. The state intervened and had him placed in a nursing home.

But county officials could not remove the woman from the home. She somehow had persuaded the man to sign over all his possessions to her.

Still, social workers involved in the case believe that had they not intervened, the man would be dead.

Unlike Ocean County, most areas of the country do not have hot lines set up specifically to take complaints of neglect and abuse in home health care settings.

They will soon, however. In 1987, Congress passed a law that requires all states to have such toll-free lines accessible in every county. The law is expected to be implemented this spring, after the Health Care Financing Administration sets regulations.

Reports of abuse of the elderly have skyrocketed in recent years, as the population has aged and older people have been forced into long-term care arrangements.

In response to increasing complaints about nursing-home abuse, several years ago Congress required states to create an office of ombudsman for long-term care. While all states have complied, officials say nursing homes account for only a small portion of the abuses committed against the aged.

The American Public Welfare Assn. in Washington says that 200,000 cases of elder abuse are reported annually, but the group estimates that the actual number of cases approaches 1 million a year.

“I feel pretty comfortable that if somebody wants to call into one of our hot lines, they will get help,” said Steve Valli, a supervisor for the New Jersey Office of Adult and County Services, which has one of the most extensive hot-line programs in the country. “But it can be pretty frightening for old people to report crimes committed against them.”

A lack of resources to follow up on abuse cases also has hampered efforts to detect and resolve incidents. In some cases, counties and states have hot lines but a scarcity of social workers. This is particularly troublesome and can result in tragic consequences.

In Illinois, a county agency received a call over its toll-free hot line from a woman who had been abused by her daughter. The agency responded by sending a social worker, who met with the daughter and persuaded her to stop the abuse.

Soon afterward, program financing was cut and the social worker stopped visiting the family for follow-up consultations.

The daughter resumed abusing her mother, who ended up in the hospital with cigarette burns all over her body. Both legs had to be amputated. Today, the woman is in a coma.

State and county welfare officials say that such tragedies are often unavoidable because resources are stretched to the limit.

“The (county) agencies just don’t have the money,” said Carolyn Stahl, supervisor of planning and program development with the Illinois Department of Aging. “We’ve asked the (Legislature) for 2 years to increase funding.” The Assembly and the governor have denied the increases.

Stahl and other state officials say that Congress is predisposed toward strengthening reporting requirements but is unwilling to provide funds for workers to resolve the problems.

In the end, hot lines for reporting cases of abuse or any other type of violence against old and young alike will only be as good as the response from state or county agencies, said Roland Hornbostel, the Ohio ombudsman for long-term care.

“The hot line will facilitate access,” he said. But “it would be a mistake to conclude that just because states have installed these hot lines that you’re ferreting out all this abuse.”