Elderly Abuse Numbers Grow as Staff Shrinks

By LISA RICHARDSON

April 7, 1996 12 AM PT

TIMES STAFF WRITER

In a pale-gray, windowless room, home to the Adult Protective Services abuse hotline, the phone rings and rings:

”. . . And she came today with bruises?” asks senior social worker Judy Winne in a soothing tone. She is speaking to the director of an adult day care center who has called about one of her clients. “She said it was her son?”

At the same time, social worker Karen Rater is on the phone with a panicked woman who has called about her neighbor, a sick, elderly man who has no one to help him change the bag he wears to catch his waste.

The hotline has grown busier than ever: Reports of elder abuse and neglect in Orange County have steadily risen since 1992, and jumped 25% in the last year. The reported number of abused adults--three-fourths of whom were senior citizens--reached a record 2,713 in 1995, and the first quarter of 1996 already has seen a 10% increase in reports over the same period last year.

Accompanying the rise in reports has been a reduction in the staff that handles them--including 12.5% of the field workers who investigate allegations of abuse--because of the county bankruptcy.

As alarming as the rise in reported abuse may be, some experts on elder care say the surge may be the result of greater awareness of abuse, not necessarily an increase in incidents.

“You could compare it to where we were with child abuse in the ‘70s. And then spouse abuse came along in the ‘80s, so now everyone is aware of domestic violence and battery,” said Peggy Witherspoon, executive director of the Area Agency on Aging. “Now, I think that for the issue of elder abuse, its time has arrived.”

Said Margaret Beck, deputy director of Adult Protective Services, an arm of the county Social Services Agency: “More than half of our reports are substantiated, which means that we’re getting quality reports--sometimes from family, sometimes from a friend or neighbor.

“But I think we’ve always felt that what we’re getting is not what’s really out there. It’s the tip of the iceberg. I think it’s always been going on but people are maybe more willing to report.

The combination of an increase in reported abuse and the staff cuts has squeezed resources, resulting in caseloads for social workers four times what the state recommends.

Emergency calls still are handled within two hours, but anything less than an urgent situation is investigated within five to 30 days. Before the bankruptcy such investigations were made in three to 10 days.

The hotline, once operating 24 hours daily, now is staffed only from 8 a.m. to 5 p.m. Monday through Friday. Reports that come in after hours or on the weekends are recorded and addressed the next business day. Callers are advised to contact the police if they have an emergency.

The causes of elder abuse are manifold. Family dysfunction often contributes, as does alcohol or drug abuse.

Violence may become an ingrained part of family relations, said Jack Light, assistant program manager of Adult Protective Services. People who are abused as children may grow up to abuse their parents, and families that have long resolved anger by lashing out do not necessarily stop because its members are aged.

“For example, we had one elderly woman who was the caretaker for her husband. She would walk over to her husband, who is bed-bound, and would position herself to be hit with a newspaper when he was angry with her,” Light said. “It was what she was used to and she thought she deserved it. We tried to tell her that she did not have to allow him to hit her.”

Sometimes, out of utter frustration, caretakers lash out.

Caring for a frail elderly person can tax the emotional, physical and financial resources of even the best intentioned person, Witherspoon said, and such caretakers must be encouraged to reach out for support.

“We think because they’re our parents we have to be there night and day for them,” Witherspoon said, adding that it is often adult daughters who become caretakers of their infirm parents.

With their own jobs and children to look after, “they’re trying to handle too much,” she said. “They have to have respite and they have to have relief.”

The identities of victims are confidential, but the department has collected a gruesome set of slides, documenting the torment and sometimes the torture of the county’s elderly.

Slides show the burns of a man who was lowered into scalding water by his caretaker as a punishment for “misbehaving.” Another depicts the bedsores on the foot of a woman so neglected by her daughter that the dead flesh has fallen away to her heel bone. Seniors dazed from over-medication to keep them quiet stare from other pictures.

Helping abused elders takes a special touch. The county does not have the right to remove adults from the power of their abusers--as it does with abused children. Instead, social workers must persuade their elderly clients to take action. Only in those cases where authorities have deemed an elder to be mentally incompetent, is a conservator appointed.

To help the various sectors of society involved in identifying and intervening in cases of elder abuse, UC Irvine psychologist Linda Nelson, an administrator in geriatric medicine, is coordinating a symposium on the topic.

We are seeing the incidence of elder abuse rising and we want to see what we can do locally to help out,” Nelson said. The target audience will include the general public, but also caregivers, the police and sheriff’s departments, bankers, professional conservators, state assembly members and substance abuse treatment providers. The date for the conference has yet to be scheduled.

Yet, the larger question of how society will care for its increasingly longer-lived population remains.

“As a society we have not decided yet what to do with our elderly,” said Light, the Adult Protective Services official. “We don’t have enough adult day care, we don’t have the mechanisms in place yet. But I think that ultimately we will.”

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

Adult Abuse Reports Rise

Protecting adults who are unable to defend themselves because of infirmity or age is a growing problem in Orange County. The number of adult abuse reports- three-fourths of them involving senior citizens- received by Adult Protection Services has increased by 181% during the last 10 years.

Abusive Profile

During the last 27 months, most abused adults in Orange County were the victims of their child or spouse, with the most typical kinds of abuse being physical or neglect:

‘95: 2,713

Abusers

Child: 34%

Spouse: 18%

Parent: 5%

Caregiver: 11%

Other relation: 15%

Other unrelated unknown: 17%

Type of Abuse

Physical / neglect: 45%

Mental: 18%

Self- neglect: 17%