Table of Contents

About This Course

1. Introduction to Elder Abuse
2. The Basics of Elder Abuse
3. Substance Use and Other Risk Factors
4. Screening and Assessment
5. Intervention and Treatment
6. Preventing Elder Abuse

Supplements
Case Studies
References
Resources

Out of the Shadows
Uncovering Substance Use and Elder Abuse

Adult Protective Services

Most States provided few services to older adults prior to passage of the Title XX amendment to the Social Security Act in 1974. This act enabled States to create services to protect adults. Without strong Federal direction, in the 1980s, States adopted their own statutes for the creation of Adult Protective Services (APS). By 1991, 42 States had mandatory elder abuse reporting laws, and 34 provided protective services to impaired adults as well as the elderly. As of 2000, only five States did not mandate reporting.ref

The APS model is based on social casework and systems approaches, aiming to provide elder abuse victims with a coordinated system of social and health services.ref

The primary activities of APS agencies covered by most State statutes include:ref

• Receiving reports
• Conducting investigations
• Evaluating risk to clients
• Assessing clients' capacity to agree to services
• Developing and implementing case plans
• Counseling clients
• Arranging various services and benefits
• Monitoring ongoing service delivery

An individual who suspects elder abuse should contact the local APS agency. The U.S. Administration on Aging outlines the APS process as following: ref

• The APS agency screens for potential seriousness following a report of suspected abuse. All information is confidential.
• If the agency finds a possible violation of the State elder abuse laws, it assigns a caseworker to investigate and provide crisis intervention if warranted.
• If elder abuse is not substantiated, most APS agencies will work with community agencies to obtain social and health services that the older person needs.

The older person has the right to refuse services offered by APS.

The APS agency provides services only if the older person agrees or has been declared incapacitated or incompetent by the court and a surrogate decisionmaker has been appointed.

The guiding principles used to shape most APS practices include: ref

• Emphasizing the client's right to self-determination
• Using the least restrictive alternatives
• Maintaining the family unit whenever possible
• Promoting use of community-based services rather than institutions
• Avoiding placement of blame
• Presuming inadequate or inappropriate services are worse than none

Although all States have employed a combination of approaches to classifying mistreatment, no two have the same set of laws. All States define abuse (and delineate categories such as physical, sexual, and emotional/psychological) and address neglect.

APS caseloads and training differ among States. States have varying definitions of abuse, neglect, or exploitation.refIn 28 States, the definition of neglect includes self-neglect, while in 5 States, self-neglect is a separate category of maltreatment.ref

Besides varying definitions, the age groups protected by various State abuse legislation differ. For example, many States protect adults over age 18 who lack the mental, physical, or emotional ability to make and carry out decisions. Other States limit protection to vulnerable adults over age 60 or 65.