Helping Elders Help Themselves

The abuse of elders is more prevalent in our communities than we may like to admit. Abuse can take many forms—physical, emotional, sexual, financial—and abusers can range from strangers to family members. But, what about elders who neglect their own personal care?

Formerly known as “Elders At Risk,” elders who neglect themselves will soon be helped by Protective Services, the group that currently helps elders who are abused by third parties. The state legislature recently enacted a law that considers “self-neglect,” and all other types of elder abuse, a part of the general elder abuse definition. This expanded definition calls for stricter reporting requirements and intervention guidelines.

The new self-neglect provision is defined as the inability of an elder to meet his or her essential needs for food, clothing, safe and secure shelter, personal care, supervision, and medical care to the point where he or she cannot remain safely in the community without assistance.

The most significant implication of the new law is that mandated reporters of elder abuse are now required to report suspected incidents of self neglect to the appropriate local Protective Services agency or to the Elder Abuse Hotline. Prior to the incorporation of self-neglect into the Protective Services program, self-neglecting elders were served under the Elder at Risk (EAR) program, in which reports by professionals were made on a voluntary basis. Mandated reporters include physicians, physician assistants, dentists, medical interns, nurses, coroners, social workers, family counselors, police officers, firefighters, emergency medical technicians, registered physical and occupational therapists, probation officers, licensed psychologists, podiatrists, osteopaths, managers of assisted living facilities, executive directors of licensed home health agencies, and executive directors of homemaker service agencies.

Despite the new law, funding for the Protective Services program (which now includes self-neglect) remains a problem. In fiscal year 2004, over 1,110 self-neglecting elders received services under the EAR program. However, close to 600 otherwise eligible elders could not be served due to staffing shortages at local Protective Services agencies. Based on caseload data for the 2004 fiscal year, a total of 852 elders in need of Protective and EAR (now Self-Neglect) services will not be served in FY 2005 because the system does not have sufficient funding.

The final state budget adopted by the legislature included a modest increase in funding for the expanded Protective Services line item. However, this increase is partially offset by the inclusion of the Money Management Program in the same line item. In the end, $1 million in additional funding is needed to adequately staff Protective Services. At the end of the legislative session, efforts were made to add $1 million to cover that projected shortfall to the Protective Services budget through a supplemental appropriation. However, when the legislature recessed for the Democratic National Convention, the supplemental bill had not been taken up.

Including self-neglecting elders in the same category as elders abused by others is a good change. However, we need to make sure there is sufficient staff and resources to meet the needs of all neglected and abused elders.