COLUMBUS, Ohio--Emma Rosenbaum never married and had no children.
So when Rosenbaum, now 88, fell and shattered her arm at her Indiana home 3½ years ago, she agreed to move to a rehabilitation center in Columbus, Ohio, to be near her niece Terri Lane and Lane’s husband, Denny.
They were her closest relatives, and she loved them as if they were her own kids. Rosenbaum gave Mr. Lane, 63, who had worked as a broker for many years, power of attorney over her affairs.
A short time later, it became clear that Rosenbaum, who had dementia and was growing physically weaker, couldn’t live alone.
The Lanes placed her an assisted-living center and were supposed to pay Rosenbaum’s monthly bills with her long-term care insurance and General Electric pension. But Mr. Lane, who was unemployed, started dipping into Rosenbaum’s money to cover family living expenses.
By the time the assisted-living center alerted police about its concerns in the summer of 2013, Mr. Lane had spent $86,026 and Rosenbaum was being evicted.
‘Invisible, Expensive and Lethal’ Problem
An estimated 1 in 10 elderly Americans is abused or neglected every year, often at the hands of family members, caregivers or others entrusted to protect them, according to the National Center on Elder Abuse. That doesn’t include people like Rosenbaum who have been exploited financially.
Elder abuse is a “rampant, largely invisible, expensive and lethal” problem that has serious and devastating effects and requires immediate action, said Kathleen Quinn, executive director of the National Adult Protective Services Association (NPSA).
Rosenbaum, who now has a court-appointed guardian, eventually went to another assisted-living center and then moved nursing home, when her health declined last December.
Ohio has seen 14,000 to 15,000 reports of abuse, neglect and exploitation of people 60 or older in each of the past five years. But the number reported elder abuse cases don’t show the whole problem. Victims often are unable or afraid to tell police, relatives or friends because of illness or fear of being harmed or removed from their homes.
A recent study funded by Ohio’s HealthPath Foundation estimates that at least 105,000 people 60-plus are abused or neglected each year in the state. By comparison, 103,000 are hurt in falls requiring emergency care and 123,000 discover they have cancer.
“Most people are shocked to learn that the incidence of elder abuse is as common as cancer,” said Kenny Steinman, an adjunct assistant professor at Ohio State University and co-director of the Ohio Family Prevention Project, which did the report.
Safety-Net Cuts to Worsen Problem
The problem will only get worse, experts say, as the nation grays and more seniors receive in-home care.
Cuts to other state safety-net programs, such as cash assistance, also are forcing more struggling adults, including some with alcohol and drug addictions, to move in with their parents and grandparents, increasing the likelihood of abuse or neglect, said Jack Frech, retired director of the Athens County Department of Job and Family Services.
Older adults who are abused often suffer lasting physical, mental and emotional anguish that can take years off their lives. Abused seniors are three times more likely to die early than those who have not been harmed, and almost 1 in 10 will go on Medicaid for the poor, after their funds have been drained, according to the National Adult Protective Services Association.
The problems with Ohio’s flawed adult-protective-services system are separate from but related to the state’s guardianship program. That system allowed court-approved guardians to neglect or abuse their wards. In early March, the Ohio Supreme Court issued new rules for the training and oversight of guardians, and the legislature is considering additional regulation.
Nationally, a new study by True Link Financial, a private financial-services company, recently concluded that elder exploitation costs victims about $36.5 billion a year — 12 times higher than previously thought.
“Sadly, they lose much more than just money,” said Kai Stinchcombe, True Link Financial’s CEO. “ Of seniors who experienced fraud, 1.8 percent lost their home or other major assets as a result, 6.7 percent skipped medical care, and 4.2 percent reduced the number of meals they ate, for budgetary reasons.”
Across the country, such programs charged with investigating reports of suspected elder abuse, neglect or exploitation are overextended and underfunded, experts agree.
“Workers are undertrained, overwhelmed and can barely keep up with the mounting caseloads,” said [Bob Blancato, national coordinator of the Elder Justice Coalition in Washington, D.C.]
Many Ohio counties have tax levies that support senior services, but few use that money to fight the mistreatment of seniors.
“Our state funding keeps getting smaller as the number of elder-abuse cases keeps growing,” said Sara Lewellen, a supervisor with the Pike County Department of Job and Family Services. “As a result, we struggle to provide bare necessities.”
Ashland County, for instance, received $2,516 from the state this year and has budgeted another $6,748 from federal block-grant funds, but that still isn’t enough to pay for a full-time elder-abuse caseworker, said Cassandra Holtzmann, director of the county’s Department of Job and Family Services.
“It’s a real dilemma: The state wants us to build up our foundation, but they’re not willing to pay for it long term,” she said. The number of Ohio’s adult protective services caseworkers has shrunk from 630 in the early 1990s to about 250 today, according to state figures.
The Center for Community Solutions found in 2013 that 39 Ohio counties lacked a full-time staff person devoted to elder abuse, leaving child-welfare caseworkers or local police to handle the investigations.
Ohio’s Protections Vary Sharply
The realities of child- and adult-welfare cases are different, said Wendy Patton, a senior project director for Policy Matters Ohio, a policy research institute.
For example, caseworkers can’t remove adults from their homes simply because of their suspicions about abuse. And, if faced with a backlog, many counties place the priority on cases involving children.
The skills are different, too, Patton said. Child-abuse caseworkers are required to attend 102 hours of training their first year, followed by 36 hours of ongoing training annually and 12 hours of domestic-violence training within two years, said Bobbie Boyer, program manager for the Institute for Human Services.
Right now, training for elder-abuse workers is voluntary, but that might be changing. The Ohio Department of Job and Family Services hired Boyer’s institute last summer to create a basic curriculum for workers in APS based on a national model including extensive in-person and online sessions.
A lack of financial and other resources has resulted in inconsistent services from county to county.
Ohio law requires that reports made to adult-protective-services agencies and programs be investigated within 24 hours in emergency situations, and three working days for non-emergencies.
After the initial investigation, the process can vary dramatically, depending on a county’s resources. Some counties investigate as required by law because that’s all they can afford. Others also connect seniors to social services such as transportation or home care and do follow-up visits to make sure the person is safe.
“Often, what you get depends on what side of the county border you happen to live on, which is unfortunate,” said Richard Browdie, president and CEO of the Cleveland-based nonprofit Benjamin Rose Institute on Aging.
Browdie, formerly Pennsylvania’s Secretary for Aging, said Ohio should beef up its mandate for the programs, set minimum standards, provide adequate funding so the requirements can be met, and hold them accountable.
Any additional support would help, advocates say, because cases are becoming increasingly complex and harder to resolve. A lack of training of law-enforcement officers, inadequate criminal investigations, low rates of prosecution and unwillingness by some courts to deal with elder-abuse issues can also be stumbling blocks.
Abuser in a Bind
In Emma Rosenbaum’s case, Franklin County APS petitioned Probate Court to appoint a guardian to help find new living arrangements. The agency also worked with law-enforcement officers and the prosecutor’s office to hold Mr. Lane accountable.
Now, though, the agency no longer works with people in eldercare facilities, as Rosenbaum was, leaving that to the state long-term care ombudsman’s office, said Sally Smith, a supervisor with APS, part of the Franklin County Office on Aging.
Mr. Lane knew what he did was wrong but felt he had little choice, said his attorney, Kyle Stoller. He and his wife were both dealing with health problems, and their daughter had been in a car crash and wasn’t insured, court records show.
“He was not using the money for drugs or gambling or fancy cars or a house,” Stoller wrote in court documents. “He was simply trying to take care of his family and stay afloat.”
Michael Juhola, a Worthington lawyer, who is Rosenbaum’s guardian, said, “I think it was a situation of a good person making a bad decision.” Mr. Lane pleaded guilty to a felony count of theft last May and was sentenced to four years in prison. He recently petitioned the court for early release so he can work to make restitution.
Juhola supports Mr. Lane’s early release as long as it benefits Rosenbaum, he said.
This article is adapted from a longer story by Columbus Dispatch reporter Encarnacion Pyle, who wrote this series supported by the Journalists in Aging Fellows Program of the Gerontological Society of America and New America Media, sponsored by the Silver Century Foundation. Also see her article, “Greed Often at Heart of Ohio Senior-Abuse Cases.” Dispatch Librarians Linda Deitch, Julie Fulton and Susan Stonick contributed research for this series. Pyle also discusses her series on Sunny95 radio.
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Ohio Elder Abuse Mirrors National Picture of Government Neglect