5 ways Louisiana has failed to investigate senior citizen abuse in recent years

By: Julie O'Donoghue

The Louisiana Legislative Auditor found several shortcomings in the state’s Elderly Protective Services office. (Andranik Hakobyan/Getty Images)

Louisiana failed to thoroughly investigate and follow up on allegations of abuse against seniors, according to a report the state legislative auditor released last week. 

The auditor reviewed cases, response times and other functions of the Governor’s Office of Elderly Affairs and Elderly Protective Services from mid-2017 through mid-2022. The office is responsible for the welfare of people 60 and older who are harmed or threatened and cannot protect themselves.

Like child protective services, Elderly Protective Services (EPS) solicits tips from the public about potential cases. It received nearly 5,200 reports of elder abuse and neglect per year from 2017 to 2022. The most common allegations included those of self-neglect (27%), caregiver neglect (24%), financial exploitation (18%) and emotional abuse (16%), according to the audit. 

The auditor found the state fell short in a number of areas, potentially leaving seniors at greater risk. In response, the Governor’s Office of Elderly Affairs said the Elderly Protective Services staff would undergo more training, advocate for funding and attempt to hire more workers.

Auditors found the following areas problematic:

1. Death investigations not always carried out.

Elderly Protective Services staff don’t always tell the local coroner when elderly clients die in the middle of an abuse investigation or follow up to find out the cause of death of clients.

In three of seven cases the auditor reviewed, the cause of death listed on the death certificates aligned with allegations of abuse or neglect received by elderly protective services, according to the auditor’s report.

“We found a caregiver neglect case involving allegations that a caregiver was not performing wound care for a bed bound client with a severe foot wound. Eleven months after this case was assigned and no case activity was documented, the caseworker noted the discovery of an obituary indicating that the client died nine months prior,” wrote the investigator in the audit.

“We obtained the death certificate and found that the client died of sepsis, respiratory failure, and an infected foot wound. These fatal conditions appear to be directly related to the allegations of caregiver neglect that were originally reported to EPS.”

The auditor suggested Louisiana establish a specialized elder fatality review team to investigate suspicious deaths of seniors. Similar review teams exist in 20 other states. 

2. Services to potential victims slow to arrive.

In a quarter of the elderly abuse cases reviewed (18 of 92), the auditor found an Elderly Protective Services staff member wasn’t assigned to the case in a timely manner. In over 40% of the cases, clients weren’t contacted within the timeframe the office requires.

Elder abuse allegations are assigned priorities of high, medium and low that require a response within 24 hours, five working days or 10 working days from the case assignment, respectively. Sometimes these timelines didn’t appear to line up with the urgency of the case, the auditor found

“For example, we found a neglect case involving allegations that the client was struggling to attend to her basic needs and did not have heat in her home despite freezing temperatures,” the auditor wrote in the report. “Despite the five-day deadline, a caseworker did not attempt to contact the client for 13 days although temperatures dropped as low as 17 degrees for the client’s area.”

“One case with neglect allegations involving parts of the client’s body turning black was assigned medium priority, and more than seven months passed before the caseworker attempted to contact the client,” an investigator wrote in the audit. 

Yet another case involved a client who was “disabled, unable to care for herself, and lived alone; was incontinent, had feces in her bed, fungus growing on her skin, and her home was infested with bedbugs,” according to the report. “This case was categorized as medium priority and the caseworker did not attempt to contact the client for seven days.”

3. Financial abuse allegations often ignored.

Elderly Protective Services doesn’t have strict criteria for rejecting cases, and those involving allegations of financial scams are among the most discarded. 

The auditor found that four of 30 rejected financial cases his investigators reviewed did not meet the criteria to be scuttled and were similar to other financial cases that stayed in the system.

Elderly Protective Services staff said they have a hard time coming up with guidelines for what type of financial cases should be investigated because of the “novelty and complexity” of the cases, according to the audit.

“According to EPS, some financial exploitation cases are beyond the scope of EPS services, especially in elaborate scams where perpetrators are unknown or are overseas,” said investigators in the audit report. 

4. Elder abuse hotline isn’t always open.

Unlike most states that staff 24-hour hotlines, Louisiana’s toll-free number to report elder abuse – 1-800-898-4910 — is only open from 8 a.m. to 4:30 Monday through Friday. There is no online option to report abuse.

Best practices say such agencies should be receiving reports of alleged mistreatment 24 hours per day, seven days per week. Reporting of elder abuse tends to increase in other states over the weekend and after holidays, when people visit with their older relatives, according to the audit.

Three-quarters of states have a 24-hour hotline for reporting elder abuse, and most staff the phones at all times.

In their response to the audit, Elderly Protective Services says it hasn’t been given the funding to run a 24-hour hotline or have people respond to calls outside of regular business hours, though it will push the issue with the Louisiana Legislature.

The auditor also suggested the office set up an email address where people could report allegations of abuse, but Shirley Merrick, executive director of the Governor’s Office of Elderly Affairs, rejected the suggestion in a letter to the auditor.

Merrick said setting up such an email account would expose the office to liability, and it was difficult to verify people’s contact information through email. 

5. Elderly Protective Services doesn’t have enough funding.

Elderly Protective Services managed over 85 cases per caseworker per month from 2017 to 2022, a larger caseload than their peers in 36 other states.

The low staffing levels contributed to most of the problems highlighted in their report, the auditor said. The office has 40 staff, including one program manager, four intake workers, six field supervisors, and 29 caseworkers. 

Louisiana devotes less money per case to Elderly Protective Services than Adult Protective Services, which investigates abuse against 18- to 59-year-old adults who can’t protect themselves. Caseworkers who handle investigations of elder abuse are also paid less than their adult abuse counterparts, according to the audit. 

Merrick, in her letter to the auditor, also implied it has been hard to attract applicants for job openings.

Elder Protective Services might be able to monitor and manage their work better with an upgraded technology system, but the implementation of a new service has been repeatedly delayed. 

The state’s Office of Technology Services now says it won’t have the new system online until September 2023, the audit report said. If the system isn’t active by then, the state may be forced to return federal funding it has used to build it, and it’s not clear where money to pay for its operation would come from, according to the auditor.

“The delays in progress have created challenges for EPS in testing modules and training staff on the new system as planned,” according to the report.

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5 ways Louisiana has failed to investigate senior citizen abuse in recent years