Year after year, Virginia’s adult protective services workers see more cases of adult abuse, neglect and exploitation — a problem that promises to intensify as the number of older people grows and the state’s caseworkers struggle to keep up with demanding workloads.
In the 2018 fiscal year, there were nearly 12,000 substantiated cases of abuse, neglect or exploitation of elderly or disabled adults. Since 2016, the number has jumped by about 1,000 each year, according to a new report from the Department for Aging and Rehabilitative Services’ Adult Protective Services Division.
The total number of reports that APS workers received grew by almost 16 percent between 2017 and 2018.
Paige McCleary, the division’s director, said she’s concerned about the rising numbers, worker burnout and ever-increasing caseloads.
“Those substantiated cases do require resources to address the issue in many circumstances,” she said. “Our funding has remained rather stagnant over the last several years, so our workers are quite creative in trying to address someone’s needs in the community.”
Her concerns are amplified by a growing elderly population. By 2035, people over age 65 are projected to outnumber children for the first time in U.S. history, according to the U.S. Census Bureau.
While APS works with both aged and disabled adults, 74 percent of the report subjects last year were over 60 years of age.
Funding for the services that abuse victims need — to cover a medical bill, for example, or to stay in a hotel to get away from an abuser — has remained level since at least 2014, McCleary said. Meanwhile, home-based funding, which helps adults stay in their homes and avoid going to a long-term care facility, has been cut by about $3 million since 2009.
“We have an ever-increasing aging population who want to remain in their homes,” she said. “We want to respect that decision, but we want people to be safe in their homes.”
Self-neglect is far and away the most common form of adult abuse that workers identify. Those are cases in which someone cannot, for example, recognize that they need medical care or help with activities of daily living, like washing or preparing meals.
But most commonly, self-neglect is identified through hoarding situations, whether it’s animal hoarding or items like magazines or certain types of boxes or paper, McCleary explained.
“I am concerned about worker burnout, and the difficult things that they do see in these homes, whether it’s a self-neglect case or a sexual abuse case or a physical abuse case,” she said. “Those are really difficult circumstances.”
Self-neglect accounted for 54 percent of substantiated reports. Other forms of abuse, though, are on the rise. Financial exploitation jumped by about 30 percent in the 2018 fiscal year compared to the previous year.
There is little data or research available on adult protective services to pinpoint specific problems like high caseloads, McCleary said. Because there aren’t any federal statutes or funding related directly to APS delivery, each state provides services differently and there isn’t much opportunity to do consistent research.
“We kind of look at child welfare stats and say ‘Yeah, that’s probably happening to us, as well,'” McCleary said.
APS was relocated from Virginia’s Department of Social Services to the Department of Aging and Rehabilitative Services in 2013. But APS workers, referred to as family services specialists, are integrated into local departments of social services, and in some smaller departments those specialists cover both child and adult protective services.
As of August, about 20 percent of the family services specialist positions all over the state were vacant, according to the Virginia League of Social Services Executives. The annual turnover for that position was 21 percent.
Andy Crawford, president of the League of Social Services Executives, pointed out that child welfare issues often get far more attention than adult services.
“The numbers are up, but there aren’t many advocacy groups to speak for them,” he said. “That’s something that we as a league have noticed: How are we going to advocate for adult services? Because there is a need there.”