a report with line chart, nursing home neglectA total of 54 out of 56 states and territories that were surveyed reported receiving nearly 1.5 million notifications of elder abuse, neglect, and mistreatment of older or disabled adults in 2016. The overwhelming number of incidents combined with the shortage of investigators has resulted in delayed response times and lengthy processing periods, with the average response time taking 4.2 days and the average investigation lasting 47 days.

The Elder Abuse and Neglect Tracking Program

The Department of Health and Human Services (DHHS), in conjunction with Adult Protective Services (APS), developed the program to create a national elder abuse and neglect tracking program. DHHS invited all states, the District of Columbia, and five territories to participate in the nationwide survey. The jurisdictions were asked to submit reports, investigations, maltreatment types, the number of full-time investigators and supervisors, assessment tools, service gaps, and standards of evidence.

Each state and territory uses a different standard of evidence, a definition of abuse and neglect, and method of review which makes comparisons between the states complicated. The DHHS report overcame those differences by requesting narrative reports that described each state’s position on elder abuse.

The Findings

The report found that participating states and territories received nearly 1.5 million reports of mistreatment and abuse in 2016. Moreover, there were only about 5,000 full-time investigators and supervisors to review these claims. The result was a dismal 4.2 days average time to respond to a report and a whopping 47 days to complete an investigation.

The maltreatment reports covered a wide range of abuse including:

  • Abandonment;
  • Exploitation (all types);
  • Emotional, sexual and physical abuse;
  • Neglect;
  • Self-neglect; and
  • Suspicious deaths.

Moreover, the report identified a broad range of investigation methodologies and standards of evidence. Investigating methodologies are standard tools that investigators use to investigate claims of abuse. The report found that only 23.5 percent of states and territories have common instruments or tools of investigation, whereas, 76.5 percent of states allow individual districts or even workers to use their discretion.

The standard of evidence refers to the amount of evidence that an investigator must uncover before an abuser is subject to penalties. In 62 percent of cases, the standard is a preponderance of evidence which means that it is more likely than not that abuse occurred. In three states, the standard is clear and convincing which is a much higher burden. One state does not have a standard. Finally, 16 percent of states only require a credible showing that abuse occurred, which is the latest standard.

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