A Day in the Life of
Adult ProtectiveServices
Prepared by County Welfare Directors Association of California,
What is “A Day in the Life of APS”? This project captured
and analyzed data about the reports APS received in California during a 24 hour period on March 5th 2004.
Project Design
Each of the 58 counties was given a spreadsheet to record all APS referrals received on March 5th:
Purpose of the Project:To “put a face on APS” by educating the reader about the:
1. types of clients who are at risk;
2. array of calls received; and
3. complexity of the issues involved.
Project Limitations This project does not
address: the results of the
investigation the case management
services offered or the end result of the
interventions.
Background Information APS in CA. is administered by 58 counties APS is a 24/7 program Definitions:
Elder=65 years and older Dependent adult= Any person between the ages of 18
and 64 (who) has physical or mental limitations that restrict his or her ability to carry out normal activities or to protect his or her rights, ..., including any person between the ages of 18 and 64 years who is admitted as an inpatient to a 24-hour health facility.
Background Information Types of abuse recognized in California
Abandonment Abduction Financial Abuse Isolation Mental Suffering Neglect Physical Abuse, including Sexual Abuse Self Neglect
Sample Vignette 211 The victim is an elderly woman with senile
dementia whose husband and sole caregiver had just committed suicide by shooting himself in their home. The victim was unable to care for herself. She did not know when to take her own medications and has no family in the area. Immediate response by APS was requested.
Sample Vignette 148 A 74 year old man was found by his
caregiver after being on the floor of the home for two to three days. The paramedics were called. The victim was dehydrated and transported to the hospital.
Sample Vignette 256 The 18 year old male victim is autistic,
developmentally disabled, and psychotic. His caretaker parents do not obtain needed medication or mental and physical health services for him. They also leave him alone with relatives who had abused him as a child.
Sample Vignette 61 While an 81 year old woman was
hospitalized for open heart surgery, her half brother got her to sign a power of attorney and a quit claim deed. He then sold her house without her knowledge or consent. The police are unwilling to press charges because of the power of attorney.
Male/Female Ratio of Victims 65+
42%
CA Population
58%37%
Victim Population
63%
0%
10%
20%
30%
40%
50%
60%
70%
Male Female
Victims with Cognitive Impairments
47%
23%
6%
19%5%
0%5%
10%15%
20%25%30%
35%40%
45%50%
No ImpairmentNoted
Demented
DevelopmentallyDelayed
Mentally Ill
Organic BrainInjury
Victims’ Ages
020406080
100120
18-19
20-24
25-34
35-44
45-54
55-59
60-64
65-74
75-84
84+
Ages of Victims
Num
ber o
f Rep
orts
Comparison of reports to population
0%
5%
10%
15%
20%
25%
30%
35%
18-19 20-24 25-34 35-44 45-54 55-59 60-64 65-74 75-84 84+
Percentage of CA Abuse Reports U.S. Population
Victims with medical issues
64%
36%
0%
10%
20%
30%
40%
50%
60%
70%
Major Medical Issues No/Minor Medical Issues
All types of abuse
Assault/Battery Constraint/Deprivation
Sexual Assault Chemical Restraint
Over/Under Medication Neglect by Others
Financial Abandonment
Isolation Abduction
Psychological/Mental Self-Neglect
Assault 15%
Neglect 23%
Financial 17%Psych 14%
Self-neglect 26%
Self-neglectPhysical care 21%
Medical care 34%
Health and Safety Hazards 31%
Malnutrition/Dehydration 6%
Other (e.g. financial)
8%
Abuse by others
Financial Neglect Mental Suffering
Physical Isolation Abandonment
Abduction Sexual
Physical 20% Isolation 4%
Financial 24%
Neglect 31%Mental Suffering 19%
ReportersReferral Source Number
Family Member/Relative 45
Hospital/Social Worker 38
Self 30
Case Manager/Social Worker 29
Friends and Neighbors 21
Home Health Agency/SW 19
Medical Personnel 18
Law Enforcement 15
Mental Health Personnel 13
Domestic Violence
18% 14%
68%
0%
10%
20%
30%
40%
50%
60%
70%
Male onFemale DV
Female onMale DV
Other FamilyViolence
Other findings 7 suicide related calls 10% of reports indicated the victim or
perpetrator had drug or alcohol issues. 6% were Regional Center clients.
Perspective on results This is only a snapshot- not the whole picture. This was a slow day for APS in California (Average =
352.4 reports per day vs 327 reports received March 5). Historically, California receives approximately 16% to
25% of the adult abuse reports nationwide. The National Elder Abuse Incidence Study 2, completed
in 1996, indicates that only 16% of all abuse is reported. If that percentage is correct, an additional 2000+ incidences of abuse occurred and went unreported in California alone on March 5, 2004.
Conclusions 37% of the abuse victims are 80+. 63% of the elderly victims are female. 64% of the victims have major medical issues. 53% of the victims are described as exhibiting
some degree of cognitive impairment. 26% of the victims of all types of abuse are self-
neglecting. If abused by others, 31% of victims are
experiencing neglect and 24% are reported as experiencing financial abuse.
Conclusions 42% of the alleged perpetrators are family
members. Family members and health care providers make
the majority of the calls to APS. The complexities of the abuse issues indicate that
the victims are likely to need interventions from more than one agency (e.g., mental health, law enforcement, in-home supportive services), reinforcing the importance of multidisciplinary teams in the treatment of adult abuse.
Next Steps
Further research Development of an “All-County” data collection
system More training for county APS staff and multi-
disciplinary team members Increased funding for these crucial programs is
needed Support for federal action to combat adult abuse