Elder Abuse Investigation and Intervention

Introduction to Adult Protective Services (APS)

The primary agency responsible for investigating allegations of elder abuse and self-neglect in the United States is Adult Protective Services (APS), which provides intervention services to protect vulnerable older adults from harm and connects them with appropriate resources and support services, with all 50 states and the District of Columbia mandating reporting of suspected elder abuse 1

Abandonment is one of the forms of elder mistreatment addressed by APS, which also includes physical abuse, sexual abuse, emotional/psychological abuse, financial exploitation, neglect by others, and self-neglect, with self-neglect being the most common type, accounting for a significant percentage of allegations 1

Mandatory reporting of suspected elder abuse is required in all 50 states and the District of Columbia, with specific requirements varying by state, and healthcare providers, social workers, family members, neighbors, or any concerned individual can make reports, which typically involves contacting a designated APS hotline or office 1
The reporting process involves receiving a report of suspected abuse or neglect, screening the report to determine if it meets criteria for investigation, conducting an investigation, determining if allegations are substantiated, developing an intervention plan if abuse is confirmed, implementing services, and monitoring and follow-up to prevent recurrence, with services including safety planning, emergency housing, medical care, mental health services, legal assistance, and financial management 1

There is a lack of standardized screening tools for elder abuse, varying definitions of abuse across jurisdictions, limited evidence-based interventions, resource constraints affecting service delivery, and difficulty addressing abuser characteristics, which are significant predictors of emotional/psychological abuse 1

Healthcare providers should be aware of their state's specific reporting requirements, document suspected abuse thoroughly, understand that APS involvement does not absolve them of their duty to provide appropriate care, recognize that early reporting to APS can prevent escalation of abuse and improve outcomes, and consider screening for co-occurring conditions like depression and substance use that may complicate abuse situations 1