Adult Services Newsletter

From the Director How Does APS Matter in a Client's Life?

By Alan Lawitz, Director, Bureau of Adult Services

Two brief vignettes sent recently by local APS supervisors illustrate vividly how important the work of APS staff can be to the lives of the vulnerable adults they work with every day:

From Pat Hand, APS Supervisor of St. Lawrence County:
“One of my caseworkers (Andrea Hayden) was assigned a referral a few weeks ago involving an 86-year-old female who resides alone, has no family, and was calling her pharmacy daily about her prescriptions. One of the problems the pharmacy had was that the client had not been seen by her doctor in years and the doctor refused to renew the prescriptions until she was seen.

Andrea visited the client and convinced her to see her doctor and made the appointment for her. Andrea attempted to call the client to remind her but got no answer. The client’s neighbor who assists was out of town. Andrea went to the home but could not get in. Neighbors had not seen the client in days and were surprised she was not answering the phone, since she rarely goes anywhere.

Andrea went to the local police department and convinced them to return to the client’s home. The client was found on the floor where she had been for over 24 hours with a possible broken hip. The rescue squad was called and the client was sent to the hospital.”

Thanks to Andrea’s knowledge of the client’s situation, her efforts to stay in contact with the client, and her diligence, she was able to work with the police to intervene and save her client from a desperate situation. That’s what APS does.

Sue Bacon, Supervisor of Wayne County APS, sent the following from Nola Colatarci, Senior Caseworker:

“I have been with Wayne County DSS for almost 30 years. I have been a senior caseworker for about 25 of those years. A few years ago, I was visiting a 74-year-old client who had been in a wheelchair due to polio since the age of nine. We had a wonderful caseworker/client relationship and she always called me her ‘angel.’

While sitting at her dining room table for assistance with paperwork, my client asked if I thought angels knew they were angels. I said that her question was fascinating but I had never given it any thought. As I again became absorbed in the paperwork at hand, I almost missed it at first, but heard her softly say ‘I guess they don’t.’ That was the nicest thing anyone has ever said and I have never forgotten it.

Never underestimate what assisting others may mean to them. The small gestures we make in our careers can mean the world to someone. Maybe all APS workers are ‘angels’ and we just don’t know it!”

Thank you for this story. This shows the enormous positive impact that a caseworker can have. Although APS workers may not hear it as often as they should, it is absolutely great when clients and others important in their lives do express their appreciation for the good work that APS does. In this issue, you will find several additional stories from across the state about how APS caseworkers help their clients.

Be well.

Alan

2014 Adult Abuse Training Institute (AATI)

Adult Abuse Training Institute (AATI) attendees report that the quality of the presentations was excellent, and there were numerous opportunities for networking and discussions of best practices. Representatives of financial institutions, law enforcement, the Securities and Exchange Commission and the U.S. Postal Inspector were among those presenting at AATI, along with many staff of local Adult Protective Services and offices for the aging.

OCFS presented preliminary findings of its New York State Cost of Financial Exploitation Study. Additionally, AATI included several plenary sessions and workshops related to the conference themes of: Recognizing and Responding to Financial Exploitation as well as Promoting a Multidisciplinary Response to Protection of Vulnerable Adults. Keynote speaker Nora David Eisenhower, Assistant Director of the federal Consumer Financial Protection Bureau’s Office of Financial Protection for Older Americans, discussed the role of the federal government in preventing and addressing financial exploitation of vulnerable elderly persons.

(Clockwise from left: Former OCFS Acting Commissioner Sheila Poole welcomes attendees; Yufan Huang, OCFS Research Scientist, presents the NYS Cost of Financial Exploitation study; representatives of credit unions and OCFS Bureau of Adult Services Director Alan Lawitz at a workshop; Allison Campbell of Lifespan and Robin Roberts of the NYC Elder Abuse Center present on enhanced multidisciplinary teams; Consumer Financial Protection Bureau’s Nora David Eisenhower delivers the keynote address.)

Centenarian's Needs Met by Onondaga County APS

By Supervisor Thomas Burgess and Caseworker Roberta Dallas
Adult Protective Services, Onondaga County Department of Adult and Long Term Care Services

A vibrant centenarian in Onondaga County has been well-served by several APS workers over the past six years. Orphaned in her late teens, this determined woman undertook the parental and provider roles for her two younger siblings and dropped out of college to work. She became the only female promoted to a supervisory role in a large Syracuse munitions plant during World War II. For decades, this strong and self-sufficient woman lived alone in her single-family residence. But in her mid-nineties, she finally acquiesced to accept the assistance of caseworkers for help reading mail and paying bills due to her limited eyesight and hearing deficits. Unable to drive and reluctant to pay for additional services, this client also accepted a county-funded elder advocate to assist with transportation for shopping and social visits.

Unfortunately, this woman had numerous hospitalizations in the past year. Due to her physical frailty, her need for daily medication management and safety supervision necessitated a higher level of care. With much patience, the current caseworker tried to persuade her that financial resources should be used to secure the care she needed. Reluctant to give up her independence, she maintained that she could continue to meet her own needs as she always had. Guardianship was sought to ensure that round-the-clock home care would be purchased to give the client the care that she required to keep her safe in the comfort of her own home. Following a court proceeding, Onondaga County became guardian with power to pay this client’s bills, a modest level of guardianship that recognizes this client’s right to self-determination in choosing where to live and who should provide care. As a direct result of the home care services being provided, this client has not needed subsequent hospitalization. Her primary care physician, who has treated her for decades, gave her an excellent report following a recent visit.

The presiding judge, the court clerk, the client’s mental hygiene legal services attorney, a surviving family member (her younger brother, who is now in his nineties), her current home care aide, and her current APS caseworker recently gathered at a local restaurant for a luncheon to help celebrate this remarkable woman’s 101st birthday. The collaborative and cooperative effort of various service providers to meet the needs of vulnerable elders in Onondaga County is evident in the outcome of this case. With the encouragement and support of her caregivers, this client is now safely residing in her own home. This summer she rediscovered the joy of gardening, since she now has assistance outdoors. After years of neglect, her lawn is trimmed and well-kept once again. She even sports a “youthful” countenance and tan that belies her years, as a result of her newfound labors in the yard of the home that she loves.

(Editor’s Note: Thanks, Tom and Roberta! This is a great example of the use of good casework and a tailored guardianship to allow a client to remain at home and to retain her autonomy to the extent feasible.)

Washington County APS Caseworker Enhances the Life of Her Client

By Jodie Smith, Supervisor, Adult Protective Services, Washington County DSS

An APS caseworker was visiting a client when she observed a family member, “Sarah,” (not her real name) who appeared quite thin and wore stained clothes. Sarah’ s niece told the caseworker that Sarah had fallen and broken her arm, but had not disclosed it to the family until a week later, when her arm was very swollen and bruised. The niece sent Sarah to the emergency room, but Sarah was sent back home the same night with instructions to return to the hospital the next day for further observation and treatment. Three weeks went by without the niece or anyone else helping Sarah to return. The caseworker set up a doctor’s appointment and transportation but the niece still failed to take Sarah for necessary medical care. Instead, the APS caseworker brought Sarah. When the doctor examined her, she weighed only 78 pounds at five feet tall. Sarah told the doctor there was very little food in the house and that the niece and other family limited what she was allowed to eat.

It was after the APS worker brought Sarah to another doctor appointment and Sarah felt that she could trust the caseworker that she disclosed to the caseworker that the niece’s boyfriend had actually pushed her down and caused her broken arm. Sarah told the caseworker that the niece had told her to lie so the boyfriend would not get into trouble. Sarah then disclosed that the niece and her boyfriend often yell at her, and push and shove her. Sarah admitted that she was afraid to tell anyone and that she was afraid to return to her residence. The caseworker assured her that she would help her and that Sarah did not have to return home if she did not want to.

Sarah also disclosed that her family was taking nearly her entire Social Security and SSI checks each month, leaving her only about $25 a month. Sarah was a victim of financial exploitation, as well as physical abuse, emotional abuse, and neglect.

Over the next month, Sarah was placed in a motel by the district and she was set up with a primary care physician. The caseworker took her to see several other specialists: an eye doctor (to get surgery for cataracts), a podiatrist (to trim very long and painful toenails), and an audiologist (to obtain a new hearing aid). Her appetite returned and she gained more than eight pounds over a month period.

A referral was made to law enforcement, but because of Sarah’s limitations it was difficult to get an accurate statement from her. It was her word against the others and ultimately no arrest was made.

APS was able to secure an assisted living bed for Sarah, where she will no longer be neglected, abused, and financially exploited, and where she will receive the care she needs.

This is a case where the caseworker spent many hours with the client helping to meet her needs and keep her safe. Sarah is a very sweet lady who is very appreciative of all that her caseworker has done for her. Her APS caseworker has made a very positive difference in Sarah’s life.
 

Schoharie County APS Staff Praised By Court for Their Compassion and Dedication

By Paul Brady, Commissioner, Schoharie County DSS

The Schoharie County Department of Social Services’ Adult Protective Unit recently received certificates of recognition for excellence in providing Protective Services on behalf of an elderly father and his adult son.

The father and son had been well-known to our agency for a long period of time. They both have complex medical and social needs. From the beginning, staff from the office managed their finances and made sure personal care aides were available to meet basic medical needs. As time went by, staff had to arrange for repairs to the home and made sure the driveway was clear so service providers could have easy access to the residence.

Over the years, the needs of both gentlemen became more complicated as they aged and their health deteriorated. For years, staff had done everything possible to help both individuals to stay in their community. Unfortunately, despite the best efforts of the staff, the son could no longer care for himself and his care could not be managed in the home. Staff worked tirelessly to secure a skilled nursing placement for the son, where he was eventually moved. This left the father in the home, and at the time of his son’s placement, he was virtually bedridden. Again, staff did their best to maintain the father in his home as long as could safely be managed. Eventually, it became necessary to consider nursing home placement for the father as well. Staff tried repeatedly to convince the father that he needed nursing home care, but he was adamant he would not voluntarily consent to placement. Staff came to the conclusion that filing for guardianship was necessary. The court hearing was held in the father’s home. By order of the court, the father was determined to be in need of a guardian, and I was appointed as such having control over his property. I was also granted authority to make placement decisions.

What brought me to recommend our Adult Protective Unit for recognition were comments made by the judge in the actual written order granting the guardianship. The judge made the following statement;

“In conclusion, the Court would like to comment on the compassion of the workers from the Department of Social Services. They obviously care greatly for [the client] and his well-being. Although he could not see either Ms. Timme or Ms. Bohringer approach him, once they were close, speaking loudly in his good ear, his face lit up. They all are obviously extremely dedicated and sincerely saddened by the fact that there are no resources available to allow [the client] to remain in his home. The Court was touched by the selfless dedication of David Hunt, JoAnn Timme and Andrea Bohringer. These workers have even arranged for placement of [the client’s] dog.”

The client was eventually placed in a skilled nursing facility, and staff were successful in getting him placed in the same facility with his son. The fact that the court took note of the quality of the work performed by the staff speaks volumes to the tireless effort they put in each and every day. Working on this case was truly a group project so I would like to recognize each of the staff in our Adult Protective Unit: caseworkers JoAnn Timme, Andrea Bohringer, Paul Koopmann, Tara Vogt, and Herminio Colon-Guasp; casework assistant Judith Kirby; and David Hunt, Central Assessment Coordinator and Unit Supervisor. 

Schoharie County APS Staff Recognized For Excellence
Front row (left to right): Herminio Colon-Guasp, Andrea Bohringer, Tara Vogt, Alan Lawitz (OCFS)
Back row (left to right): Chris Coons (OCFS), Judith Kirby, Paul Koopmann, David Hunt, JoAnn Timme, Commissioner Paul Brady