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16 Dec 2007

By Tracy Breton

For 19 years, Rhode Island law has required the director of the Department of Elderly Affairs to provide "for the use of the general public, a statewide, 24-hour-a-day, seven-days-a-week" telephone line to report elder abuse.

And for the past 26 years, Rhode Island law has also required people who believe that an elderly person is being abused, exploited, neglected or abandoned to make "an immediate report" to the DEA. Failure to make such a report is a crime punishable by up to a year in prison and/or a $1,000 fine.

But until May 14 of this year, no one manned the elder-abuse hot line at the DEA on nights, weekends or holidays. Unless someone called in to report abuse between the hours of 8:30 a.m. and 4 p.m. weekdays, there was no immediate response.

Now, things have changed. The state has provided $113,000 for an after-hours service that is contracted out to Family Service of Rhode Island. Elder-abuse calls that come in to the state's hot line on nights, weekends and holidays are routed to a geriatric social worker who can respond right away to emergency situations, even in the wee hours of the morning. The social worker on duty - there are two of them who take turns - carries a beeper that goes off whenever someone calls the hot line. Calls are returned swiftly - usually within just two to three minutes.

Between May and the end of November, the two social workers logged 260 calls and forwarded reports to the elderly affairs department for 82 Rhode Island residents who had cases requiring investigation. "The complaints ranged from suspected abuse and neglect to general questions about services and the police calling in and asking for assistance with an elder," says Sarah Kelly, of Family Service of Rhode Island, which supervises the social workers running the after-hours line.

The number of calls is increasing each month, according to Corinne Calise Russo, the DEA director. And the average age of the caller is 77.6 years old. Russo said she believes the reason so many elderly are calling the after-hours hot line late at night "is that is the time, if they are still living independently, that they are usually alone. They feel safer making the calls" if the person who is abusing or exploiting them is not around.

Russo says that her caseworkers verify about 80 percent of the 800 to 900 complaints of abuse received each year, much higher than the national average of 46 percent.

"Our after-hours line is not just for abuse calls but also for emergency service calls regarding health care," says Russo. In May, the first month the hot line was running, about 50 percent of the calls coming in had to do with a medical problem that an elderly person needed help with - some of them emergencies that needed immediate attention. But by September, 55 percent of the calls were to report abuse of an elderly person. "The thing we are seeing is we are getting more calls from public safety officials. They are asking for guidance and help with elder calls placed to the police after-hours. Also, health-care people are calling, discharge planners in addition to family members, neighbors or people who are self-reporting abuse."

Paula Parker, the DEA's assistant administrator for community and planning services, says the social workers who run the after-hours line have master's degrees and have "lots of training in counseling trauma and crisis situations and training in dealing with elders."

And they provide help to the six full-time elder-abuse investigators who work the day shift, she says. Parker says that 40 to 45 percent of the elder-abuse cases her department investigates "involve repeat clients" from families "where there is a lot of dysfunctional substance abuse/mental health problems that go back generations. … Now, with the after-hours hot line, if we are concerned that there will be an escalation of a problem that has developed in a daytime shift, we send an alert to the after-hours workers with the specifics and the background of a case. We now have information flowing back and forth from them to us and us to them. It provides a continuity of care in the community. Someone can be alerted for a crisis that occurs at night so older people don't fall through the cracks."

Among the things the after-hours social worker can do is to bring in a substitute home-care worker for a bedridden elder if an abuser is arrested or a home-care worker falls ill. If necessary, the social worker can place the elderly victim temporarily outside his or her home until a substitute caregiver can be found.

Detective Sgt. William Merandi, the commanding officer in charge of the Special Victims Unit of the Providence Police Department, says the new after-hours hot line has been a huge help to his department.

"The DEA doesn't work after 4 in the afternoon and on weekends. When my phone rings at quarter of 12 at night and we have a crack-head son who's caring for his mother and she's confined to a bed and sleeping by a quartz heater, we now have a social worker who can meet us at the house and help us address the situation. It's just knowing there is something in place," says Merandi.

"Before this partnership with Family Service, we had no protocol, policy or procedure in place" for dealing with emergency situations after-hours. "I'm very grateful that we do now."
With the state's budget crunch, there is no guarantee that the after-hours hot line will continue after next June. But Russo calls it "a very important initiative. It's been supported by the governor and we've put it in our budget request for next year, so we do plan on continuing it indefinitely."

Copyright 2007. Used with permission from The Providence Journal.