Adult Protective Services

Adult protective services have a long history of controversy and periods of unpopularity with the public. This pattern is no less true in the twenty-first century. Moreover, its sources remain the same as those delineated by Mildred Barry in her remarks at the 1963 Arden House Seminar on Protective Services for Older People: "One of our major problems in this field of protective care has been that our goals have not been clear, nor generally acceptable; nor the problem clearly defined, nor its extent and complexity known; nor have there been norms or standards upon which to base program objectives" (Barry, 1963, p. 1).

At the start of the new millennium adult protective services still suffer from vagueness of problem definition as evident both in law and through research. There is no consensus on the meaning of elder abuse as the target for protective intervention. Consequently, state laws and research studies differ in the definitions they use, making generalizations across jurisdictions or study findings very difficult. Also, without national prevalence data, it remains impossible to know the scope of the problem it addresses. Although national forums, including workshops held by the National Institute on Aging and National Center on Elder Abuse, have prioritized initiatives in these areas, they have yet to occur. Moreover, public skepticism regarding protective services continues to rest on questions surrounding its effectiveness along with ethical dilemmas that accompany its implementation, such as the appropriateness of mandatory reporting or the use of costly interventions for older persons whose situations represent repeated abuse or neglect.

Evaluative research on adult protective services since the 1970s is rare. Reason for case closure remains the primary outcome measure, although some states are employing risk assessment instruments to standardize it. An analysis of Illinois protective services clients indicated significant movement to low-risk status at case closure for the majority of cases. Among high-risk clients, the reasons usually given for case closure were institutionalization, death, service refusal, or relocation to another community (not unlike findings from the Benjamin Rose Institute in the early 1970s). The Three Models Project on Elder Abuse evaluated various interventions and found public protective services the least effective, in part because they lacked the resources to go beyond simple report receipt and investigation. In fact, adult protective services in most states are inadequately funded, particularly due to cuts and shifting in federal Social Services Block Grant revenues beginning in the 1980s.

A growing older population and increasing reports of elder abuse in both domestic and institutional settings have led to adult protective services becoming an established part of public welfare systems nationwide in spite of the controversy and skepticism that continue to plague them. Since the late 1980s there also has been a growth in professionalism among protective services workers, largely because of training opportunities and credentialing in some locales. Furthermore, networking through such organizations as the National Association of Adult Protective Services Administrators has helped decrease the historic isolation of protective services workers, improve protective standards, and enhance the knowledge base of the field.