Dear Students of Social Work,

You would have, of late, been reading about protecting vulnerable adults particularly the elderly. The services provided will include and to a larger extent be administered by an Adult Protective Service (APS), as well as partners working with APS. This will be an area where more social workers will be required to play a significant and purposeful role. What does an APS caseworker do?

APS Caseworker

An APS caseworker performs advanced social work related to protecting the elderly and adults with disabilities who are unable to protect themselves. An APS caseworker has an interesting job that includes:

• Conducting home visits to assess if the person is at risk of harm.
• Talking to clients about their situation and even asking some quite intimate questions.
• Engaging in discussions with the client about all aspects of their life – including money, health, relationships and even terminal illness or death.
• Responding quickly in a crisis situation involving vulnerable adults in an abusive/ neglectful situation.
• Interacting objectively with “caregivers” who have abused adults in their care.
• Educating clients in order to change previous behaviour that has led to abuse, neglect, or exploitation.
• Spending a significant portion of time documenting casework activity.
• Appropriately dealing with verbal abuse from clients who may not understand or accept why the caseworker is there.
• Working under constant time pressure created by the nature and volume of the cases, prioritizing efforts and working flexible work hours.
• Convening family conferencing to draw up care and safety plans.
• Maintaining a balance of objectivity and empathic understanding in dealing with families living in stressful or crisis situations.
• An APS worker always works in a team, supports other caseworkers and follows the directions of the courts and agencies.

An APS worker always works in a team, supports other caseworkers and follows the directions of the courts and agencies.

What is “Social Work” as it relates to APS?

Social work intervention would include investigating allegations of abuse, neglect or exploitation of people who are elderly or disabled. This involves:

• Helping clients maintain their dignity and as much as possible, their independence.
• Building community relationships with law enforcement agents, medical personnel, court personnel, and representatives from various agencies and organizations.
• Conducting assessments of clients and their living conditions, developing service plans and providing or arranging for services to remedy problems.
• Identifying some agencies that might be helpful in developing a service plan which includes involuntary interventions.
• Researching the agencies and obtaining information from direct contact, brochures, consultations with supervisors, and recommendations of co-workers in order to develop appropriate case plans with and for clients.

Interventions for Older Adult Abuse, Self-Neglect and Self-Harm

Social workers are in an ideal professional position to discover and intervene in elder abuse, self-neglect or self-harm in an older adult. Besides remedy, social workers often can take the lead in establishing safeguards for an older adult as a form of preventive work in these areas. Assessment is among the first activities that the social worker carries out and it involves the following:

• Finding out what support systems are available to an older adult. These may include available caregivers, local social services, home health care, GPs and dentists.
• Developing a comprehensive understanding of the older adult’s financial situation. Sometimes this requires a collateral information if the older adult appears unaware of his or her financial status. Signs of financial abuse include large withdrawals from bank accounts that are not consistent with prior banking activity, endorsement of cheques or documents that do not match the older person’s signature or thumbprint and an increase in ATM cash withdrawals that do not match prior banking activity.
• Acting as a co-ordinator or a voice for the older adult needing services.
• Initiating a psycho-educational support group for the older adult and his or her family/ caregiver to facilitate better self-care and to create a safe environment for the older adult.
• Developing a comprehensive understanding of the older adult’s culture. This will enable the service provider to make positive engagements through adaptations to their culture.
• Checking for signs of self-neglect or self-abuse such as sudden weight loss, extreme thirst, bedsores or unattended wounds, poor hygiene, and obvious body odour.
• Checking for signs of physical abuse which may include bruising, rope marks on wrists or ankles, unexplained injuries and refusal to seek medical help for injuries.
• Checking for signs of sexual abuse which may include torn or stained underwear or bedding, bruises in genital areas or on breasts, bleeding vaginally and newly diagnosed sexually transmitted infections.

Inter-Agency Work

An effective protective service is built on good relationships among law enforcement agents, medical personnel, court personnel and representatives from various service providers. Very often, social workers play the role of advocate, case manager and convenor of case management and decision making platforms. For vulnerable adults, especially those with complex needs or needs that require the services of more than one agency, department or professional, the experience of a coordinated response and commitment to a case plan will better safeguard the interest of the client. The adult will have a better sense of safety, care and support. Now that we know that inter-agency work is important, it is a working style that agencies will have to adopt and commit to in order to utilize the expertise of various professionals in safeguarding the interest of vulnerable adults.