Many elderly people in the city who are physically or mentally unable to care for themselves have become victims of neglect or outright abuse, District officials recently told a group of more than 100 people at a conference on care for the aged.
For many elderly people living alone, home is a squalid, vermin-in-fested apartment or rooming house without proper utilities, they said.
"I found a woman 75 years old who had been lying in bed in feces and urine a month," said District protective services worker Evelyn Taylor. The woman hadn't had a bath for 16 years, Taylor said a friend of the woman's told her.
"She didn't want to leave," Taylor said. And although the apartment was rancid with garbage and human feces, under the law Taylor could not force the woman to leave her apartment involuntarily.
Other elderly people live under similar conditions in shoddy, privately operated, unlicensed group homes, officials told the audience at the day-long conference at Greater Southeast Community Hospital.
"We got a call last year from the fire department ambulatory squad," said Theodore Gordon, chief of the D.C. Bureau of Occupational and Institutional Hygiene, the agency responsible for monitoring health and safety conditions at homes for the elderly and other facilities. "A patient was picked up (from a private group home) with bed sores that were infested with maggots. Four other people were in the facility and the lady running the facility was elderly herself," Gordon said.
"There just aren't enough day care centers and emergency homes for the elderly," added Minnie Bingham, an agent with the city's Area B Mental Health unit. Bingham said she is responsible for an area that encompasses 250,000 city residents; her job is to investigate complaints about those who may be mentally impaired and dangerous to themselves or others.
"Some geriatric patients can't function in geriatric programs," said Bingham, explaining that they are too ill or senile to participate in structured programs. Family members caring for these elderly persons at home must always be on the alert lest the person wander out at night or hurt themselves, Bingham said.
The day-long conference was attended by area residents, social service workers, federal officials and those providing protective services to abused and neglected adults in the District and Montgomery County.
The conference, which also addressed the investigation of complaints, enforcement problems and other issues involving the elderly, was sponsored by the D.C. Providers Council, a group of area churches, hospitals, professional homemakers and social service workers that came together in 1976 to help coordinate information and interaction between local social service programs providing help to the elderly.
"I don't think I would want to be an elderly person in need of care in the District," said Karel Cornwell, supervisor of the District Protective Services Office for Adults. There's no adequate place for them to go, she said.
During the past 18 months, Cornwell said the adult protective services unit, which has five caseworkers, handled 246 cases. Of those, 87 abuse cases and 159 "gross neglect cases of people unable to care for themselves" were substantiated. Presently, 145 cases are active. Cornwell said nearly all those involved are living in their own homes.
In contrast, workers with the Montgomery County Social Service Office explained that while they have not solved all their problems with the aged, they have had the legislative and financial support to resolve many problems.
"Budget requests have been well received in Montgomery County," said Doreen Getsinger, a protective ser vices supervisor with the county. "If you've got a responsive administration, you can get the job done."
A Maryland protective services law for adults allows a city worker to gain entrance to home to investigate a complaint. The law also entitles a worker, or a citizen, to be court appointed as a legal guardian to elderly people unable or unwilling to handle their own affairs, Montgomery officials said. The guardian can also make requests to public and private social service groups to provide specialized care to the individual.
The care needed is determined through a multidisciplinary assessment center the county has developed to evaluate the physical and mental problems of elderly people in need of specialized care.
Cornwell said the District has neither program, though they are both critical to providing adequate care for the aged.
"We're not passing the buck," Cornwell said. "We're willing to go in and try to find where we're going to place these people." However, in the absence of an adult protective services law in the District, Cornwell said agency investigations are often thwarted by group home operators and relatives who refuse to let investigators in their homes.
In 1977, the District passed the Community Based Facilities Licensure Act requiring group homes that provided services to adults to be licensed. Robert J. Sauls, chief of social services at the District Department of Human Resouces, and Gordon are jointly responsible for reviewing and licensing the facilities.
Sauls said the program has been at a standstill because staff was not provided for it. Although two people are expected to start work this month, "we (now) have one staff member and that's me," he said.
Gordon added that four positions he requested in 1977 were refused.