The first ring of the telephone at the intake center of Sacramento County’s Adult Protective Services office is something like the call that comes in the middle of night.

The caller may be a doctor, police officer, firefighter, clergyman or simply a concerned neighbor.

The report may be about abandonment, physical abuse or financial fraud committed against a senior, or a request from a family for in-home assistance caring for a parent.

Whatever the reason, Adult Protective Services (APS), a program of the county’s Department of Health and Human Services, works as an advocate for elders and dependent adults.

Katy Brown is a human services supervisor at Adult Protective Services where four intake room workers receive approximately 400 cases per month.

“A lot of people think the goal of Adult Protective Services is to run in and grab your grandmother and put her in a nursing home,” she said. “We don’t place anybody anywhere. Our goal is to keep seniors independent in the least restrictive environment for a long as possible.”

While abuse reports come into APS via letters, walk-ins and e-mail, the nerve center is the telephone intake center. It is there that people such as Carol Britto do the critical work of screening calls.

“When the phone call comes in, we first have to determine if the person if safe,” Britto said. “If they’re not safe, we have to make an instant assessment and determine who needs to deal with it.”

Possible courses of action in abuse cases include referral to law enforcement authorities, health care agencies or a public health nurse.

Debra Morrow, APS program manager, said reports of abuse take many forms, including physical and sexual abuse, financial abuse, and abandonment and isolation, but the most prevalent reason people call is self-neglect.

“People become fragile, isolated, not able to care for themselves as in the past...but are afraid to ask for help for fear of being taken from their homes,” Morrow said.

In most cases like these, Adult Protective Services can provide some answers by connecting clients with public health services, assisting them in establishing a “gatekeeper” to look out for the senior’s needs or referrals to board and care or other appropriate agencies.

One of the fastest growing types of senior abuse in Sacramento County, second only to neglect in reported cases, is financial abuse.

Senior victims referred to APS in Sacramento County lost an estimated $8 million between Sept. 1999 and Dec. 2002.

Unfortunately, Morrow said, financial abuse is most often carried out by family members.

“What is terribly sad is the phenomenal amounts of money that vulnerable seniors are losing as the result of unscrupulous people in their lives,” she said.

Senior assets in the form of CDs (certificates of deposit), paid-off homes, and large savings accounts are among the lures attracting greedy relatives and scam artists alike.

Prevalent are variations of “the godson scam,” perpetrated by men who attach themselves to wealthy elderly women in order to be legally adopted and control their finances.

Thomas Harris, supervisor of the APS finance abuse unit, recalled one case of an 87-year-old client whose dealings with an unethical financial planner resulted in the loss of more than $60,000 of her savings. While by the time APS is called, it is often too late to recover a client’s loss, in this case a joint effort of the state attorney general’s office, law enforcement, and APS enabled the client to completely recover her savings.

In recent weeks, during a period of five business days, the finance abuse unit prevented more than $1 million in unauthorized funds from being removed from clients’ bank accounts.

Although it is not one of the most frequently reported types of abuses, 184 cases of domestic violence were reported in Sacramento County in 2002.

“Domestic violence does not just involve youngsters,” Brown said. “We have women who have been in a battered relationship for 50 years.”

She said in some of these cases, as in some self-neglect cases, Protective Services’ hands are tied if the victim refuses to take action.

“The only time a person can be taken without their consent is when arrested for a crime, detained for being a danger to themselves or others or if they’re unconscious and can’t talk for themselves,” Brown said. “Adults have rights and among those rights is to make incredibly dangerous choices.”

Leslie Ann Clement, an attorney with Clement and Associates, a Sacramento-based legal firm that represents and counsels elders and dependent adults, says elders can take pro-active steps to avoid many abuse issues.

Clement’s cases include seniors who have experienced neglect and physical and financial abuse in 24-hour care facilities and at home. She urges seniors to be extremely careful about who they invite into their homes, and who they allow to access their bank accounts, credit cards and mail.

“It’s tough because many times (seniors) are living alone and are really just lonely,” said Clement, who advises elders to try to become involved in as many community services and activities as are available to them. “They need to be cautious about these new friends who come into their lives.”

While APS agencies statewide are seeing an increase in the number of reported abuse cases of elderly and dependent adults, Morrow said the increase is the result of several factors. She said the number of mandated reporters — people who have full or intermittent care or custody of an elder or dependent adult — has increased, the senior population is growing, and there is much more information about abuse being publicized.

One agency whose sole mission is to heighten public awareness in Sacramento County about the need to protect seniors and dependent adults is Take A Stand Against Elder Abuse.

Begun in 2002, the coalition of businesses, non-profit and public organizations contributes all the funds it raises to Adult Protective Services.

Take A Stand is made up of people such as Barney Donnelly, who refuse to turn their backs on elder abuse.

“I think it’s atrocious what we do to a lot of our older people,” said Donnelly, president of Take A Stand Against Elder Abuse Corporation. “It’s so destructive to people at the end of their lives.”

Donnelly has been a member or chair of the Sacramento County Adult and Aging Commission for nearly 20 years. He recalls an event in 1984 that served as a wake-up call for many elder abuse advocates. That December, two elderly sisters died within a few months of one another, victims of neglect and starvation.

“That stirred up a lot of rage and led the county to take another look at the whole area of adult protection,” he said.

At the time, a community group, which would later become the county’s Adult and Aging Commission, made its mission to increase public awareness of elder abuse.

Picking up the torch, over the past year Take A Stand has raised $40,000 that is specifically earmarked to be available to APS if state and county budget deficits result in cuts in basic services to seniors and dependent adults.

Donnelly said church congregations have the potential to be valuable allies in advocacy for senior and disabled persons who are abused or neglected.

“Churches could be a connecting link between their parishioners and congregations and public entities in this area,” he said.

To provide more of those connecting links for seniors, APS also serves as resource center.

“Some of the best of what Adult Protective agencies do is act as a resource,” Morrow said. “We’re in touch in the community with potential helpers for seniors and their families.”

The state attorney general’s office has activated a statewide hotline the public can call to report suspected abuse. The number, (888) 436-3600, puts callers directly in touch with the closest Adult Protective Services agency. The Long-Term Care Ombudsman Crisis Line is reachable through the same number. That office investigates allegations against facilities serving the elderly.

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