A watchdog group has issued a report alleging that a state agency didn’t do enough to prevent an 80-year-old Vermont man from being neglected and financially exploited by his son over a five-month period in 2011.
The man, identified as John Doe, later died in a nursing home in October of that year.
John Doe had dementia, diabetes and depression, and he needed 24-hour care because of his frail condition. He lived with his son who neglected his caregiving needs, according to the report.
Disability Rights Vermont charges that the Vermont Adult Protective Services (APS) program failed to investigate allegations of abuse in a timely way, failed to provide adequate protective services, denied the elderly man access to emergency care and failed to substantiate clear neglect by a caregiver.
In addition, the federally funded watchdog organization says APS failed to maintain records that adequately demonstrated the reasons for these failures.
Disability Rights Vermont reported that although John Doe did not die as a result of the neglect, he suffered for months while the state could have taken action to protect him and ensure he received 24/7 care.
In 2010 and 2011, Adult Protective Services had a backlog of hundreds of cases that had been reported and were awaiting investigation. APS investigations during that period took weeks and sometimes months to complete.
In November 2011, Vermont Legal Aid and Disability Rights Vermont sued the state for not investigating alleged reports of abuse, neglect and financial exploitation within a 48-hour time frame as required by statute.
Susan Wehry, commissioner of the Department of Disabilities, Aging and Independent Living, wrote a response to the Disability Rights Vermont report on Monday. The commissioner said her staff reviewed the case files and the report’s timeline of events and determined that the department is unable to respond to “many of the specific concerns listed in the report.”
Wehry wrote that reports alleging abuse, neglect and exploitation of vulnerable adults will not be tolerated and that reports alleging such conduct will be addressed promptly and investigated thoroughly. “The facts presented in your report, if true, are disturbing,” Wehry wrote.
The commissioner went on to say the department couldn’t match the dates in the report with department records, nor could it verify the findings. “The dates do not match up, and there is no way to account for that, owing in large part to the fact that information was entered by hand by different people at different times under irregular supervision,” she wrote.
Moreover, the staff who handled John Doe’s case are no longer with the department, she said.
Since John Doe died in October 2011, the department has installed a new database for intake and screening documentation. Wehry wrote that there are 12 investigators on staff now, and cases are reviewed weekly.
On Wednesday, she told reporters that the John Doe case had been brought to her attention, but she wasn’t sure on whose behalf.
“Cases like that make it clear we can never go back to the way it was,” Wehry said.
Wehry said when she was hired as commissioner, she “inherited a mess.” The department had high staff turnover, there were not enough investigators (as few as four at one point) and an outmoded reporting system, she said.
AJ Ruben, an attorney for Disability Rights Vermont, said though the neglect and exploitation took place a year ago, the case illustrates that “real harm can happen to individuals when APS isn’t doing its job.”
“Over five months, [John Doe] suffered immense pain and suffering,” Ruben said. “The system is supposed to respond quickly.”
Ruben said the department has improved its response times to cases of abuse and neglect since October 2011, but questions remain about whether the improvements are enough to meet federal requirements and to re-establish trust with the public.
The reason the law requires the commencement of an investigation within a 48-hour timeframe, he said, is to prevent people from suffering for weeks.
John Doe’s case
The report details a long-running back and forth between advocates for John Doe and Adult Protective Service.
Charges of neglect and financial exploitation were first reported in March 2011. In April, the son threatened to pull a gun “if anyone talked about guardianship.” After that, advocates from the Area Agency on Aging refused to visit the home again.
At that point, advocates reported that “the alleged perpetrator has denied medical care or treatment which is likely to result is [sic] an imminent impairment of the vulnerable adult’s health.”
Though APS records show that a field investigator was supposed to visit John Doe within two business days, it was nearly two months before he was assigned an investigator.
In July, more complaints were filed. John Doe was back home after a nursing home stay. He was sent home on the condition that the son provide 24-hour care. Instead, the son didn’t set up supervision and care for his father. He went to work during the week and on the weekend went touring on his motorcycle.
An investigator was ordered on the case July 6. At that point, John Doe had been to the emergency room three times over a four-month period to be treated for dehydration, low blood sugar levels and confusion.
His doctor sent a notarized letter to APS with a dire assessment of the situation: “If [John Doe] does not have twenty four hour care and monitoring, any one of these events repeated could lead to irreparable physical and mental damage and even death. Based on our clinical assessment, [John Doe] does not have the capacity to care for himself adequately.”
Later that month, a man asked for more fentanyl pain patches for John Doe who was receiving one dose of the painkiller a day instead of two, as prescribed. Advocates pressed APS for an emergency petition for new guardianship; the agency filed a standard application in August. Not long afterward, John Doe was admitted to a nursing home.
John Doe died seven weeks later.
Disability Rights Vermont concluded that the failure of APS to respond quickly and “prolonged the time John Doe suffered without proper care and resulted in his sustaining avoidable injuries and hospitalizations prior to mid-August when a guardian was finally appointed.”
