Protecting the aging population

An interview with Sylvia Pla-Raith, Director, Elder Justice Unit, Consumer Protection Section, Ohio Attorney General’s Office

May is National Older Americans Month. In this Big Ideas, we are honored to share some thoughts from Sylvia Pla-Raith, the Director of the Elder Justice Unit within the Ohio Attorney General’s Office. Sylvia told us that a big part of her unit’s job is community education, so contributing to this blog was right up her alley. As she shared, elder abuse and exploitation takes many forms - but it’s something we can all play a role in stopping.  

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CLA: Thank you for taking some time to talk to us about this important issue. Many of our readers may not know about Ohio’s Elder Justice Unit. What do you do? 

Sylvia: The Elder Justice Unit was added to the AG’s office in 2014. Our purpose is to bring together an elder justice system that was fragmented - where all systems didn’t (and sometimes still don’t) always have an established way to talk to one another. I like to say that our office serves as a navigator. If you are an older adult who experienced victimization of any kind and you don’t know where to turn for help, you call us. We help callers get to the right agency. We can even make warm referrals, calling with the victim. Because these circumstances can be scary. Imagine, for example, if your son or daughter was neglecting or exploiting you. All the layers there. It can be incredibly hard to acknowledge the truth - let alone find it within yourself to ask for help. That’s made so much harder when the system is confusing. 

We also play an important education and resource-sharing role. Just as victims can call us, so can all the entities out there who help victims. You are in law enforcement and you are working hard to determine whether elder abuse rose to a criminal level? Call us. You are a legal aid attorney and need some help with referral ideas? Call us. We are here for case consults. Or if you just want to pick our brains. Even professionals can also get confused, and especially in this arena. In some cases, we’ve even served as a liaison or neutral party to help all the players remember their roles and stay victim-focused. And we also have a community education function - getting out all across the state to share information, ideas, and resources on how we can all help seniors. 

Finally, in some cases, we may be the final stop. It’s our role to investigate allegations related to seniors living in licensed care facilities when they arise to the level of a crime. Otherwise, we are making referrals. Just this past winter, we had two really sad stories in two different care facilities in the state. Elderly residents were left unattended and got stuck outdoors in cold temperatures. Sadly, both ended in tragedy. We help ensure accountability so this doesn’t happen next time. 

CLA: Can you talk a little more about the system fragmentation? 

Sylvia: Too often, older Ohioans are victims of exploitation or abuse. This could look like financial fraud, mistreatment or neglect in a care facility, domestic violence, scams, and more. When this happens in our state, there are special resources and protections - but older victims or the people working with them didn’t always know who to call. Age matters, and there can be a lot of confusion around that in our state. For example, Adult Protective Services can be involved at age 60, and at age 65 a victim is considered a special population in the eyes of the criminal justice system. Further, older victims could find themselves passed back and forth between agencies. Law enforcement might advise them that theirs is a civil matter, but when they turn to Adult Protective Services they are advised it's criminal. Additionally, before our unit, there was no clear entity to investigate cases for seniors living in licensed care facilities. That role lives with our office, and it’s such a critical one. 

CLA: What are some challenges in working with older adults? 

Sylvia: Oh, these cases can be very complicated and intense. Sometimes, we have patterns or behaviors that have been going on for decades. We may have victims who are uncooperative, uncomfortable, living with dementia, unaware, or even in deep states of denial. Health and mobility may impact a victim’s ability to access services or follow-through on next steps. 

CLA: What are the common forms elder exploitation and abuse take? 

Sylvia: Financial exploitation is a major issue we’re seeing in our office. It’s one of the fastest growing categories of allegations, and the issue was really exacerbated during the pandemic when people were told to go home and “be safe”. Unfortunately, for some, the opposite happened. We were isolated, many were lonely - and this made for good targets. One great example was the rise in so-called “romance” schemes. We’re all social beings, and the bad guys know this. In these schemes, the people who usually end up victimized are vulnerable due to their loneliness. Perpetrators may begin by building trust, grooming, and promising a relationship. This usually evolves into asking for money. Even the ask might be designed to tug at the heart strings - for example, “my daughter is sick and needs money to get treatment”. These cases can be so hard to prove, and could constitute either civil or criminal matter depending on the details. 

CLA: Can you talk a little about the overlap between domestic violence and elder abuse? 

Sylvia: This is a complicated and heartbreaking intersectionality. We know that when people live through decades of domestic violence, they are at high risk across many arenas. It often changes them emotionally and impacts their physical and mental health in very ingrained ways. According to the National Center on Elder Abuse, older adults who experience abuse have a 300% higher risk of death within a seven-year period compared with peers who have not experienced abuse. When I first saw that stat, I had to re-read it to make sure it wasn’t a typo! Age can complicate the power and control dynamics of domestic violence. For example, what happens when a perpetrator ages and loses capacity? In some circumstances, the original victim then begins carrying out what looks like abuse on the original perpetrator. It can become very hard to define exactly who is the victim. 

Another thing that makes this field tough is that the role of the traditional domestic violence advocate can feel different from the role of APS in a case that involves an older adult with vulnerabilities. In the latter circumstance, APS is often protecting someone who has been deemed unable to protect themselves. There can be some conflict between this role and the role of the DV advocate to empower and support a victim in decision-making.

CLA: What are we doing well in Ohio, in terms of protecting older victims from exploitation, crime, and abuse? 

Sylvia: We’re doing a lot right in Ohio. Many will point to increased reports of elder abuse and exploitation, but I think a lot of that has to do with better reporting and better mechanisms to receive and process those reports. Also, we recently added 16 new categories of mandated reporters. Bank, paramedics, ambulance - people who are gatekeepers and now required to to make a report. This is huge. If nobody knows there’s a problem, we can’t help. We are also getting really good at collaboration. And this is so crucial, given the complicated nature of so many of these cases. Aside from the role I described for our office, the Adult Protective Services agency in each county is required to have an interdisciplinary team that meets to review difficult cases that are just stuck. Not all states require this. The process can bring together APS, legal aid, physicians, law enforcements - all coming together to share information and push forward results for the victim. 

CLA: What can we be doing better? 

Sylvia: There’s definitely room for improvement around record-keeping. We just don’t have great stats around elder justice - and we all know this is tied to our ability to target services and also support our need for funding. We need a central database that collects a deeper profile of demographics on our victims. And this is a positive and negative - we are moving in the right direction with funding for each county to protect seniors, but we still need more. Around ten years ago, it was only around $30,000 per county. Now it’s a little better and we are expecting another bump here soon. The AG can provide free support, but because Ohio is a “home rule” state we need to be invited in to support law enforcement or prosecutors. This often takes an extra level of resources and information that some locations simply don’t have.

CLA: What is the best way our readers, many of whom are community partners in helping roles throughout the social services community, can help? 

Sylvia: We do a lot of training. Find one of the trainings. Or we will come to you. We put together trainings upon request for your agency. You can request training online at our website here. Like I talked about a little earlier, we are truly here for case consults. Pick up the phone and give us a call. We can talk things through, brainstorm, share resources, and consider obstacles together.

CLA: Even though we usually come at things from the perspective of lawyers, most of us also have older adults we love. Is there anything we can do to help protect them from victimization? 

Sylvia: Yes, there’s something that’s pretty simple. We know social isolation is the number one risk factor leading to elder abuse/ exploitation. One good way to protect your loved ones is to help prevent isolation. Or if it’s already happening, help rebuild their support system. This is critical to keep older people safe. Overall, just pay attention. And this goes not just for our loved ones - but the people we work with in our jobs. 

CLA: Any parting thoughts? 

Sylvia: Elder abuse impacts us all. And we can all play a role in reporting it - you don’t have to be a mandated reporter. And you don’t need to be the one to decide if a crime or exploitation happened. You see a red flag, you call. It won’t guarantee abuse will stop, but it’s the first step. And without a call, it’s likely to continue. 

Elder Justice Unit by phone: (800) 282-0515

Adult Protective Services by phone: (855) 644-6277

This article is part of Legal Aid’s “Big Ideas” series. 

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