In recent years, Pennsylvania has seen a significant rise in the number of elderly deaths reported after instances of abuse or neglect. This is likely due to the impact of COVID-19 on the country, as well as an increase in complaints and difficulties in retaining caseworkers within agencies.

The state data demonstrates a significant rise, with the number of reported deaths increasing from 120 in 2017 to nearly 1,400 in 2022, representing a more than tenfold increase. This could have been influenced by multiple factors, and the agencies responsible for handling and examining complaints at both the state and county levels provided different explanations for this trend.

Mostly, Pennsylvania’s Department of Aging and county-level agency officials speculated that it had to do with a growing population of people 65 and older, an increase in complaints and the devastating impact of the COVID-19 pandemic on older adults.

One county reported that mistakes in their data input process, which have since been fixed, resulted in an undercounting of data in the early years. Another county cited longer durations for open cases as a contributing factor.

Several county agencies refused to provide any information about it.

The rise occurred as organizations in Pennsylvania and across the country faced challenges in retaining caseworkers during the pandemic and handling an influx of cases.

The Department of Aging reported that there is no evidence indicating that a shortage of caseworkers played a role in the rise of fatalities. They also caution that the data may be misleading as the deaths may not be directly linked to the initial report of abuse or neglect.

The agency stated that the data does not show any connection between the provision of protective services and the cause of death for older adults.

The cause of death is not monitored by the department, and it is not mandatory for county agencies to report this information to the state. When caseworkers input data for a case, they select from a list of reasons for closing the case, which includes death.

According to former employees of the department and county officials, if there have been any changes in recent years, the efforts made by the state to train caseworkers have likely resulted in improvements in the recording and inputting of data on cases.

The exact impact of improved data collection on Pennsylvania’s rise is uncertain, but indications show that similar regions did not experience a comparable sharp rise.

Representatives from the National Adult Protective Services Association stated that there has been no mention of a significant rise in fatalities within state programs that handle reports of mistreatment and negligence towards adults.

Even though states have varying methods for looking into complaints and gathering information, two states with comparable populations, namely Illinois and Michigan, both noted substantial rises in fatalities.

However, those rises, which were approximately triple the usual amount during the pandemic, were not nearly as large as those in Pennsylvania.

The overall mortality rate for elderly individuals did not experience a significant rise during the pandemic. It went from approximately 4% in 2018 to 4.5% in 2021, according to data from the federal government.

In total, the data from Pennsylvania indicates that 120 cases of neglect or abuse were closed by caseworkers in 2017 due to death.

The number consistently increased each year, reaching 784 in 2020, 1,284 in 2021, and finally 1,389 in 2022 – a growth of over 10 times in a span of five years, or over 1000%.

The amount of grievances reported to caseworkers also increased during that time. However, the increase was significantly smaller, at approximately 55%, according to state records.

In the current year, there was a slight decrease in the rate of closed cases due to death, but it still exceeded the pace set in 2020. In the first half of 2023, there were 528 deaths, putting it on track for a total of 1,056 deaths by the end of the year.

The department does not reveal specific information about case investigations or any deficiencies discovered during performance evaluations of the 52 county-level “area agencies for aging” in Pennsylvania.

Certain organizations are operated by the county, while others are non-profit, and receive state funding to respond to reports of elder mistreatment or negligence. They hire individuals to look into these reports and collaborate with medical professionals, service providers, and in some cases, law enforcement.

The majority of calls deal with individuals residing independently or with a relative or caretaker. Financial hardship is frequently a contributing factor.

In compliance with Pennsylvania’s open records law, the department has provided the requested death statistics to The Associated Press after their formal request.

After examining internal emails, the AP made a request following concerns raised by state protective services staff regarding the handling of three individuals’ cases in Philadelphia in 2021, which were also obtained through an open records request.

The department refused to disclose the fate of the three people — including when a state lawmaker asked about it following AP’s story on it.

According to data from Pennsylvania, case workers experienced extended closure times for certain cases during the progression of the pandemic, and frequently managed a higher volume of cases than permitted by state regulations.

Due to the COVID-19 pandemic, there was a severe lack of caseworkers. This led the administration of then-Gov. Tom Wolf to take unprecedented action in 2021 by mobilizing state employees to conduct investigations for the agency in Philadelphia.

The Philadelphia Corporation for Aging, a nonprofit agency, documented four closed cases due to death in 2017. By 2020, this figure increased to 220. In 2021, it reached 472 before declining to 295 in 2022.

The director of the Area Agency on Aging for Dauphin County, Bob Burns, stated that he was not shocked by the rise in fatalities due to the destructive impact of the COVID-19 pandemic.

According to Burns, the lack of caseworkers results in an increase in workload due to potential delays in case resolution. However, counties have started assigning more seasoned caseworkers to promptly assess complaints and identify urgent situations.

Gov. Josh Shapiro’s secretary for the Department of Aging, Jason Kavulich, told lawmakers in a March hearing that many county-level agencies “are struggling for a variety of reasons, from not having adequate staff to a high number of staff turnover to some serious training issues, that we need to get them up to an acceptable level of understanding.”

Prior to the pandemic, there had been criticism regarding the performance of agencies focused on aging in the area.

In 2018, the state’s Office of Inspector General, which conducts internal investigations, released a report denouncing the way the state and counties deal with reports of abuse and neglect. The report highlighted shortcomings in the timely investigation of complaints as mandated by state law, as well as insufficient staffing at the Department of Aging office responsible for overseeing these agencies.

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