Vulnerable Adults Lack Protection

By Linda H. Lamb

As a registered nurse for more than 30 years, Cynthia Gilstrap gave help and comfort to patients during some of their most vulnerable times. But during her own most vulnerable time, following a stroke in 2015, she often has found help agonizingly hard to locate.

Gilstrap, 55, of Pelzer, her sister, Lisa Evans, and legal advocates say the state Department of Social Services made things worse after Gilstrap—temporarily lacking a family caregiver—called DSS for assistance one night in June.

She ended up in a hospital emergency room and then in a nursing home for almost a month—against her will and that of her family.

“It wouldn’t have taken a whole lot for someone to come in here, clean her up and sit with her for a while,” said Evans, who was dealing with another family crisis that night: Their mother had just been hospitalized.

Gilstrap and Evans said that instead of receiving short-term assistance, they were plunged into a legal and financial mess that was resolved only when an advocacy group agreed to represent Gilstrap’s interests in Anderson County Family Court.

“One of the things I think is important about this case is, it could happen to anybody,” said Anna Maria Darwin, an attorney with the Greenville office of Protection & Advocacy for People with Disabilities Inc., the nonprofit that helped return Gilstrap to her home.

AARP South Carolina considers that important, too. That’s why it is gearing up for a push to improve Adult Protective Services when the General Assembly convenes in January.

Driving the effort is a new survey of DSS caseworkers revealing that they, too, see a need to improve services.

Services ‘Marginalized’
While budget cuts have hit all social services hard, much more attention has been paid to problems with children’s services, noted Teresa Arnold, AARP South Carolina state director.

“Funding for Adult Protective Services has been cut in half,” she said, from $7.5 million in 2001 to $3.4 million this year. “And at times, we’re putting vulnerable adults in the most expensive places possible, just because we don’t have the options in the community.”

DSS has been struggling to modernize services under Susan Alford, its director for barely two years. Alford told a state Senate panel last year that budget and staff cuts had “marginalized” the ability of DSS to assist vulnerable adults.

Arnold praised the agency for cooperating with the caseworkers survey, coordinated as a pro bono project by the Nelson Mullins Riley & Scarborough law firm. The 105 respondents represented 95 percent of caseworkers and supervisors surveyed.

Among the findings:

• 75 percent agree or strongly agree that additional training would help them assess cases.
• 63 percent said they believe a majority of caseworkers feel overwhelmed by their caseloads.
• 89 percent said they do not have enough options when they need to place a vulnerable adult in an alternative setting.

Among the recommendations AARP will make to the Legislature are more staff training at all levels, improved data collection, a central call center, expanded options for placement, better cooperation among agencies and a “family first” emphasis aimed at keeping vulnerable adults out of institutions.

“Removing folks from their home is probably the last thing you want to do,” said Carla Damron, an independent social worker in Columbia with 30 years’ experience. But determining how to handle these cases—and whether people are subject to abuse, are neglecting themselves, or just need help with daily tasks —can be extremely difficult, she said.

Improving training for caseworkers could be a step in the right direction, Damron said. At the same time, it’s crucial to improve support for stressed-out caregivers, such as household help and respite services, she said.

Linda H. Lamb is a writer living in Columbia, S.C.