County official answers questions about elder abuse

Earlier this week, The Times published two more parts of an ongoing investigation by staff reporter Michael J. Berens into Washington's adult family homes. Page Ulrey, King County senior deputy prosecutor, who specializes in elder-abuse cases, answered questions Tuesday from our online readers.

Q: What can we do to help you and the police bring these cases? Should we try to get evidence, take some pictures or video?

— Seeking Guidance, Seattle

A: Reporting these cases to the police and to the Department of Social and Health Services (DSHS) as soon as possible is most helpful. The quicker law enforcement can get to a scene and begin taking photographs and securing evidence, the better. If you are working in a medical setting so that taking pictures is part of your job, then taking pictures of any signs of neglect is also extremely helpful.

Q: My grandma is in a home between Renton and Kent and the owner has strict visiting hours only from about 2 p.m. to 4 p.m. as she said this is her personal private home and she doesn't need people in and out all the time. To me this sounds like it could be a red flag.

— Tinkerbell, Duvall

A: It concerns me, too. That home is your grandmother's home, as well as the owner's. I would call the Ombudsman's Office and see if they can help you with this. I would also report it to DSHS. (1-800-EndHarm)

Q: What role does inadequate training play in the problems you have found in prosecuting adult family home (AFH) caregivers and operators? Do you find a pattern of harm?

— Louise Ryan

A: There are plenty of neglect cases that occur as a result of inadequate training. The cases we end up prosecuting are usually not those cases. In order to prosecute, we must show that the caregiver acted with criminal negligence, recklessness or intent. A case of someone not being trained properly would typically not rise to that level.

Q: Due to the low profit margin of most AFHs and the focus on the clients, rather than PR, do you have any ideas on how to highlight examples of good AFHs and care-management staff? That would help potential clients make informed choices and serve as a deterrent for negligent homes.

— John M

A: That's a very good question, because there are some excellent adult family homes out there. I might talk to Senior Services, which provides referrals for services for elders throughout King County. They may have some good ideas of how to do this.

(Editor's note: Previously in the series, The Times also told the story of good adult family homes. seattletimes.com/seniorsforsale.)

Q: About a month ago, Attorney General Rob McKenna wrote an article blaming attorneys and big verdicts as one of the major issues facing the state. Do you agree with him, or would you recognize that holding the state accountable for gross negligence is a way to spark reform?

— Mark

A: I don't work on civil cases, so I simply can't speak to the effect of those lawsuits on reform. I can say that Mike Berens' articles have done more to reform the systemic response to elder abuse in Washington than anything else I have witnessed since I have been doing this work. As a result of his first series, we have been holding regular meetings with DSHS to address improvements to the system. I am very hopeful that some real change will be made as a result, including increased reporting to law enforcement.

Q: My mom lives in an adult family home in Kent for the last four years. My brother and I are very happy with the care she's had. The last couple of days, some members of my family have called me and asked questions about her care and why I'm not moving her out of there into a nursing home nearby. She moved to the AFH from a nursing home because she was not being taken care of there. What do you think I should do?

— Jessica

A: There are some excellent adult family homes in King County. The danger that Mike Berens writes about comes from the fact that they are so unregulated. If I were in your shoes, I wouldn't move my mother out of an adult family home if I was going to the home frequently and satisfied that she was happy there and getting good care.

Q: To run an adult family home what sort of qualifications are needed? I think some caretakers are not "fit" to take care of seniors.

— I want justice

A: State regulations require that people who run adult family homes take a course in caregiving. There is also a list of crimes that people may not have on their records if they want to run an AFH.

Q: If those AFHs are doing such a bad job why aren't they shut down?

— Flavius

A: That's a question for DSHS. Criminal sanctions don't include the ability to shut down adult family homes.

Q: How do you make a case against persons who have power of attorney and can't provide any financial documents showing exactly how they spent the money?

— Guest

A: In order for us to prove abuse of a power of attorney, we have to show where the elder's money went, and that it was spent on the attorney-in-fact, rather than for the elder's benefit. That evidence can be obtained through a concerned person — including Adult Protective Services — demanding an accounting of the attorney-in-fact. It can also be obtained by law enforcement obtaining a search warrant for the suspect's and victim's bank records.