Between July 1, 2011 through June 30, 2012, Adult Protective Services (APS) responded to 11,000 reports of mistreatment or self-neglect of at-risk adults in Colorado. These reports involve the abuse, exploitation, and neglect of people 18 years old or older who cannot provide for their own health, safety, or welfare; or obtain services necessary to keep themselves safe and healthy. Some of the conditions that may make an adult at-risk of mistreatment or self-neglect include dementia, Alzheimer's disease, developmental disabilities, severe physical disabilities, or serious medical conditions.

APS' response depends on the allegations and the condition of the at-risk adult. When APS responds to a report, the first step is to interview the at-risk adult and determine if the mistreatment or self-neglect is actually happening.

Next, APS tries to find out if the adult has the ability to make responsible decisions and if they understand the consequences of their decisions. The ability to understand and communicate responsible decisions is referred to as "decisional, mental, or cognitive capacity". Adults with capacity have all the same rights as any other adult no matter what their condition or disability might be. Adults with capacity have the right to refuse or accept some or all of the help APS offers. The right to accept or refuse services is known as "Consent". APS must get the consent of an at-risk adult who has capacity in order to provide protective services.

There are a lot of things to consider when APS investigates a report. Some people choose to live in a way that appears unsafe or strange, but as adults, they have the right to live that way if they have capacity. In all cases APS tries to work with the at-risk adult and other community resources to keep the at-risk adult safe. There are circumstances when an at-risk adult does not have capacity or the ability to understand the consequences of their actions. In these cases, where there is apparent and on-going risk to the adult's health, safety, or welfare, APS may assist the client without their consent.

When investigating abuse, exploitation, and caregiver neglect, APS caseworkers must coordinate their efforts with law enforcement and the district attorney to determine if a crime has taken place. APS may share information with the police if there is evidence of criminal activity. In this type of case the police have the role of investigating and prosecuting crimes and APS works with the at-risk adult to keep him or her safe.

APS cannot provide legal advice or be an adult's medical proxy decision maker. APS cannot force a client to participate in medical or mental health treatments or place the adult in a facility against their will. If a court determines that an at-risk adult lacks the ability to make decisions to keep them safe, APS may ask a court for guardianship.

Regardless of the at-risk adult's capacity or the allegations, APS caseworkers are always guided by three principles: 1) confidentiality, 2) self-determination, and 3) the least restrictive intervention. APS caseworkers are required by the APS statute to keep any and all information about a report and client confidential. Self-determination is an adult's right to make their own decisions and to choose their own course of action. Finally, the principle of least restrictive intervention means that APS caseworkers try to provide the minimum amount of services necessary to stop or prevent the mistreatment and self-neglect.

Remember, if you suspect mistreatment or self-neglect, it's okay to speak up. You should immediately report the situation to the Montezuma County Department of Social Services at (970-564-4110). Ask to speak to Adult Protection. If calling about an emergency situation during non-business hours, contact law enforcement (970-565-8441) to make the report.

All reports are confidential and may be made anonymously. However, it is helpful to APS if you provide your contact information so APS can contact you, if needed.

Warning signs of abuse, neglect and exploitation are as follows:

S udden changes in behavior, finances, or lifestyle

P hysical injuries, dehydration, or malnourishment

E xtreme withdrawal, depression, or anxiety

A bsence of basic care or necessities

K ept away from others

U nsanitary living conditions

P ersonal items or money missing

Holly Bock is the Montezuma County Adult Protection Caseworker. She can be reaced at 564-4110.