As pandemic unfolded, deaths of older adults in Pennsylvania rose steeply in abuse or neglect cases

All told, Pennsylvania’s data shows caseworkers reported closing 120 neglect or abuse cases due to death in 2017.

That number rose steadily every year. It reached 784 in 2020, 1,284 in 2021 and then 1,389 in 2022 — rising by more than 10 times in five years, or more than 1000%.

The number of complaints called into caseworkers rose over that period, too. But it rose by a much smaller proportion — by about half, or 55%, according to state data.

This year, the pace of cases closed due to death slowed a bit, but still remained well above 2020’s pace. Through the first six months of 2023, the number of deaths was 528, on pace for 1,056 over the full year.

The department also doesn’t disclose the details of case investigations or what shortcomings it finds when it inspects the performance of the 52 county-level “area agencies for aging” across Pennsylvania.

Some agencies are county-run while others are nonprofits, and field calls about elder abuse or neglect under state contracts. They employ caseworkers to investigate complaints and coordinate with doctors, service providers and if necessary, law enforcement.

Most calls involve someone who lives alone or with a family member or caregiver. Poverty is often a factor.

The department released the deaths data in response to a request filed by The Associated Press under Pennsylvania’s open records law.

The AP submitted the request after reviewing internal emails — also released through an open records request — showing that state protective services staff had become alarmed at how Philadelphia’s agency had handled the cases of three people in 2021.

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.

In Pennsylvania, state data shows caseworkers took longer to close some cases as the pandemic wore on and often handled more cases than state regulations allow.

The shortage of caseworkers during the COVID-19 pandemic became so extreme that, in 2021, then-Gov. Tom Wolf’s administration took the extraordinary step of marshaling state employees to handle investigations for Philadelphia’s agency.

The agency, the nonprofit Philadelphia Corporation for Aging, reported four cases closed due to death in 2017. By 2020, that number rose to 220. In 2021, it hit 472 before dropping to 295 in 2022.

Bob Burns, the director of Dauphin County’s Area Agency on Aging, said he wasn’t surprised by the increase in deaths, considering the ravages of the COVID-19 pandemic.

The shortage of caseworkers leads to higher caseloads because it might take longer to close out a case, Burns said. But, he said, counties began using experienced caseworkers up front to quickly investigate complaints to determine right away if a person was in a dire situation.

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.”

Even before the pandemic, the performance of area agencies on aging had drawn criticism.

In 2018, the state’s internal investigation agency, the Office of Inspector General, issued a report that criticized how the state and counties handle abuse and neglect reports. That report pointed to failures to properly investigate complaints under timelines required by state law and inadequate staffing of the Department of Aging office that monitors those agencies.