Pennsylvania recorded a steep increase in the deaths of older adults following an abuse or neglect complaint the last few years, as COVID-19 ravaged the nation, complaints grew and agencies struggled to keep caseworkers on staff.
The staggering increase shown in state data — from 120 deaths reported in 2017 to almost 1,400 in 2022, a more than tenfold increase — may have had several contributing factors, and the state and county-level agencies that field and investigate complaints gave varying answers explaining why.
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 said errors in its data entry procedure — now corrected — led to undercounting in the initial years. Another pointed to cases staying open longer.
Some county agencies wouldn’t answer questions about it at all.
The increase came as agencies in Pennsylvania and nationwide struggled to keep caseworkers on staff through the pandemic and manage caseloads.
The Department of Aging said it has no data to suggest that a lack of caseworkers contributed to the increase in deaths, and suggested that the data could be misleading since the deaths may have had nothing to do with the original abuse or neglect complaint.
“The data does not make any correlation between the provision of protective services and how the older adult died,” the agency said.
The department doesn’t track causes of death, and individual county-level agencies aren’t required to provide that information to the state. When caseworkers enter data on a case, they are given a choice of reasons for why a case was closed, including death.
If anything changed in recent years, state efforts to train caseworkers likely improved how data on cases was recorded and entered, former department employees and county officials said.
It’s not clear to what extent better data collection helps explain Pennsylvania’s increase, but evidence suggests that other similar jurisdictions did not see a similarly steep increase.
Officials from the National Adult Protective Services Association said they had not heard discussion of such a steep increase in deaths among the state programs that investigate abuse and neglect complaints of adults.
Although states have different practices for investigating complaints and collecting data, two states with similar-sized populations — Illinois and Michigan — also reported significant increases in deaths.
But those increases — roughly triple during the pandemic — were nowhere near the proportion of Pennsylvania’s.
The broader death rate of older adults did not increase nearly as steeply during the pandemic, going from about 4% of those 65 and older in 2018 to 4.5% in 2021, according to federal statistics.