This requirement is described in additional detail later in this  report. Each of  these can affect older adults with guardians, as well as those without. The Extent of Elder Abuse by Guardians Is Unknown, and Available Information Varies by State and Locality, but Some Efforts Are Under Way to Gather More Data

		Courts Lack Comprehensive Data on Older Adults in Guardianships and Elder Abuse by Guardians, but Some Courts Have Limited Information

The extent of elder abuse by guardians nationally is unknown due to  limited data on the numbers of guardians serving older adults, older  adults in guardianships, and cases of elder abuse by a guardian. While  courts are responsible for guardianship appointment and monitoring  activities, among other things, court officials from the six selected states  that we spoke to were not able to provide exact numbers of guardians for  older adults or of older adults with guardians in their states. Court officials from the six states we spoke with described the varied,  albeit limited, information they have related to elder abuse by guardians  and noted the various data limitations that prevented them from providing  reliable figures on the extent of elder abuse by a guardian. Detailed information on  financial exploitation specifically may be available at the county level. Court officials directed us to state Adult Protective  Services (APS) elder abuse complaint data. The illustrative examples  of selected closed cases of elder abuse by a guardian we identified are  nongeneralizable and cannot be used to make inferences about the  overall population of guardians. Stakeholders we spoke to described their observations about elder abuse  by a guardian. Federal, State, and Local Entities Have Some Efforts Under Way to Collect More Information on Elder Abuse by Guardians

Federal, state, and local entities have some efforts under way to try to  collect better data on elder abuse and guardianship to support decision  making and help prevent and address elder abuse by guardians. In 2013, HHS’s Administration on Aging began developing the National  Adult Maltreatment Reporting System (NAMRS)—a national reporting  system based on standardized data submitted by state APS agency  information systems. According to  HHS officials and the contractor developing NAMRS, this system will  have the capability to collect information that could help identify cases of  elder abuse where a guardian was involved. Compiling data points. Representatives from the National Center for  State Courts (NCSC) are using data collected from Minnesota’s  Conservator Account Auditing Program to identify “red flags,”—or risk  indicators—such as unusually high guardian fees or excessive vehicle  or dining expenses that would help courts detect cases that need  additional review or monitoring. Federal Agencies Provide Funding to Support Coordination and Sharing Information, While State and Local Entities Oversee the Guardianship Process to Help Protect Older Adults with Guardians from Abuse

		Federal Agencies’ Measures to Help Protect Older Adults with Guardians Include Providing Funding to Support Coordination and Sharing Information

While the federal government does not regulate or directly support  guardianship, federal agencies, such as HHS, may provide indirect  support to state guardianship programs by providing funding for efforts to  share best practices and facilitate improved coordination. The federal  government also shares information that state and local entities can use  related to guardianship. State and Local Measures Can Include Screening, Education, Monitoring, and Enforcement

State and local courts have primary responsibility over the guardianship  process and, hence, have a role in protecting older adults with guardians  from abuse. For example, a court  official in Washington told us some reviews are paper audits where no  one conducts a site visit to the person under guardianship to verify his or  her well-being. Agency Comments

We are not making recommendations in this report. Guardianships: Cases of Financial Exploitation, Neglect, and Abuse of  Seniors.
Why GAO Did This Study

The number of older adults, those over age 65, is expected to nearly double in the United States by 2050. When an older adult becomes incapable of making informed decisions, a guardianship may be necessary. Generally, guardianships are legal relationships created when a state court grants one person or entity the authority and responsibility to make decisions in the best interest of an incapacitated individual—which can include an older adult—concerning his or her person or property. While many guardians act in the best interest of persons under guardianship, some have been reported to engage in the abuse of older adults.
GAO was asked to review whether abusive practices by guardians are widespread. This report describes (1) what is known about the extent of elder abuse by guardians; and (2) what measures federal agencies and selected state and local guardianship programs have taken to help protect older adults with guardians.
GAO reviewed relevant research, reports, studies, and other publications issued by organizations with expertise on elder abuse and guardianship issues. GAO also conducted interviews with various guardianship stakeholders including federal agencies such as HHS, six selected state courts, and nongovernmental organizations with expertise in guardianship-related issues. In addition, GAO identified eight closed cases of abuse by guardians in which there was a criminal conviction or finding of civil or administrative liability to use as nongeneralizable illustrative examples. GAO makes no recommendations in this report.

What GAO Found

The extent of elder abuse by guardians nationally is unknown due to limited data on key factors related to elder abuse by a guardian, such as the numbers of guardians serving older adults, older adults in guardianships, and cases of elder abuse by a guardian. Court officials from six selected states GAO spoke to noted various data limitations that prevent them from being able to provide reliable figures about elder abuse by guardians, including incomplete information about the ages of individuals with guardians. Officials from selected courts and representatives from organizations GAO spoke to described their observations about elder abuse by a guardian, including that one of the most common types appeared to be financial exploitation. Some efforts are under way to try to collect better data on elder abuse and guardianship at the federal, state, and local levels to support decision making and help prevent and address elder abuse by guardians. For example, the Department of Health and Human Services (HHS) plans to launch the National Adult Maltreatment Reporting System—a national reporting system based on data from state Adult Protective Services (APS) agency information systems by early 2017. According to HHS and its contractor, this system has the capability to collect information that could specifically help identify cases of elder abuse where a guardian was involved. GAO also identified state and local initiatives to capture key data points and complaint data as well as identify “red flags” such as unusually high guardian fees or excessive vehicle or dining expenses.
The federal government does not regulate or directly support guardianship, but federal agencies may provide indirect support to state guardianship programs by providing funding for efforts to share best practices and facilitate improved coordination, as well as by sharing information that state and local entities can use related to guardianship. State and local courts have primary responsibility over the guardianship process and, as such, have a role in protecting older adults with guardians from abuse, neglect, and exploitation. Measures taken by selected states to help protect older adults with guardians vary but generally include screening, education, monitoring, and enforcement.