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Department of Health Services inspection supervisor Cathy Rodriguez says the truth of her own mortality often hits her when she's out in the field.
"You're looking at someone and you say to yourself, 'That's me 40 years from now,'" says Rodriguez. "This country does not realize what it's facing. We're in big trouble right now."
DHS records indicate that about 4,000 elderly Arizonans live at residential adult-care homes that are licensed or in the process of getting licensed. That number doesn't include untold numbers of seniors who live--mostly for financial reasons--in "underground" homes around the state.
Most adult-care home residents are members of the middle or lower-middle class; wealthier people can afford skilled nursing homes if they choose, while poorer folks may qualify for government assistance at a county foster-care home.
"Nobody expected people to live this long," Cathy Rodriguez says, "but unless there's a Corliss Ford case or something that interests the media, this group is hidden away, kind of the forgotten population."
Rodriguez is one of 11--that's all--DHS inspectors whose job it is to visit Arizona's residential adult-care homes. She and the others determine, among other things, whether an elderly person has been physically abused or should be receiving a higher level of care.
These inspectors are not ogres eager to make life miserable for care-home operators like Corliss Ford. Rodriguez and other inspectors contacted by New Times express similar feelings about the importance of their mission--ensuring the safety of vulnerable adults.
"My people come in angry or crying or both at times," Rodriguez says. "You've got families who just don't care, and the families who can't afford any better and are doing the best they can. Or there are no families at all. I've seen the most vulnerable elderly people you can imagine that no one is looking out for."
Rodriguez says she and her peers are keenly aware of the impact their inspection reports may have on care-home residents and their families.
"Say you order a home to move someone out because they need more care," says Rodriguez. "You know there are going to be repercussions down the road--families who can't afford any better. I'll admit, it's not cut-and-dried a lot of the time. But you have to follow the law."
This year, for example, records supplied by DHS show the agency's inspectors have substantiated 368 complaints involving adult-care homes. Those complaints ranged from physical abuse to not keeping an up-to-date list of discharged residents.
DHS also has issued 16 cease-and-desist orders this year to homes operating without a license. About 90 percent of the complaints to DHS involved unlicensed homes, in part because only 144 adult-care homes have been so certified since Arizona law mandated it in July 1992.
DHS records show another 501 adult-care homes "currently under review" for a license. Many of those homes have received permits to operate while the state processes their applications.
"Those kinds of homes had been going without any oversight for years and now they're finally getting some," says Anne Lindeman, executive director of the Governor's Advisory Council on Aging. "It used to be, 'Don't bother a system that generally works.' But there were and are some terrible abuses."
National statistics suggest anywhere from one in eight to one in fourteen cases of physical elderly abuse are reported to authorities.
Experts agree a vast majority of the abuse takes place within the family, though the state of Arizona has had its tragic share of crimes against the elderly at adult-care homes.
"Some people honestly don't know what they're getting into," says Cathy Rodriguez. "They say, 'How hard can it be to take care of old people?' Well, sometimes it's very hard. And more and more people are going to have to become aware of this."
With about 17 percent of Arizonans over the age of 60--the fastest-growing segment of the state's 3.5 million residents--Rodriguez isn't just talking.
"We're still learning what to look for and how to deal with what we see at a home," she says. "I'd like to think we are getting better at going into these homes with an open mind. But I'll tell you one thing all of us in this line of work know is true: Society is getting caught with its pants down when it comes to dealing with its elderly.