In observance of National Victims’ Rights Week, the Georgia Department of Human Resources is urging people to report suspected cases of elder abuse.

Coincidentally, the initiative comes one week after a Gainesville man and his girlfriend were arrested and charged with abusing the man’s 79-year-old mother.

Gladys Smallwood died April 6 at Northeast Georgia Medical Center, about six weeks after she was removed from the Hazel Street home of her son Larry Smallwood. Authorities said the woman was found suffering from malnutrition and lying in her own waste.

Larry Smallwood, 56, and Brenda Ivey, 46, were charged with felony cruelty to a person older than 65. Hall County Sheriff’s Maj. Jeff Strickland has said additional charges could be filed based on results of an autopsy.

The couple were also charged with forgery in connection with cashing two of Gladys Smallwood’s Social Security checks. And Ivey had a prior charge of simple battery, for allegedly hitting Gladys Smallwood in the face during an argument about food in July.

It was a classic case of elder abuse, encompassing physical and emotional punishment, neglect and financial exploitation, officials said. Barbara Pastirik, aging coordinator with the Department of Human Resources Adult Protective Services, said such horror stories will continue to occur unless people speak up.

"Elder abuse is still underreported," she said. "I think we have a big challenge ahead of us. But people need to understand that we work under extreme confidentiality, and the reporting source is never given out."

In the Smallwood case, neighbors claimed they had tried to get help for the woman. But social service agencies said they had no record of receiving calls regarding Smallwood.

Pastirik said there still seems to be confusion about how to report elder abuse. Many people still try to call the Division of Family and Children Services, which was separated from Adult Protective Services in 2004.

The best number to call, she said, is the toll-free Adult Protective Services central intake line, 888-774-0152.

Adult Protective Services handles cases of suspected abuse, neglect or exploitation of people older than 65 and adults of any age who are disabled.

"We’re not law enforcement, but when we do have a preponderance of evidence that there’s something criminal going on, we report it to law enforcement," she said.

Pastirik said the agency has hired a forensics nurse who helps gather medical evidence that may support claims of abuse.

"She also trains our social workers and law enforcement on what to look for," she said.

Signs of possible abuse can include unexplained injuries, such as bruises, burns or bedsores; lack of personal grooming or hygiene; weight loss without a medical cause; fearful behavior, such as crying or refusing to talk; and filthy living conditions.

Pastirik said fear often prevents elderly people from calling Adult Protective Services on their own behalf, even if they are aware of the agency. There is a real possibility that they’ll be punished if the abuser finds out.

"It does sometimes happen that if the victim reports, the abuser retaliates," she said. "We try not to leave the elderly person more at risk than when we found them."

On the other hand, victims may believe that as bad as their circumstances may be, the alternative might be worse.

"Victims are sometimes afraid that (if they report) they’ll be ‘sent to a nursing home,’ and that is not what we do," Pastirik said. "Our goal is to keep the person at home whenever possible."

If an elderly or disabled person is bed-bound, neighbors may not even know the person exists. That’s why Georgia has a list of "mandated reporters," people who may come into contact with the victim as part of their job and are required to report suspected abuse. These include home health workers, hospital staff, law enforcement and senior centers.

"I always err on the side of caution (when it comes to reporting abuse)," said Barbara Woodward, a case manager at Northeast Georgia Medical Center. "The patient is asked, ‘Do you feel safe going home?’ If they don’t answer right away, we start asking questions about what’s going on."

Miriam Duncan, long-term care coordinator at the medical center, said signs of abuse are often discovered by an alert nurse when the patient is admitted to the hospital for an unrelated reason.

"Someone may come in with pneumonia, and during the assessment we discover a fracture that never seems to have healed," she said.

Pat Freeman, director of Legacy Link, the Area Agency on Aging in Gainesville, said her case managers travel throughout Northeast Georgia checking on about 1,200 elderly people.

"Our staff are trained to look for signs of abuse," she said. "Legacy Link does not have the power to investigate, but we report to (Adult Protective Services), and we have a close relationship with them."

Freeman said exploitation is among the most common forms of abuse she sees.

"Drug abuse is often a factor in the financial abuse of elders. People try to cash their Social Security checks to buy drugs," she said.

Dianne Currans, health programs manager for Legacy Link, said local banks are a valuable source for detecting exploitation.

"Bank tellers are good about reporting (possible forgery)," she said.

As for physical abuse, Freeman said people seem more willing to report mistreatment of a child than an adult, even if the two are equally vulnerable.

"If a 3-year-old gets smacked around, people say, ‘They can’t defend themselves,’" she said. "But if it’s an 85-year-old, they say, ‘Well, that’s a grown-up.’ People don’t want to get involved."

But if the frail elderly were able to defend themselves, there wouldn’t be state laws set up to protect them. Freeman said agencies need the public’s help in detecting cases of abuse.

"Everybody needs to be vigilant," she said. "And if you’re not sure who to call, you can always call the police.’