The woman, in her mid-70s, shared her house with an unemployed, alcoholic son. Over time, she developed Alzheimer's disease and turned her house and Social Security check over to him.
And that was when her life turned for the worse, says Thomasine Baskerville, a supervisor in the Howard County Department of Social Services.
"Within a few months, the lady was in bed, unable to get up and take care of herself," she said. "The son would not help her at all in terms of personal hygiene. If he did give her something to eat, it would be oatmeal or beans, nothing healthy at all."
Fortunately, county social service workers were able to get her outside of her home and into a nursing home, Ms. Baskerville said, speaking at a recent Coalition of Geriatric Services meeting about preventing and reporting elderly neglect and abuse.
"The thing about it is she got better -- noticeably better," she said.
Social services gets about 50 calls a year from neighbors or friends concerned that an elderly person is being neglected or abused.
"As [seniors] depend more on other people, it lends itself to abuse," Ms. Baskerville said.
But social service workers believe many cases in the county never get reported, often because people hesitate to file a complaint. Many elderly people don't report abuse because they think their family will abandon them, Ms. Baskerville said. "Some of the elderly can be afraid . . . of losing what little contact of the past they have."
Whether to report elderly abuse, neglect or self-neglect is a hard call, said Phyllis Madachy, program manager for Adult Community Evaluation Services (ACES), which handles complaints involving seniors over 65. It depends on what the callers have seen and the extent of their knowledge, she said.
"It's probably better to err on the side of calling rather than not," she said.
But complaints are often very difficult to prove because the seniors who are victims or alleged victims are often people who can't report what's happened, she said.
"They forget, or sometimes they're afraid. It's just very difficult to prosecute. It's a fuzzy area," she said.
In Howard County, she said, neglect or self-neglect is more prevalent than outright abuse.
"Neglect is not providing somebody something they need," Ms. Madachy said.
Friends, neighbors or service providers such as nurses can call ACES if they believe an elderly person is being abused or neglected. The caller's name is kept confidential, and under state law that individual cannot be prosecuted if the claim is unfounded.
ACES takes the abused victim's name, address, phone number and any other pertinent information, including the nature of the alleged abuse and the names of other persons in the home. Social workers then follow up with face-to-face interviews.
Complaints about seniors who live in nursing homes go to the county Department of Aging's ombudsman, who investigates allegations in the county's three nursing homes and notifies either law enforcement personnel or the licensing and certification department.