Abandonment of older adults in island hospitals up 45% from 2017

 A study published by Medicina/Salud Publica challenges the traditional view of abandonment as an intentional act. Social worker and gerontologist Erika Colón Ortega, who led the study, said many families are willing to care for their older loved ones but lack the financial resources or suitable housing to support people discharged from hospitals with disabilities or long-term care needs. (www.arecibo.inter.edu)

Study spotlights socioeconomic factors, challenges traditional view that families make deliberate decision not to care for their elders

By THE STAR STAFF

The number of cases of older adults abandoned in hospitals has increased by 45% in Puerto Rico since 2017, according to a study published by Medicina/Salud Publica.

An investigation led by social worker and gerontologist Erika Colón Ortega found that the abandonment of older adults in hospitals is often tied less to deliberate decisions by families than to economic hardship, inadequate housing, social isolation and a lack of support networks.

“At times, the patients were alone and had no relatives to support them,” Colón Ortega said, according to Medicina/Salud Pública. “Not only because relatives were not present, but because they did not exist in these people’s lives.” 

The study challenges the traditional view of abandonment as an intentional act. Colón Ortega said many families are willing to care for their loved ones but lack the financial resources or suitable housing to support people discharged from hospitals with disabilities or long-term care needs.

“The reality is that support resources for care may be available, but they do not have the financial resources or housing facilities to care for a person with a disability after a hospital discharge,” she said.

The research also identified social isolation as a major factor, especially when older adults need help after hospitalization. The problem became more visible after Hurricane Maria in 2017 and later during the COVID-19 pandemic, both of which exposed vulnerabilities linked to Puerto Rico’s aging population.

According to data cited by the researcher, about 700 cases were documented in 2017. For fiscal year 2024-2025, the island Family Department reported 1,018 cases of older adults abandoned in medical-hospital institutions. Colón Ortega noted that current statistics do not distinguish how many cases were intentional and how many stemmed from social or economic conditions.

One recommendation from the study is for government agencies to collect more detailed information about the causes of the phenomenon, the social determinants that influence it and the costs it creates for the hospital system.

The issue comes as Puerto Rico undergoes a significant demographic transformation. Older adults currently make up 31% of the population, and projections indicate that figure could reach 40% by 2050.

“We have more older people than the rest of the population,” Colón Ortega said.

That scenario, combined with the outmigration of relatives off the island and the increase in people aging alone, has brought the problem into sharper focus. Beyond the logistical challenges of hospital discharge, the study highlights the emotional impact on older adults who remain hospitalized without a support network.

Colón Ortega said many patients are aware of their situation and experience the uncertainty of having no place to return to and no one who can take responsibility for their care. In other cases, patients have neurodegenerative diseases such as Alzheimer’s or Parkinson’s, which adds complexity to their cases.

The research also found that these cases place an additional burden on hospital social workers, who must manage administrative duties while handling complex cases involving older adults who cannot be discharged because of a lack of family or community support.

Among the study’s main recommendations is reactivating the implementation committee for Law 121, legislation that protects the rights of older adults in Puerto Rico. The proposal seeks to ensure that agencies work in a coordinated way to develop comprehensive solutions instead of handling cases in a fragmented manner.

Colón Ortega also called for changing the public narrative around abandonment and focusing on the social determinants of health that shape well-being in old age. For her, the solution requires participation from all sectors of society, not only the hospital system.