The recession has led more people to take responsibility for elderly relatives, and they're often unaware of the difficulties involved, according to a report released Tuesday.

Sacramento County's Elder Death Review Team saw a number of cases in the last fiscal year that were the result of that lack of knowledge.

"What they don't understand is how overwhelming the care can be," said Marv Stern, an assistant chief deputy district attorney who serves on the team.

Suspected neglect at home was the single biggest reason for a case review by the team, ahead of gap in service and suspected homicide, which was last with 10 percent of the eight cases reviewed.

This lack of knowledge is why the team wants to promote a brochure, "Independent Living: A Resource Guide," Stern said. The brochure contains referral contact information for a number of agencies, nonprofits and associations that can provide help with mental health, medical and other needs. See the brochure here.

The review team is made up of officials from a number of disciplines, including social services, health care and law enforcement. It makes recommendations about how to address patterns of elder abuse and neglect.

This year's report contained numerous cases of people who were apparently unprepared to handle their elderly relatives.

In one case, a 58-year-old woman was brought the hospital with wounds all over her body – pressure wounds from not receiving adequate care at home, the report states.

Other cases questioned whether doctors played a role in deaths, including a 91-year-old woman who died after a public health nurse made repeated requests of her doctor to refer her to a hospice.

The team sent a letter to state officials outlining its concerns about the doctor.

Some cases are difficult and resist easy explanations. As county Supervisor Roberta MacGlashan put it, elderly patients are adults who can't typically be forced to get care when they don't want it.

For instance, the team noted the death of a 57-year-old woman who was morbidly obese but had not seen a doctor in 10 years, despite the protests of her boyfriend, her caretaker.

The report said "there is little that the community can do when there is a competent elder in need of care who refuses it."

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