EL PASO, Texas -- A report finds the elderly care program in Texas is in need of major improvement.

The report says problems with training, staffing and organization are to blame for residents being left in homes without water or power -- and filled with excrement. Some were living in their cars through sweltering summers and freezing winters.

Such cases were sometimes closed after being called "lifestyle choices."

The preliminary review examined 200 El Paso cases and Adult Protective Services, or APS, policies statewide.

State investigators found in 35 percent of the cases, the investigation did not fully address all the allegations of abuse, neglect or exploitation.

In 41 percent of the cases, appropriate action to prevent further abuse was not taken. In 57 percent of the cases considered severe, the client did not receive any more contact from a case worker.

"(The findings) frankly confirm that serious deficiencies exist in almost every aspect of the APS program," said Gregg Phillips, chairman of Texas' Health and Human Services Commission.

While some have described the report as shocking, people directly involved in the numerous cases of neglect and abuse say this report just confirms what they have known for years, reported KFOX-TV in El Paso.

Terry Hammond is the attorney for many of the cases.

"There will literally be millions of elderly and disabled people who will feel the effect of the work that has been done here, and that's remarkable," Hammond said.

The investigation will now be taken statewide, where it is believed similar problems exist.

Texas Gov. Rick Perry said the review is a first step toward fixing the problems, but some families say their loved ones have already been changed forever.

Elena Slape says the home of her uncle, 86-year-old Francisco Chapa, had no plumbing or gas and was filled with knee-high trash. Chapa is a decorated war veteran who lived in his station wagon for 10 years.

Slape said Chapa's life would have been much different had APS intervened when she called the state agency for help years ago.

"In our case, if this person had followed up, none of this would have happened," said Slape. "He is now 86 and has been under poor conditions in his home and his health. We are barely starting to take him to doctors and seeing that he has a place to sleep at night."

Read Preliminary Report