Friday, December 28, 2007

Why do people look the other way? Do you...?

Stopping Elder Abuse Before it StartsStopping elder abuse and nursing home neglect is important, but a lot of people either do not know how they can help or they are too reluctant to get involved in doing anything.Most Recent Articles Submitted... -

T is for Trespass by Sue GraftonBy Kristie(Kristie) Though set in the late eighties, T is for Trespass could not be more topical: identity theft; elder abuse; betrayal of trust; the breakdown in the institutions charged with caring for the weak and the dependent. ...Kristie Loves Books -


Monday, December 10, 2007


What is the definition of elder abuse?

Elder abuse is the intentional or unintentional hurting, whether it be physically, emotionally, sexually, or financially, of a person who is age sixty or older.

What are the types of elder abuse?

Elder abuse usually occurs in one of two locations: domestic elder abuse (in the elder's home); institutional elder abuse (in a nursing home or other long-term-care facility)

The types of elder abuse are:

  • Physical abuse of the elderly.
  • Emotional abuse of the elderly (psychological or verbal).
  • Neglect or abandonment of elders by caregivers.
  • Self-neglect by elders.
  • Sexual abuse of the elderly.
  • Financial exploitation of seniors (elder financial abuse).
  • Healthcare fraud or healthcare abuse of the elderly.

What is nursing home elder abuse?

  • Most elder abuse occurs at home.
However, a significant proportion of elder abuse occurs in long-term-care facilities, such as in nursing homes, out of sight of the general public. Nursing home abuse can take any form: physical abuse; emotional abuse; sexual abuse; neglect; financial exploitation; or healthcare abuse. Elder abuse in nursing homes has recently gained media attention, and a federal program has been established to help prevent and resolve such abuse of the elderly. Choosing a reputable nursing home is as important as continually keeping watch over the quality of care in the chosen facility. Look carefully at the contract for the residential care facility. The National Long-Term-Care Ombudsman Resource Center provides advocates to help choose a safe nursing home, as well as to resolve suspected senior abuse in a long-term-care facility.

What is physical abuse of the elderly?

Physical abuse is physical force that results in injury, impairment, physical pain, or the threat of such physical force. Physical violence against an elder in the home is a form of domestic violence. The injury from physical abuse may be from physical punishment of any kind, such as: assault (for example, during a mugging); beating, whipping, hitting (with or without an object); paddling, slapping, or punching; pushing; shoving; shaking; choking; throwing; kicking; pinching;, biting; scratching; spitting; force-feeding; hair-pulling; burning; inappropriate use of drugs and physical restraints; rough handling during caregiving or when moving the body; administration of medicines. The practice of physically restraining elders in a nursing home is particularly troublesome and controversial. Physical restraint may sometimes seem necessary if the elder wants to get up and move around, but is unable to walk without falling. Where staffing is low, the elder cannot be left alone, so the staff uses physical restraints to keep the person in bed or in a chair. If the senior resists the physical restraints, the staff medicates them so that they are more compliant with the restraints. Physical restraint is legal, but many family members would prefer that their loved one fall occasionally, rather than be strapped into a chair or bed against their will.

What is emotional abuse of an elder?

Emotional elder abuse is a verbal or nonverbal act that inflicts emotional pain, anguish, or distress on the elder. It is sometimes also known as verbal abuse, mental abuse, or psychological abuse.
Emotional elderly abuse is almost always accompanied by another form of abuse, such as physical abuse.
Emotional abuse of the elderly can range from a simple verbal insult to an extreme form of verbal punishment. The following are examples of emotional abuse: ignoring the elder; isolating an elderly person from family, friends, or regular activities; habitual scapegoating or blaming; harassment; name-calling; cursing;, humiliating; insulting or ridiculing; threatening to punish or deprive; intimidating; treating an elder like an infant; using extreme or bizarre forms of punishment, such as confinement to a closet or dark room; tying to a chair for long periods of time; or terrorizing, yelling, or screaming
Some overlap exists between the definitions of emotional abuse and emotional neglect. Regardless, they are both elder abuse.

What is elder neglect?

  • Neglect of the elderly can be either physical or emotional.

Neglect consists of confinement, isolation, or denial of essential services. The caregiver who neglects the elder refuses or fails to provide or pay for the necessities of life, such as food, water, shelter, clothing, healthcare, medicine, comfort, and safety.

Abandonment, a type of neglect, is when the responsible caregiver deserts the vulnerable senior.

Physical neglect of the elderly.
A caregiver who physically neglects an elder does not provide for basic physical needs. This kind of neglect includes: lack of supervision and monitoring; inappropriate housing or shelter; inadequate provision of food or water; lack of assistance with eating or drinking; inappropriate clothing for the weather; abandonment; denial or delay of medical care; inadequate help with hygiene or bathing; inadequate hand-washing on the part of the caregiver, which leads to infections; physical restraint (in bed or in another area of the house); incorrect body positioning, which can lead to limb and skin damage; lack of help in moving around, either within the bed or within the physical environment; lack of access to the toilet, or inadequate changing of diapers or disposable briefs, which can lead to incontinence, agitation, and falling when trying to get to the bathroom independently, skin damage from sitting in urine and feces, and indignity.

Emotional neglect (psychological neglect) of the elderly.

Emotional neglect is a lack of basic emotional support, respect, and love, such as: not attending to the elder; ignoring moans, calls for help, or hospital call bells; inattention to the elder's need for affection; failure to provide necessary psychological care to the senior, such as therapy or medications for depression; isolation of the elder from the outer world, including restriction of phone calls, mail, visitors, and outings; lack of assistance in doing interesting activities, such as watching preferred television programs or going out for cultural or intellectual activities.
Some overlap exists between the definitions of emotional abuse and emotional neglect, regardless, they are both elder abuse.

What is elder self-neglect?

Elders can neglect themselves by not caring about their own health or safety. Elder self-neglect can lead to illness or injury. The senior may deny themselves or ignore the need for: food or water; bathing or other personal hygiene; proper clothing for the weather; shelter; adequate safety, or clean surroundings; essential medications or medical attention for serious illness.
In addition, self-neglectful elders may have the following behaviors: hoarding; leaving a stove on, but unattended; confusion.
Note that some elders who are of sound of mind, and not dependent on a caregiver may choose to deny themselves some health or safety benefits. This is not self-neglect, but, rather, personal choice. Others must therefore be sensitive about intervention.

What is sexual abuse of the elderly?

Elder sexual abuse is sexual contact with an elder without that person's consent.
This includes: coerced nudity; fondling, touching, or kissing, particularly the genitals; making the elderly person fondle someone else's genitals; forcing the elder to observe sexual acts; photographing the elder in sexually explicit ways; sexual assault of any type (coercion to perform sexual acts), including rape or sodomy; showing the elder pornographic material; spying on the elder in the bathroom or bedroom; telling "dirty" stories.

What is financial exploitation of the elderly?

Financial or material exploitation of an elder is when someone illegally or improperly uses an elder's assets, funds, or property.
Because elderly people are sometimes unable to hear or see well or to be as forceful physically or verbally as they used to be, they are easy targets for exploitation.
The financial abuser may take, misuse, or conceal the elder's belongings or money.
The financial abuser can be a family member; a caregiver or caretaker; a professional, such as an accountant, lawyer, doctor, or banker; a new boyfriend, girlfriend, spouse; or partner; or a stranger.A caregiver who financially exploits an elder takes control of the elder's world.
The caregiver might isolate the senior from the outside world, handle all financial matters, withhold food and medicine to weaken the elder, and psychologically abuse the elder so that he or she is afraid of doing anything about the situation.
Such a caregiver tells elders that no one else cares about them; that if they don't do what the caregiver says, they will lose their house and have to go into a nursing home; and that they must listen to the caregiver or be punished with physical harm or neglect. If isolated and weakened enough, the elder cannot tell the difference between a caring person who is trying to put financial matters in order and a scheming person who is taking advantage of them.

Some of the types of financial elder abuse are: cashing an elder's checks without authorization; using the elder's charge card number for one's own benefit.

Handling an elder's money without a Durable Power of Attorney (the only way which authorizes a person to manage the elder's finances); withdrawing cash from an elder's bank account with an ATM card; transferring money from an elder's bank account without the elder's permission, or forcing/intimidating (UNDUE INFLUENCE) the elder, to gain access to the elder's bank account; scamming an elder by convincing him or her to withdraw money from the bank, and then taking the money; stealing elders' checks, such as Social Security checks or pension checks from the U.S. mail; identity theft, including collecting checks and cashing them after the person has died. Convincing or forcing an elder to sign a contract that results in unwanted financial or material commitments. Convincing or forcing an elder to alter a will to benefit someone that a clear-thinking elder would not have chosen.

Enrolling a senior in unneeded services or subscriptions.
Getting donations from an elder under false pretenses, defrauding an elder so that they sign up for a particular investment opportunity that isn't really appropriate (investment fraud).
Giving the elder incorrect change for a purchase in a store, stealing household goods or money while caring for an elder.
Telemarketing fraud by selling sweepstakes entries, where the elder is extremely unlikely to win anything.
Forging the senior's signature in a long-term-care facility; not depositing resident funds in separate interest-bearing accounts, embezzling, marrying someone for his or her money, either for a current lifestyle change or to inherit their money after death.

What is healthcare fraud or healthcare abuse of the elderly?

Healthcare fraud or abuse is less visible than some other forms of elder abuse. Healthcare abuse includes: not providing healthcare, but charging for it; overcharging or double-billing for medical care or services; getting kick-backs for referrals to other providers or for prescribing certain drugs; patient abuse or neglect in a hospital, at home, or in a residential care setting; overmedicating or undermedicating; recommending fraudulent remedies for illnesses or other medical conditions.
Medicaid and Medicare fraud: includes any of the above types of healthcare fraud or abuse, but specifically carried out in a Medicaid or Medicare facility or funded by Medicaid or Medicare.

Those who carry out healthcare abuse can be: doctors; nurses; hospitals; caregivers; unlicensed medical "professionals" and "nonprofessional" healthcare providers.
Some overlap exists between the definitions of caregiver neglect and healthcare abuse.

What are the signs and symptoms of elder abuse?

The following are warning signs of some kind of elder abuse:
frequent arguments or tension between the caregiver and the elderly person;
changes in personality or behavior in the elder.

If you suspect elderly abuse, but aren't sure, look for clusters of the following physical and behavioral signs.

Some signs and symptoms of physical abuse of the elderly: symmetric injuries on two sides of the body; unexplained bruises; pressure marks; black eyes, welts; lacerations; cuts; burns; bone fractures; broken bones; sprains; dislocations; internal injuries; bleeding; bite marks; broken eyeglasses or frames; signs of being restrained such as rope marks; laboratory findings of medication overdose; under-utilization of prescribed drugs; a sudden change in behavior; caregiver's refusal to allow visitors to see the elder alone; an elder's report of being physically abused.
Some signs and symptoms of emotional abuse of the elderly: being upset or agitated apathy; withdrawal; depression; non-communication; sucking; biting; rocking; (behaviors usually attributed to dementia).

Caregiver behaviors such as: belittling; threats; other powerful or controlling behavior; an elder's report of being verbally or emotionally mistreated.

Some signs and symptoms of elder neglect: dehydration; malnutrition; extreme hunger; untreated health or medical problems, such as bed sores; hazardous or unsafe living conditions (e.g., improper wiring, no heat, or no running water); unsanitary and unclean living conditions (such as dirt, fleas, scabies, body lice, soiled bedding, fecal or urine smell); unsuitable clothing for the weather; being dirty or unbathed; unusual weight loss; desertion of the elder at a hospital or nursing facility, or other similar institution; desertion of an elder at a shopping center or other public location; physical restraints; chemical restraints (drugs used for behavior control); contractures (muscles that are too stiff to move easily); an elder's report of being mistreated or abandoned.

Some signs and symptoms of elderly self-neglect: dehydration or malnutrition; physical weakness; foul body odor; poor personal hygiene; foul household odor; human or animal feces and urine in the house; medical conditions left untreated; lack of medical aids, such as hearing aids; glasses; no dentures; homelessness; inadequate, unsafe, or unclean housing; no running water; no heating; no functioning toilet facilities; nonfunctional wiring; pest infestations; inadequate clothing for the climate.

Some signs and symptoms of sexual abuse of the elderly: bruises around the breasts or genitals; unexplained venereal disease or genital infections; unexplained vaginal or anal bleeding; torn, stained, or bloody underclothing; an elder's report of being sexually assaulted.

Some signs and symptoms of financial or material exploitation of the eldery are: large cash withdrawals from the elder's bank account; the elder's withdrawal of a large sum of money from the bank when accompanied by another person; numerous withdrawals from the elder's bank account, particularly in round amounts, such as $100 or $1,000, $10,000, etc; large checks written to unusual or unknown recipients; names being added to the senior's bank account signature card; objects or money missing from the senior's household;, withdrawals from investments, in spite of penalties for early withdrawal; abrupt changes (such as beneficiaries) in wills, trusts, contracts, Power of Attorney, Durable Power of Attorney, property titles, deeds or mortgages, changes in beneficiaries on insurance policies or IRA's; sudden changes in the elder's financial situation; home or institutional care that is lacking, despite sufficient funds to cover the care; unpaid bills, despite enough assets to cover the payments; forged signatures; unnecessary services, goods, or subscriptions.

Financial activity that is inconsistent with the elder's abilities or usual activity, such as ATM withdrawals, (such as when the elder never leaves the house, or elder is in hospital or nursing home); the sudden appearance of friends or relatives claiming the right to goods or inheritance; sudden close relationship with a much younger, more able person (including marriage or domestic partnership); an extreme interest in and participation, or control of the elder's financial matters on the part of the caregiver; the caregiver has no other means of support besides caring for the elder; the caregiver has drug or alcohol problems; the caregiver has a gambling problem; the caregiver has mental health problems; the elder's sudden reluctance to discuss financial matters; increasing tiredness or depression on the part of the elder; increasing lack of contact with and interest in the outside world; reluctance to accept visits or phone calls; the caregiver restricts the elder's contact with the outside world, such as speaking for the elder, refusing phone calls, preventing visits, reading mail for the elder, handling all expenditures, and not taking the elder on purchasing errands or other outings, or leaving them in the car; the elder's admission or expressed fear of their well-being and financial or material exploitation, or suspected exploitation.

Some signs and symptoms of healthcare abuse or fraud of the elderly: duplicate billings for a medical service or device; the count of pills left in a container is either under or over the expected amount for the period of time for which they were prescribed; lack of or inadequate medical care, even though bills are being paid in the elder's living space; a huge number of remedies for various medical conditions, including many non-prescription remedies.

What are the causes of elder abuse?

Sometimes, those who care for elders are not suited to the requirements of the job (drugs, alcohol, gambling, mental health, etc.), and they allow themselves to vent their impatience, frustration, and anger on the elder whom they are supposed to be protecting and nurturing.

In nursing homes, in particular, staff may be prone to elder abuse because of: insufficient staffing; lack of training; stressful working conditions; staff burnout.
Sometimes neglect is not intentional, it may be the result of lack of adequate training about how to care for the elderly or because staff members cannot monitor needy elders in a timely manner.

Taking care of the elderly, whether at home or in an institution, can be very stressful. The incidence of depression is very high among caregivers.

Caregivers habitually lack exercise and outdoor time; have inadequate nutrition; and need more sleep.

Many people with dementia have trouble sleeping, so caregivers are kept up caring for them.

Caregivers have a high level of anxiety, because stress affects the heart and cardiovascular system, the stresses of caregiving can even lead to death in the caregiver. The amount of stress that the caregiver experiences depends upon: the elder's type of disease or dementia.

The progression of the elder's requirements for care; at first, care may have been mundane errands or financial management, but the needs may have progressed to helping to eat, bathe, and toilet. How the caregiver perceives the responsibility of caring for the elder (burdensome or not), what the elder thinks about the caregiver, how the caregiver perceives the care recipient, if the caregiver finds the care recipient to be ungrateful, the caregiver is more likely to feel stressed. How close the elder and caregiver were before and how close they are now. How the caregiver copes with stress, in general (resilience), whether others help with the caregiving. Violence or aggression from the elder. Caregiver depression, and living with the care recipient are predictors of caregiver elder abuse. Violence from a care recipient toward the caregiver is strongly related to subsequent caregiver violence. A history of domestic violence in the household makes a senior more likely to be included in the domestic violence.

Financial exploitation of the elderly is related to the lack of boundaries regarding using another person's belongings and money. Sometimes this lack of boundaries is criminal, and sometimes it is simply a lack of ethical behavior. The exploiter gains because of the vulnerability of the elder.

Who abuses the elderly?

Most elder abuse occurs in the elder's home, and the abuser is usually a family member.
Most commonly, the perpetrators of elderly abuse are spouses/partners, of elders.

Next most frequent abusers are the adult children of elders, and sibblings of elders.

Abusers can be men or women. Men ages thirty-six to fifty are the most common perpetrators. In nursing homes and other long-term-care facilities, the abusers may be employees, outside visitors, or intruders.

Anyone associated with an elder may abuse them: friends, relatives, doctors, lawyers, bankers, accountants, clergy, caregivers, or strangers.

What are the results of elder abuse?

Elder abuse can have a host of resultant conditions: inability to move (immobility); incontinence; longer time to heal pressure sores or bed sores; dehydration; malnutrition, or starvation.

Depression, loss of dignity, or self-esteem, loss of friendships, and companionship, loss of assets, poverty, homelessness, criminal attack (due to lack of precautionary measures), worsening or irremediable medical conditions, and death.

How can I get help if I am an elder who is being abused?

If you are an elder who is being abused, neglected, or exploited, tell at least one person. Tell your doctor, a friend, or a family member whom you trust. Other people care and can help you.

You can also call Eldercare Locator at 1-800-677-1116.

The person who answers the phone will refer you to a local agency that can help. The Eldercare Locator answers the phone Monday through Friday, 9 am to 8 pm, Eastern Time.

How do I report suspected elder abuse?

  • If you suspect elder abuse, call someone now!
  • You do not have to be sure of the abuse, and you do not have to give your name.
  • You are protecting someone from further harm by reporting elderly abuse or suspected elderly abuse.
  • If an elder is in danger now, call 911 or your local police emergency number, or your local hospital emergency room.
  • If you have some time to notify authorities, call your State Elder Abuse Hotline.
  • Each state's elder abuse hotline has two options. These two numbers are for:
  1. domestic elder abuse (APS)
  2. elder abuse in a nursing home (the institutional number).

All state elder abuse hotlines are free and anonymous.

  • When you call to report elderly abuse, be ready to give the elder's name, address, and contact information, and give details about why you are concerned.
  • You will be asked for your name, address, and telephone number, but you do not have to give this information in most states.
  • The highest priority to everyone is to make the elder safe.
  • Some states have emergency shelters for elders who are being abused.
  • When you report the elder abuse to the elder abuse hotline in your state, ask for help in getting the elder away from the abusive situation.

Out of State elder abuse:

  • If you need to report abuse of an elder in another state, Look in the State Elder Abuse Hotlines table to see if the phone number for the elder's state accepts out-of-state calls.
  • If not, call the Eldercare Locator for a referral at 1-800-677-1116.
  • Various state, local, and county agencies investigate and enforce elder abuse laws. The first agency to respond to a report of elderly abuse.
  • In most states, is the Adult Protective Services (APS).
  • There are no federal funds set aside and no federal regulations regarding the operation of each state's APS, so each APS agency operates independently and somewhat uniquely.
  • Many Adult Protective Services apply for and receive federal grant money, but the vast majority of funds come from state or local funds.

The role of APS is to:

  • investigate abuse cases, intervene; and offer services and advice.

In some states, certain professionals are required or encouraged to report elder abuse.

  • The people required to report elder abuse in these states are doctors and nurses, psychologists, police officers, and social workers.
  • No states mandate that a neighbor or friend are required to report suspected elderly abuse.
  • Remember that suspected abuse is sufficient reason to make a report to authorities.

How do I get help if I think I may abuse an elder, or if I have already abused an elder?

For immediate help, phone yourState Elder Abuse Hotline orthe National Domestic Violence Hotline:

  • 1-800-799-7233or email
  • If you are deaf, call 1-800-787-3224 (TTY)or email
  • Either hotline has people who can talk to you and provide referrals for you, to help prevent your abusing an elder.
  • Over the long term, find ways to relieve the stresses of being totally responsible for the care of an elderly person.
  • Ask others to help care for the elder so that you can take breaks. Seek out local respite care agencies (for short breaks).
  • Find an adult day care program to give you time off during the day.
  • If you typically resolve frustration or anxiety with abuse, neglect, or violence, learn other ways to cope.
  • The first step in changing is to talk with a friend, family member, counselor, therapist, pastor, priest, or rabbi.
  • If you are using alcohol or drugs to mask your frustration, contact Alcoholics Anonymous or another self-help or support group.

How can elder abuse be prevented?

Elders themselves are unlikely to be on the forefront of prevention of elder abuse.

  • Elders are most often silent in their suffering because they may be physically unable to speak out and because society does not listen well.
  • One of the ironies of elder abuse is that younger people may be too busy to listen or act.
  • Elders in westernized societies are often pushed away from the hub of action and ignored.
  • Prevention is especially important because the majority of elder abuse cases go unreported.
  • We cannot even count how many elderly abuse cases we prevent by making changes that stop abuse.
  • Through prevention, we can make elders' last years more pleasant, and we can save elders' lives.
  • Key elements in the prevention of elder abuse are:

    • Educate.
    • Enforce
    • Intervene.

      The public can help to prevent elder abuse by helping to educate seniors, professionals, caregivers, and others about elder abuse.

    If you cannot directly help, you can volunteer or donate money to the cause of educating people about elder abuse.

    • Encourage law enforcement agencies to prosecute elder abuse when they find it.
    • Mental health professionals, social workers, nurses, and lawyers can step up interventions.
    • Caretakers can prevent abusing their elderly charges by doing the following:

    1. Stay healthy and get medical care for yourself when necessary.
    2. Get professional help for drug or alcohol abuse, which can lead to elder abuse.
    3. Seek counseling for depression, which can lead to elder abuse.
    4. Make contact with domestic violence prevention services.
    5. Find a support group for spouses, partners, or grown children caring for the elderly.
    6. Family members and friends who are not caregivers of the elder can help to prevent abuse.
    7. Watch for warning signs that might indicate elder abuse.
    8. Make sure that the elderly person is eating properly and taking required medications. A weakened elder cannot think clearly about the care being given.
    9. Scan bank accounts and credit card statements for unauthorized transactions, if you can get access permission from the elder.
    10. Watch for possible financial exploitation.
    11. Call and visit as frequently as you are able.
    12. Keep the lines of communication open so that the elder feels comfortable talking about abusive behaviors.
    13. Gain trust so that the elder allows you more oversight in financial and caretaking matters.

    • An elder can do the following to prevent elder abuse:

    1. Plan for your own financial future with a trusted person or persons.
    2. Make sure that your finances are in order: beneficiaries of insurance policies and IRAs; durable power of attorney; your will; a living will for healthcare instructions; any trusts you wish to create; titles to your assets, and so on.
    3. Be socially active and avoid social isolation, which can make you vulnerable to elder abuse.
    4. Keep in touch with family and friends. If you are not happy with the care you are receiving from your family or from another caregiver in your home, speak up. You have a right to your preferences. If you live in a long-term-care facility and have no one close to you who can speak up for you when you are not happy about your care, contact your state's Long-Term-Care Ombudsman. The Ombudsman's charter is to be your advocate and to intervene when necessary. References and resources about elder abuse. Important phone hotlines. National Domestic Violence Hotline is a crisis intervention and referral phone line for domestic violence. The service also has an email address and access for the deaf. Hotline staff members can speak in English or Spanish and have access to translators for many other languages. State Elder Abuse Hotlines is a list of phone numbers for reporting elder abuse in the fifty United States. Each state has one number for reporting domestic elder abuse and another for reporting institutional abuse. Because each state is ultimately responsible for investigating elder abuse cases through Adult Protective Services, you need to contact your state's authorities. Always call 911 first if the elder abuse is an emergency situation. National Long Term Care Ombudsman Resource Center gives phone numbers for long-term-care ombudsmen, by state within the United States. The federal government requires that each state have a long-term-care ombudsman to help people to find satisfactory long-term care and to help resolve problems with long-term-care facilities. Eldercare Locator: Community Assistance for Seniors, from the Department of Health and Human Services, and the Administration on Aging, provides a toll-free hotline for locating safe, reputable services and housing for seniors: 1-800-677-1116. The website also can help you to locate services for your geographical area. Use the handy wizard to locate what you need. If you are dealing with elder abuse, for the question entitled Aging Information Source, specify Elder Abuse Prevention to get information on elder-abuse resources in your area. General Missing Voices: Views of older persons on elder abuse, from the World Health Organization (WHO), the International Network for the Prevention of Elder Abuse (INPEA), and other partners, is a very thought-provoking, sophisticated, and sensitive article that challenges the existing categorizations of elder abuse.

    By interviewing elders and primary healthcare workers in five developing countries, the researchers identified the following additional categories of elder abuse that have not been discussed much in the western-focused literature on elder abuse.

    • Structural and societal abuse (being pushed to the edges of society).
    • Disrespect and ageist attitudes.

    This is the first international, cross-cultural research study to be published on elder abuse. It teaches us to consider the cultural context of elder abuse, as well as to value the viewpoints of the elders themselves in helping us to prevent abuse. The ultimate goal of the study was to develop a global strategy for preventing elder abuse. The researchers place the burden of prevention on society, they do not consider elder abuse to be solely a family issue. A quote from the article sums up the message.

    "The challenge for all of us is not only to listen to what has been said, but to believe and act upon it."

    Elder Abuse and Neglect, In Search of Solutions, from the American PsychologicalAssociation Online is a general article that covers the basics about elder abuse, identifying elder abuse, reporting elder abuse, and prevention of elder abuse.

    Promising Practices, from the National Center on Elder Abuse (NCEA), is a database of help for specific kinds of elder abuse, neglect, and exploitation.

    1. You enter the category of elder abuse, the state where the elder lives.
    2. The results show resources available for that kind of abuse in that state.
    3. A Response to the Abuse of Vulnerable Adults.

    The 2000 Survey of State Adult Protective Services, from the National Center on Elder Abuse (NCEA), summarizes elder abuse statistics as collected by Adult Protective Services agencies in the fifty states. Help for caregivers A Fact Sheet on Caregiver Stress and Elder Abuse, is an excellent brochure documenting the reasons for caregiver elder abuse, the signs of caregiver stress and elder abuse, how caregivers can avoid abusing an elder, and what other people can do to prevent caregiver abuse.

    Preventing Elder Abuse by Family Caregivers, from the National Center on Elder Abuse (NCEA), is an article reviewing the scientific literature on family caregiver abuse. The article looks at caregiver stress and at the predictors of caregiver abuse.

    Among many other non-intuitive findings is the assertion that caregiver depression and living together with the care recipient are predictors of abuse. A good portion of the article lists resources for preventing abuse.

    Preventing Stress from Becoming Harmful. A Guide for Caregivers speaks directly to caregivers who are about to abuse or who are abusing elders. This brochure, from the Institute on Aging for the National Center on Elder Abuse, offers practical, concrete suggestions on what the caregiver can do to avoid becoming abusive. Ensuring elders' safety and comfort in their own homes.

    Aging Parents and Adult Children Together (A/PACT), Making the Home Senior-Friendly, from the Federal Trade Commission in partnership with AARP, discusses ways to make the senior's home safe and comfortable, to prevent injury and stress. A home that is designed for senior living can prevent unintentional caregiver neglect or elder self-neglect.

    Elder abuse in nursing homes, Housing Choices. If Nursing Home Problems Occur is the American Association of Retired Persons' (AARP), coverage of the topic of how to deal with lack of care or abuse of an elder in a nursing home.

    Financial exploitation of the elderly.

    Elder Financial Abuse, is a concise summary of the definition of financial abuse, warning signs, who might exploit an elder, what to do to prevent elder financial abuse, how to choose an elder's caregiver, and more. Although the brochure was produced for residents of San Bernardino County in California, the information is useful for everyone.

    Aging Parents and Adult Children Together (A/PACT): Consumer Fraud Against the Elderly, from the Federal Trade Commission in partnership with AARP, discusses telemarketing and consumer fraud, particularly as they apply to the elderly. The words "free" and "act now" are particularly common in consumer fraud. The article includes recommendations for how to prevent telemarketing fraud.

    Aging Parents and Adult Children Together (A/PACT): Daily Money Management Programs, from the Federal Trade Commission in partnership with AARP, describes a simple way of helping an elder with daily money management: hiring a daily money manager. If a loved one does not have the ability or time to help an elder with such financial matters as paying bills, balancing the checkbook, and reconciling health insurance claims, hiring a money manager is the first stage of helping the elder to manage their finances. You can hire a daily money manager to come in as a convenience, and thus prevent a later financial emergency that could occur if the daily matters were not under control.

    Aging Parents and Adult Children Together (A/PACT): Alternatives to Guardianship, from the Federal Trade Commission in partnership with AARP, is a broad article describing various legal ways to help an elder with financial matters. The article discusses the legal definitions of financial guardian, financial conservator, power of attorney, durable power of attorney, representative payee for Social Security payments, and living trust. If the elder is having trouble managing finances, he or she may need to appoint someone as an agent. A power of attorney or durable power of attorney is the most flexible, mild way of appointing someone to help the elder with finances. If the elder is totally incapacitated, someone may need to push for a financial guardian or conservator.

    Healthcare fraud and abuse.

    Most Common Medicaid "Rip Offs" lists examples of Medicaid fraud and abuse, with instructions on how to report such rip-offs.

    Tips to Prevent Fraud, from the Centers for Medicare and Medicaid Services, provides tips for watching out for Medicaid abuse, plus instructions on how to report Medicaid fraud or abuse.

    Self-protection for elders IMPACT Safety Programs is a self-defense training program for people, including seniors, that focuses on quick response and retreat from danger. Impact teaches verbal response to stop aggression, as well as physical self-protection to stop an attacker so you can get away and call for help.

    Impact is called Model Mugging in some parts of the country. A key element of the classes is padded instructors who "attack" the participants so they can practice their newly learned self-defense skills. Classes for seniors are tailored to the abilities of people who may not be strong or mobile.

    F.A.S.T. Defense lists locations around the world where you can take FAST self-defense classes. Many of the locations offer self-protection classes for seniors. FAST stands for Fear-Adrenal-Stress Training. FAST self-defense teaches how to respond verbally to a threat, as well as how to respond physically when required. Part of the effectiveness of this training is the use of padded instructors that class participants fight against. No one is hurt, and classes for seniors are customized to suit the abilities of the participants.

    The Raising Canes Club, a part of the FAST location in British Columbia, teaches the novel technique of using your cane for self-defense, to fight off a physical attack on the street or in your home. You can either attend their classes or purchase a video online that summarizes what the class teaches.


    State of California

    Financial Abuse Reporting Act, SB 1018

    Beginning January 1, 2007 this new mandate requires employees of banks and credit unions to report suspected financial elder abuse to Adult Protective Services or law enforcement authorities.

    SB 1018 (Simitian) >>

    California Welfare and Institutions Code §15630.1 >>

    California Bankers Association review of California Welfare and Institutions Code §15630.1 and 15655.5 (pdf)>>

    Omnibus Conservatorship and Guardianship Reform Act of 2006, AB 1363

    Beginning January 1, 2007 this mandate requires private and public conservators to be certified by the court and comply with educational requirements by January 1, 2008 and licensing by July 1, 2008.

    AB 1363 (Jones) >>

    California Assembly summary page on Probate and Related Matters >>

    American Bar Association Legislative Updates (scroll down to Guardianship) >>


    2006 Reauthorization of Older Americans Act (OAA), HR 6197

    For the first time since the Older Americans Act was enacted in 1965, the law formally mentions elder justice.

    Administration on Aging page on Reauthorization of OAA >>

    National Center on Elder Abuse elder justice-related highlights of OAA, October 2006 >>

    Elder Justice Act

    National, regional, state, and local advocacy groups have endeavored to bring about the passage of landmark federal legislation to support a comprehensive approach to addressing elder justice issues. The prospect of passing the Elder Justice Act makes this a critical time in the history of elder abuse prevention.
    In 2003, Senators John Breaux (D-LA) and Orrin Hatch (R-UT) and Representatives Rahm Emanuel (D-IL), Roy Blunt (R-MO) and Peter King (R-NY), first introduced the Elder Justice Act (S. 333/HR 2490). The bill was reintroduced in 2005 by Senator Hatch and Representative King, and is now under debate in a time when the nation is becoming more aware of the pervasiveness and complexity of elder abuse and neglect. The authors have applied the lessons learned in the fields of child abuse and women’s abuse, neglect, and violence in an effort to combat crimes against older adults. By combining law enforcement, public health, and social services the act encourages the inter-disciplinary approach to studying elder abuse and neglect. This approach will have far-reaching effects on the detection, treatment, prosecution, and prevention of elder abuse, neglect, and exploitation.

    Chairman’s Mark of S. 2010, Elder Justice Act >>
    S. 2010, Elder Justice Act Substitute (section-by-section summary) >>
    S. 2010 >>
    H.R. 4993 >>

    For more information on the Elder Justice Act, visit

    Additional Interest Groups
    Protection & Advocacy Inc. serves Californians with a wide range of disabilities - including cognitive, mental, sensory, and physical disabilities - by guarding against abuse; advocating for basic rights; and ensuring accountability in health care, education, employment, housing, transportation, and within the juvenile and criminal justice systems.

    Aging Services of California formerly the California Association of Homes and Services for the Aging, is the primary statewide association for nonprofit organizations providing health care, housing and community services to older adults. It is the mission of Aging Services of California to advance housing and services for older adults and to support and inspire its members through advocacy, education research and services enabling them to meet changing needs of their clients and communities.

    California Advocates for Nursing Home Reform has been fighting since 1983 for the rights of long-term care residents in California. CANHR has directed its resources toward the following long term care issues:
    · Developing consumer information and making it affordable and accessible to consumers
    · Aiding residents and their families in finding the legal services they need
    · Providing consumers, attorneys and social workers with accurate information on Medi-Cal and long term care issues
    · Tougher sanctions against homes that abuse or neglect residents
    · Eliminating the inappropriate use of physical and chemical restraints
    · Fighting for fair and equitable Medi-Cal rules to protect the poor and middle class from impoverishment and loss of their homes
    · Determining root causes of poor care and developing legislation and policy to address them


    Helpful Links

    Federal Trade Commission (FTC)
    One-stop national resource to learn about the crime of identity theft
    Consumer Sentinel, an innovative, international law enforcement fraud-fighting program
    Federal Bureau of Investigation (FBI), Be Crime Smart
    Resource for consumer information from the federal government
    FBI, Avoiding Internet Auction Fraud
    Internet Crime Complaint Center (IC3)
    U.S. Securities and Exchange Commission
    National Association of Attorneys General
    Florida Department of Agriculture and Consumer Services
    Office Of The Attorney General of Florida (OAG)
    Florida Department of Financial Services
    Consumer Information
    Onguard Online
    Maryland Attorney General
    Snopes (Urban Legends and other false stories exposed)

    Disclaimer: These links come to our office from various sources, and we link to their web sites for informational purposes only. The site owners control their pages and these links sometimes "expire" after a certain amount of time.



    Elder LawEstate PlanningSocial SecurityElder AbuseHealth: Elder Care/Aging Information:
    Federal AgenciesState AgenciesNon-Governmental AgenciesSupport Information Through PublicationGeneral Support InformationNursing Home InformationGeneral Health InformationGrief/Death
    General Elder/Aging SitesMedicare/MedicaidHealth: Alzheimer's
    SeniorLaw Home Page -- A site for senior citizens, their families, attorneys, social workers, and financial planners can access information about Elder Law, Medicare, Medicaid, estate planning, trusts, and the rights of the elderly and disabled.
    National Senior Citizens Law Center -- Established in 1972 to help older Americans live their lives in dignity and freedom from poverty, through legal work in support of elderly poor clients.
    National Academy of Elder Law Attorneys, Inc. -- The Academy is a non-profit association which assists lawyers, bar organizations, and others who work with older clients and their families.
    Premack Elderlaw Page -- Contains an archive of Paul Premack's legal advice columns dealing with elder law issues.
    The Elder Law FAX -- Maintained by attorney Timothy L. Takacs, this site offers an opportunity to have a publication e-mailed to you each week. Publications offer information on a variety of subject material.
    Commission on Law and Aging -- The ABA Commission on Legal Problems of the Elderly (CLPE) is dedicated to examining the law-related concerns of older persons.
    National Handbook of Laws and Programs Affecting Senior Citizens (ABA)
    Canadian Centre for Elder Law Studies

    Crash Course in Wills and Trusts -- A concise and practical guide to what everyone should know about the law of Wills and Trusts.
    Estate Planning Memoranda -- Maintained by the estate planning group at Pillsbury Madison & Sutro LLP, this is their Estate Planning page of their site that offers discussions on estate and gift planning topics.
    National Association of Financial and Estate Planning -- Information provided on estate planning, protection of assets from lawsuits and judgments, and tax saving tips.
    National Network of Estate Planning Attorneys -- dedicated to the enhancement of the Estate Planning practice for both attorneys and clients.

    Social Security Reality Check -- Maintained by the American Association of Retired Persons. FAQ on Social Security.
    Social Security Law Materials -- Maintained by the Legal Information Institute at Cornell Law School, this page allows you to search the Social Security laws and links to other Social Security materials.
    Social Security: A Brief History -- Maintained by the Social Security Administration. This page contains information on the history of the Social Security program and the Social Security Administration.
    Social Security Administration -- Among the many services provided are options to obtain forms, report fraud to the government, answers basic questions about the SSA, allows you to obtain information about the current level of funding in your SSA account for your retirement.
    Social Security Handbook 1995 -- This Handbook summarizes information about the Federal Retirement, Survivors, Disability, Supplemental Security Income, Health Insurance, and Black Lung Programs

    Elder Abuse Prevention: Information and Resource Guide -- Information and resource guide on elder abuse. Site contains definitions of elder abuse, tips on recognizing elder abuse, and local resources in California you can contact for assistance.

    Federal Agencies
    Administration on Aging -- Maintained by the Department of Health & Human Services, this U.S. government site offers a wide variety of information for older adults.
    Area Agencies on Aging (Yahoo! search) -- This is a listing of all of the Area Agencies on Aging currently listed on Yahoo-online. The AOAs are funded in part by the federal legislation entitled as the Older Americans Act. This site offers a link to these AOAs, which provide site specific information on services offered.
    Calgary Free-Net Seniors Page -- Based in Calgary, Alberta, this site is designed to provide community, provincial, federal, and international information for today's seniors. Among the many links to information are sites for health, the law, money, and government programs.
    Food and Drug Administration -- Among the information provided is information on human drugs, animal drugs, FDA news, cosmetics, biologics, and children and tobacco.
    National Institutes of Health -- Provides health information and links to some of its institutes and consumer health information.
    U.S. Department of Health and Human Services -- Provides news, consumer information, and an ability to research the Department's databanks.
    State Agencies
    Florida Agency for Health Care Administration
    Mid-Florida Area Agency on Aging -- Contains a wide variety of information, including relevant elderly laws and regulations, directories of agencies and service providers, and links to other sites dealing with aging issues.
    Illinois Department of Aging -- Provides access to news, publications, resources available to older Illinois residents, support groups, and links to other sites.
    Maine's Bureau of Elder & Adult Services -- Offers a wide variety of information and services available to those in Maine. Information is also useful and informative for those who do not live in Maine.
    Vermont Department of Aging and Disabilities -- The Department of Aging and Disabilities is the center of the Agency of Human Services' program management and policy development with respect to older persons and persons with disabilities.
    Non-Governmental Organizations
    AARP WebPlace -- Maintained by the American Association of Retired Persons.
    American Medical Association -- Provides consumer information, access to medical publications, and links to other medical sites.
    American Public Health Association -- Offers news, policy information, legislative affairs and advocacy information.
    Caregiver Survival Resources -- In addition to links to caregiver resources on the Internet, this site includes local, regional, and state sources for caregivers
    National Council on the Aging -- Maintained by a private, nonprofit association that is committed to promoting the dignity, self-determination, well-being, and contributions of older persons.
    Support Information Through Publication
    Caregiver Network -- This site offers advice to those caring for their loved ones from the site's author. The author explains the resources and lessons she has learned while caring for her father. The author's goal is to assist others by sharing her experiences and thereby allowing visitors to not "reinvent the wheel" themselves while caring for another. Contains categorized links.
    Caregiving Online -- Wellness for caregiver of an aging relative, friend, or neighbor. Offers an online support service and a monthly newsletter.
    Today's Caregiver Magazine Online -- A print and web magazine dedicated to those caring for loved ones. Written for Caregivers by Caregivers dealing with such topics as stress and depression management, financial, legal and medical advice, housing, incontinence and adult day care issues.
    General Support Information
    Nursing Home Information
    Florida Agency for Health Care Administration -- Offers the opportunity to research and compare the nursing home costs in Florida.
    Nursing Home Information Site -- Offers answers to questions concerning nursing homes, such as costs, how to select a home, regulations, Medicare, and Medicaid. Includes Nursing home links, search engine for nursing home sites.
    General Health Information
    Healthgate Extensive listing of medical information and free access to Medline.
    HealthAtoZ -- Giant health information directory and search engine.
    Emory University's MedWeb -- Contains a database enabling you to search a wealth of medical information on many issues, including aging.
    Families USA -- A national, state, and grassroots level organization established to shape health care policies in the public and private sector. Site contains reports and analysis of health related issues.
    Family Caregiver Alliance -- An information resource on long-term care.
    Institute of Gerontology -- Maintained by Wayne State University. Contains an online library for researchers, educators, and others interested issues surrounding gerontology and geriatrics.
    Hardin Meta Directory -- This site is maintained by the Hardin Library for the Health Sciences at the University of Iowa and contains links to many resources on the Internet dealing with geriatrics.
    Healthfinder -- A gateway consumer health and human services information web sponsored by the Department of Health and Human Services. You can search for selected online publications, clearinghouses, databases, web sites, and support and self-help groups, as well as the government agencies and not-for-profit organizations that produce reliable information for the public.
    The National Health Law Program, Inc. -- A national public interest law firm that seeks to improve health care for America's working and unemployed poor, minorities, the elderly, and people with disabilities.
    SageSite -- Maintained by the Center on Aging at the University of Texas Medical Branch at Galveston. Provides a wide range of information and resources on aging from both local and national perspectives. Seniors, caregivers, and professionals are this site's intended users.
    Web Resources on Aging: Andrus Gerontology Library -- Maintained by the University of Southern California Library, this site contains numerous links to fields including library catalogs, newsletters and journals, web sites focusing on senior citizens, and medical information.
    The End of Life: Exploring Death in America -- Web site for the National Public Radio (NPR) year-long series examining issues relating to dying. The "All Things Considered" reports examine how we care for the dying, how death affects loved ones and what communities are doing to change people's attitudes about end of life care. This is the web site designed specifically for the series. It features resources and contacts for over 100 agencies providing services to people facing life-threatening illness; transcripts; excerpts from literature written about death; a bibliography and an area where visitors can share their experiences.
    Choice in Dying -- The inventor of living wills in 1967, is dedicated to fostering communication about complex end-of-life decisions. The nonprofit organization provides advance directives, counsels patients and families, trains professionals, advocates for improved laws, and offers a range of publications and services.
    Griefnet -- Offers connections to a variety of resources related to death, dying, and emotional and physical loss. Among the resources offered are discussion and support groups, a library, and bookstore.

    General Elder/Aging-Sites
    American Geriatrics Society
    Age of Reason -- Site contains over 5,000 links for the over 50 age group, broken down into sites contained either in Canada, the United States, or internationally.
    Department of Veterans Affairs -- Offers information on facilities, benefits, medical information, and news.
    Friendly4Seniors -- This site contains useful links to organizations and information on issues including elderlaw, financial matters, state and federal government agencies, newsgroups, associations, and medical information.
    Senior Corner -- A resource for senior citizens and those who care for them. Contains state specific information, statistics, and demographics.
    National Institute on Aging
    Medicare -- Maintained by the Centers For Medicare and Medicaid Services providing information for Medicare beneficiaries about coverages, programs, etc.
    New York State Medicaid Law -- An brief explanation of the rules governing Medicaid in New York State.
    Centers for Medicare and Medicaid Services -- The official government web site for information, manuals,, transmittals, and more about Medicare and Medicaid.

    Alzheimer's Association -- The Alzheimer's Association is the oldest and largest national voluntary health organization dedicated to research for the causes, cure, and prevention of Alzheimer's disease and to providing education and support services to Alzheimer's patients, their families and caregivers.
    Alzheimer's: Coping with Alzheimer's Disease -- A journal and resources from a woman who provides ongoing care to her mother.

    Alzheimer's Links from Yahoo!
    Home General Info Admissions Alumni / Development Part-Time Program Library Legal Resources Faculty/Courses Student Publications Advocacy Programs & Clinics Offices Elder Law Health Law Center CLE LLM International Programs CalendarStudent Resources News Library Catalog E-mail Directory Stetson University (DeLand)
    Stetson University College of Law1401 61st Street South,Gulfport, FL 33707-3299Phone: 727-562-7800URL: (Click here for departmental contact information.)

    Copyright © 1995-2003Stetson University College of LawAll Rights Reserved


    Is Law Enforcement doing their part to end ELDER ABUSE?

    Elder abuse is bad enough, but when law enforcement opts to ignore evidence of elder abuse that is even worse.
    Why would California authorities fail to investigate when a conservator/caretaker of a senior withholds news of that senior's final illness, then provides a false date of death to family, along with other misinformation?

    Posted by: Dave Futornick

    12/10/2007 10:20 AM



    Elder financial abuse has become a ...
    hidden national epidemic!!
    Contra Costa Times
    Article Launched: 12/09/2007 04:28:47 PM PST
    AN EX-CONVICT who works at an Antioch car wash "befriends" an 82-year-old customer with dementia. Over time, he not only persuades the World War II veteran to give him more than $300,000 in cash and annuities, but he also gets the elderly man to change his will making him sole beneficiary.
    An East Palo Alto woman takes out a $200,000 loan on her 92-year-old grandmother's house without her knowledge. She leaves the wheelchair-bound senior alone in a house full of rats while she goes on a $75,000 shopping spree -- buying herself a champagne-colored Hummer.
    After her arrest, she gets a mortgage broker to bring her loan documents in jail so she can take out another $400,000 loan on her grandmother's house.
    Members of a nomadic crime family stage a string of car accidents with a 96-year-old Alameda woman. They scare her into thinking she'll lose her license if she doesn't pay them for the bogus damage to their car. They're able to keep playing the same cruel hoax over and over because she has dementia and forgets each incident moments after it happens. They swindle her out of $100,000.
    All across California, shameless predators are robbing vulnerable seniors of their hard-earned nest eggs. Former Attorney General Bill Lockyer called elder financial abuse "the fastest-growing crime in the country."

    It may not leave bruises or broken bones in its wake, but when an elderly person is suddenly deprived of the safety net that it took a lifetime to weave -- with no chance of ever making the money back -- it takes a terrible psychological toll.

    In fact, it's common for seniors to die within weeks of making the traumatic discovery that someone whom they trusted has robbed them.

    Countless lives have been ruined. Huge sums lost. And, with 75 million baby boomers across the nation hurtling toward senior citizenship, it's going to get a lot worse. We believe current laws are inadequate for dealing with the situation.
    When a predator steals all of an elderly person's resources, it's the state that must step in and provide for him or her.
    That means we taxpayers get saddled with the tremendous cost of caring for the tsunami of destitute elderly people.
    Elder financial abuse is a national disgrace.

    Yet where is the public outrage? Why hasn't the Congress passed a single piece of comprehensive legislation to protect vulnerable seniors? Why have lawmakers in Sacramento done so little to address this statewide contagion? Have we become so obsessed with youth that we don't care that our elderly parents, grandparents, aunts and uncles are being ruthlessly exploited? And that we pretend we aren't aware of their suffering?
    "When the guy threw the poodle out on the freeway my mother in New York called me to ask if I'd heard about it," says Shadia Merukeb, a consultant for the Alameda County District Attorney who works with elder abuse victims. "But no one hears about elder abuse."
    She's right. It's only the most sensational cases that make news, or those involving huge sums of money.
    When the grandson of Brooke Astor accused his father in court papers of stealing millions of dollars from the 105-year-old philanthropist and society maven, it made international headlines.
    That's because Astor, who died in August, was a celebrity.

    But, for the most part, elder financial abuse occurs in obscurity and it gets scant attention.
    It is not even a blip on the radar.
    No one has made it a priority. Not the authorities. Not the courts. Not the Legislature. Not the Congress. Not the press.

    We believe that it's high time someone do something about this.

    "Theft of Elder Nation" is an editorial series based on months of interviews and reviews of public records.

    Our aim is to help drag the hidden national epidemic of elder financial abuse out of the closet.

    By focusing the spotlight on the rampant financial exploitation of our seniors, we hope this newspaper can help spur a meaningful public dialogue that will lead to reforms to protect our seniors from the wolves at the door.

    Our intention also is to provide readers with valuable information that will help them to protect themselves and their loved ones from elder predators.


    What exactly is elder financial abuse?

    Generally speaking, it is the illegal taking of money or property from an adult 65 or older without that person's freely given consent -- and using that property for one's own personal gain.
    In the past decade, elder financial abuse has quietly become a national disease. According to the U.S. Senate Special Committee on Aging, 2 million seniors are victims of financial crimes every year.
    Those are just the people who we know about. Many seniors never report the abuse -- either because they're too scared or too ashamed to come forward. That's especially true when the bad guy is a family member or someone else whom they depend upon for care.
    The National Center on Elder Abuse estimates that for every case that gets reported to authorities, at least three don't.
    For a variety of reasons, very few elder predators actually get prosecuted.
    In a criminal case, prosecutors have to prove guilt beyond a reasonable doubt.
    That is exceedingly difficult in elder financial abuse prosecutions.
    Victims typically don't make good witnesses. They have trouble remembering. They're easily confused. They break down under ruthless questioning from relentless defense attorneys. They lie to protect their abusers.

    They often die.

    Elder financial prosecutions also take huge amounts of manpower to establish a paper trail between the victim and the abuser.
    Even when prosecutors do win a conviction, the worst thing that usually happens is a judge will order the elder abuser to pay the money back.
    Sometimes, he may get county jail time. But state prison tends to be the exception rather than the rule.
    Ordering an elder abuser to pay back the money he stole is like no punishment at all.
    By then, it's already been squandered at the casino or spent on $55,000 Hummers or Hawaiian cruises.
    Most of what was stolen never gets repaid.
    That's why it's so important to prevent the abuse before it happens and to mete out serious jail time after it does.

    Ground zero

    When it comes to financial fraud against elderly people, California is ground zero.
    The reason is quite simple: More people 65 and older live in our state than anywhere else in the country: 4 million and counting.
    People 85 and older are the fastest-growing segment of the elderly population.
    With tens of millions of baby boomers fast approaching retirement age, law enforcement authorities are predicting an explosion in financial crimes against the elderly.

    Adult Protective Services, the main government agency that investigates elder financial abuse, has seen a dramatic increase in complaints.
    Frustrated APS investigators say they're so swamped, they're often unable to take action until it's too late.
    Yet when we talk about the challenges that our nation faces as the population grows rapidly older, we dwell on future concerns. We worry that Social Security will run out. That the health care system will collapse under the weight of so many sick old people. What we don't consider are the devastating effects of elder financial abuse and its impact on elderly people and their families in the here and now.
    Elder financial abuse is where domestic violence was 20 years ago. Which means that we, as a society, are pretty much in denial.

    The police and the courts (there are some notable exceptions) tend to treat financial crimes against the elderly as civil matters: misunderstandings, or business arrangements gone sour, rather than crimes. Even when elder financial abuse cases do land in the judicial system, they're placed on the bottom of the totem pole. They often fall through the cracks.

    The abuse usually happens behind closed doors. Victims are invisible.
    What's not happening in front of our faces is easy for us to ignore. And, for the most part, we do.

    Eventually, however, sheer demographics will make it impossible to go on ignoring what is happening.

    People are living longer. Millions of today's baby boomers will develop Alzheimer's and other debilitating conditions that make them easy prey.
    If we as a society don't take action, there will be many, many more victims in the future.

    "It's a Pandora's Box," says Chayo Reyes, a retired Los Angeles police detective who teachers elder abuse prevention for the U.S. Justice Department. "We know what's in the box."

    Many scams

    There are more scammers out there intent on prying seniors from their hard-earned money than there are ice cream flavors.
    Many of these parasites are the very people you'd expect to be looking out for vulnerable old people.-- their own family members.
    We have become a nation of adult children and grandchildren with a warped sense of entitlement.
    In an age when instant gratification rules, many people can't be bothered to wait for a death before claiming their inheritance. It's going to be theirs anyway so why should they have to postpone their grand plans for the good life?

    Then, there are the countless opportunistic parasites who aren't relatives: Thieving caretakers, dishonest lawyers, accountants, mortgage brokers, cons selling worthless securities and real estate, bogus "senior investment planners," fake nurses, shady contractors, trusts mills, Canadian lotteries and "Sweetheart" swindlers are but a few of the predators operating. The list is endless.

    "I knew it was a problem," says Virginia George, director of the Elder Law Clinic at John F. Kennedy University in Pleasant Hill, which gives free legal advice to elder abuse victims. "But I had no idea how wide and how deep it was."

    Why target?

    Why do criminals target seniors? Because that's where the money is. People 50 and older control 70 percent of the nation's wealth. That's about $70 trillion.
    Most of this bounty is due to a meteoric rise in real estate prices. That's especially true in once-hot markets such as the Bay Area.
    Someone who bought an executive house in Contra Costa County for $60,000 decades ago is sitting on more than $1 million in equity. The market has cooled, but homeowners still have access to the equity unless they've maxed out their credit.
    Many elderly people are paper rich and cash poor. They're desperate for extra money to help supplement their fixed incomes. They're anxious to tap the equity in their homes to help relieve the financial pressure of mounting medical bills, home improvements and other costs.
    Sleazy operators see a gold mine. They've devised all kinds of schemes to steal equity. Predatory loans, foreclosure rescue scams; shady contracting deals where seniors take out thousands of dollars for home repairs that never get completed; or even bad reverse mortgages.
    Crooked mortgage brokers use high pressure tactics to get elderly people to take out home equity loans that there's no way they can afford to pay back. It's quite common for the unscrupulous to convince seniors to lie about their income in order to qualify.
    Nothing surprises Bill Denny, who heads the real estate fraud division for the Alameda County District Attorney.
    "I've seen a 92-year-old man listed as an auto mechanic, and an elderly blind woman as an interior decorator," Denny says.
    When a senior is not able to repay the loan and loses his home, the shady broker has long since collected his fee and moved on to his next victim.
    The fact is, it's a whole lot easier to hold an old person up for his home than it is to rob a bank.
    A bank robber might get $5,000, if he's lucky. He might also get shot.
    "But you go into an old person's living room, they'll serve you coffee, you hand them their pen and they'll sign over $200,000 to you," says Pleasanton Attorney Alan Ramos who represents elder financial abuse victims.
    A frail senior battling cancer or dementia is hardly in a position to fend off an assault on his finances. If he's got Alzheimer's, he's probably too out of it to even realize what's going on.
    Walter Condon had just had surgery for colon cancer. His wife had suffered a massive stroke and was in a nursing home.
    The 75-year-old Pacifica attorney started spending a lot of time with a Concord man named Daniel Villasenor who he had met through a legal client.
    Before long, Condon had given the 42-year-old Villasenor permission to cash his $3,000-a-month pension check. He started loaning a man he hardly knew thousands of dollars. He even gave him power of attorney over his financial affairs, which allowed Villasenor unlimited access to Condon's assets.
    Condon had been mentally confused since his surgery. His son Marc Condon found out that he'd started loaning Villasenor money. He suspected that the younger man was taking advantage of his father's declining mental state and frail health.
    But Walter Condon wouldn't listen to his son. In fact, Walter Condon made Villasenor his caretaker.
    He moved 50 minutes away to Pittsburg to open a bankruptcy practice with Villasenor.
    Then, Walter Condon disappeared.
    Several months later, Marc Condon learned that his parents' house had been transferred into Villasenor's name.
    He suspected foul play and went to the police. Concord police officers located Villasenor at his home. They arranged for him to bring Walter Condon to a neutral location later that evening so that the police could verify his well-being and Marc Condon could speak with his father.
    The meeting took place at 10:40 p.m. on the side of Farm Bureau Road in Pittsburg.
    Walter Condon was sitting in Villasenor's car. His son asked him to come home with him. But Walter Condon refused. He said he couldn't because he had to go to a doctor's appointment the next day.
    The police officers concluded that Walter Condon was lucid and was not being held against his will. They allowed him to leave with Villasenor.
    A few days later, a California State Bar investigator named Michael Hummer contacted the Concord police. The bar was investigating Walter Condon for charging clients for bankruptcy services that he had not completed.
    Several of the complainants had identified a man fitting Villasenor's description as the person who claimed to be attorney Walter Condon.
    Hummer had also contacted Marc Condon. He filed a missing person's report with the police.
    But now, all of a sudden, Villasenor and Walter Condon were nowhere to be found.
    Detective Ken Carlson searched for the pair for more than a month, without success.
    Then, on a December afternoon in 2000, Carlson got a tip. He knocked on the door of a dark apartment in Pittsburg.
    Josephine McCray and her husband Vern answered the door. They told the detective they had no idea where Walter Condon lived. That they would have to ask Villasenor.
    Suddenly, an elderly man in a diaper burst into the room. He was holding a colostomy bag in one hand.
    "Vern? Is that someone looking for me?" he asked.
    The police had found Walter Condon.
    The elderly man was shocked to learn that his credit cards had been run up to $330,000. A bankruptcy petition had been filed in his name. His house was in foreclosure. And, his professional reputation was in tatters.
    "I thought he was helping me out. I trusted him," the veteran of three foreign wars told the police of Villasenor. "But from what I've learned, I don't know him very well at all."
    After a three-year investigation, the Contra Costa County District Attorney charged Villasenor with grand theft and elder financial abuse.
    He also was charged with grand theft for stealing money from people who'd hired Walter Condon to prepare their bankruptcy petitions. Some of them told a state bar investigator that Villasenor had led them to believe that he was Walter Condon.
    But the district attorney would later drop the most serious elder financial abuse charges. Last year, a Contra Costa Superior Court Judge sentenced Villasenor to two years probation for defrauding Walter Condon's legal clients.
    They didn't pursue the more serious allegations that Villasenor had held Walter Condon a virtual captive while he looted his assets.
    A smug Villasenor told a Times reporter that he got such a good deal because prosecutors would have had a "hell of a case to prove."
    We'll never know whether that's true. What we do know, however, is that Villasenor got very lucky.
    The case was plagued by delays. It got transferred to several different detectives. The first prosecutor went out on maternity leave. By the time the District Attorney's Office was prepared to present its case, Walter Condon had died.
    That would have been a serious blow in and of itself. But then, the U.S. Supreme Court delivered the knock-out punch.
    In Crawford v. Washington, the high court ruled that videotaped testimony is not admissible at trial because it violates a defendant's Sixth Amendment right to confront his accusers.
    Villasenor obviously couldn't confront a dead man in court.
    Unable to use the tape that would have allowed Walter Condon to testify from the grave, prosecutors decided not to pursue the elder abuse charges.
    After Walter Condon's death, his estate filed a civil lawsuit to get the title of his Pacifica house transferred out of Villasenor's name back into the name of Iyoko Condon, Marc Condon's mother. The action cost $35,000 in legal fees.
    Marc Condon remains bitter over the outcome.
    "People like Villasenor can't be stopped," he said.

    Lonely life

    Besides illness, what often makes elderly people so vulnerable is loneliness.
    Their spouses and their contemporaries have died. Their children and grandchildren don't have time for them.
    Their only company is the TV.
    A widow might seek out the grocery store clerk who speaks whenever she goes shopping. Or develop a relationship with a nice man who has offered to fix the roof.
    The problem is, these seemingly sympathetic strangers often mean them no good.
    Nancy Leslie thought she'd made a good friend in Teresa Szymczak, a teller at her local U.S. Bank branch.
    Szymczak would always wait on the 90-year-old Alameda woman. She helped Leslie balance her checkbook. Before long, she started spending time with the elderly woman outside of the bank.
    Szymczak cooked Leslie meals and helped her get to doctor's appointments.
    She also helped herself to Leslie's checking account.
    An Alameda police investigation revealed that Szymczak had come up with a crude ruse to steal from Leslie.
    The teller had her address put on Leslie's bank statements. When they arrived, she altered them to hide the thousands of dollars that she was withdrawing from the older woman's account. She then resealed the statements and mailed them to Leslie.
    The teller got caught after a $4,620 check for Leslie's move into a long-term care center bounced. She should have had more than enough money in her checking account to cover it.
    Leslie's nephew, who had a power of attorney over her affairs, called the police.
    The teller was convicted of elder abuse and forgery last year and ordered to repay nearly $17,000 -- despite her claims that the money that she took was a loan.
    Like Leslie, many older people are desperate for companionship, which is why they also get sucked into telephone solicitations.
    A Concord woman named Lori Swiech raked in nearly $200,000 over a two-year period by soliciting mostly elderly people on behalf of charitable organizations.
    Swiech knew how to tug at the heartstrings. She said she was raising money for hungry tots. Battered women. Jobs for vets. A food bank.
    She had the con down to a science. When authorities searched her home, they found hundreds of 3-by-5 index cards on her desk -- each listing personal details about her victims.
    Swiech used these cue cards to bond with her victims.
    "She was incredibly charming over the phone," says Contra Costa Deputy District Attorney Ken McCormick.
    Swiech would never use the mail, but she had her victims leave a check under their doormat. Her cohort Ken McElroy would pick it up.
    Fortunately in this case, the amounts stolen from each person were relatively small. Most elderly people wrote checks for $100 or less. Occasionally for $1,000.
    The scam was so lucrative because there were so many victims. Investigators suspect there were thousands going back as far as 1990.
    Swiech and McElroy were sentenced to two years probation and ordered to pay back the money they stole to the charitable organizations they had claimed to be representing.
    "People need to imagine the person on the other end of the phone wearing a black hood over their head," says Helen Carr, a Bay Area senior who teaches fellow seniors how to avoid falling victim to financial fraud. "We need to retrain ourselves."

    Special crimes

    California Penal Code 368 recognizes that crimes against elders are deserving of special attention -- much like crimes against children.
    According to the law, those convicted of elder abuse face harsher penalties.
    A theft is legally considered elder financial abuse if the perpetrator had every reason to know that the victim was 65 or older and took their property - without their consent.
    The problem is unscrupulous, stronger-willed people use all kinds of nefarious tactics -- that aren't illegal under current law -- to manipulate elderly people into giving their consent for financial transactions.
    Transactions that enable that thief to loot a senior's assets.

    It's called, "using undue influence" .

    Perpetrators isolate a senior so that he becomes totally dependent to the point of doing anything the predator tells him to.
    Scare the senior into thinking that if he doesn't sign the power of attorney turning over control of his assets, he'll wind up in a nursing home.

    It's a form of brainwashing - not unlike what goes on in cults.

    Yet undue influence isn't against the law -- even though elder predators are using it to get away with criminal conduct.
    A California appellate court has suggested that undue influence is no more than persuasive salesmanship.
    However, we believe that when someone brainwashes or intimidates an elderly person into turning over his life savings, that goes far beyond good salesmanship.
    Let's say a predator pressures a vulnerable elderly woman into signing over the deed to her house, knowing full well that she is incapable of understanding the implications of her actions. He then sells the house, leaving her homeless.

    We believe that ought to be a crime.

    If using undue influence to commit theft is not a crime, it's time our lawmakers gave serious, thoughtful consideration to making it one.

    Vulnerable elderly people need and deserve our protection.

    Easy prey

    Elder predators are everywhere. They know where to find their victims. They scout out neighborhoods, looking for well-tended yards and handicap access ramps. They hang out at bus stops and grocery store parking lots. Outside senior centers and retirement complexes.
    They take advantage of the fact that people who grew up during the Depression tend to be more trusting. That they come from a time when a man's word was his bond. When agreements were sealed with a handshake. That if someone tells them a loan is for $200,000, they don't expect it to contain $50,000 in hidden fees.
    If a friendly sounding woman calls on the telephone and says she's with the government, they take her at her word. They believe that the personal information that she wants is for official government business.
    They can't imagine that criminals have purchased lists of elderly people from banks and are using the information that unwitting seniors divulge over the telephone to clean out their bank accounts. -- all the while expressing sympathy for the recent loss of a spouse.
    There are those fortunate souls who will remain healthy and reasonably self-sufficient. Those miracles who are still driving in their 90s.
    But age works overtime on many seniors. Illnesses weaken their bodies. Dementia ravages their minds. Other mental disorders make elderly people hoard to hold onto what they already have, which makes them especially susceptible to con artists peddling "low-risk, high yield" schemes.
    Other seniors go to the opposite extreme: they're seized with fits of generosity that lead them to make unusually large gifts to people they hardly know.
    These age-related infirmities make them easy targets for criminals and the criminally minded.
    It will take a community effort to fight these heartless con artists.
    We can start by beginning to keep a watchful eye out for our elderly neighbors and family members.
    If we notice that the 92-year-old woman next door who used to sit out on her porch and greet the neighbors has suddenly become a recluse now that her adult granddaughter has moved in, we ought to pause a moment and ask ourselves why?

    The welfare of our elderly residents is our collective responsibility.

    The baby boomers have always prided themselves on doing everything better than previous generations.
    That includes aging better. As we're so fond of saying, "60 is the new 50."
    The fact is, though, if your brain goes, it doesn't matter how smart and successful you once were.
    You, too, will lose your independence. You'll have no choice but to rely on the kindness of family members, paid care-takers and others for your basic needs.

    If for no other reason than selfish ones, we should all care about fighting elder financial abuse. Because one day, if we live long enough, it could very well happen to us.

    Drummond is an editorial writer for the Bay Area News Group-East Bay. Her e-mail is

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