Then please step up and be sure to take the appropriate precautions to make sure they don’t become one of the MILLIONS of American seniors who have been taken advantage of financially by opportunistic criminals or even worse, trusted caregivers.

According to Adult Protective Services, 1 in 20 older adults have reported some sort of financial mistreatment in the recent past.

Ways to prevent elder financial abuse:

• Remove all checkbooks from the home so that the person cannot unwittingly have a check stolen or be duped into writing checks. If they require a check for a regular helper, either arrange to have one check at a time given to them, or create electronic payments that don’t involve the senior. Decide together what is the largest amount of check that the person can write without discussing with you and/or how much cash they can have at home.
• Take as many credit and debit cards as you can out of the home. You can leave one low limit credit card if necessary for emergencies.
• Have all financial mail forwarded so that no mail which includes information about retirement income, bank accounts, social security numbers, Medicare or taxes comes to the house.
• Make arrangements for the computer. Lots of older people have unsecured significant information on their home computer, especially if they have used it for bill paying. Copy files onto a portable device and remove the files from the desktop or laptop if they are no longer necessary on the person’s computer.
• Monitor computer use and email, too. If credit cards are removed from the house, then less damage can be done on the computer, but do monitor the email and web surfing to make sure the person isn’t giving away private information or divulging anything that would harm them (like telling a stranger when they are alone, for instance).
• Place an inconspicuous hidden camera to watch the computer screen to be sure that caregivers aren’t trying to access the computer.
• Make an inventory of valuables and photograph them. Consider moving some of the values to another location or to a safe deposit box.
• Be sure that the elder person knows how to use the phone and is still appropriately doing so.
• Talk to your loved one about the financial scams out there (a person pretending to be a grandchild needing money, people posing as workers who want inspect the property but end up stealing things, people posing as charitable workers and asking for donations, lottery scams). Try to role play with them and see what they would do if they encountered these situations.
• Door safety. Encourage your loved one to only let in people they know well. You can install software that alerts you when people arrive on their doorstep, so you can also observe and intervene if necessary.
• Make sure that all accounts are held jointly with the senior so you can be apprised if anybody else tries to get their name on the account. That is an immediate red flag and grounds for firing and reporting to Adult Protective Services.
• Watch in-home caregivers like a hawk! When they run an errand, do they bring the change back to the senior? Are they trying to use extra checks to pay their own bills? Are their timesheets true or falsified (typically these have to be signed by the senior)? Are they doing their job or are they ignoring the senior and collecting a check?

Seniors can be vulnerable physically and financially. It is up to us to protect them and be sure they aren’t victimized financially, which could affect their standard of living, their self esteem, their mental health and even their physical health.

First of all, it’s important to visit your loved ones regularly and at different times: weekends and weekdays, mornings, mid-day and evenings. Varying your visiting pattern will show the range of their behavior, their interactions with others, their most lucid and active times and the times of day that are the most challenging for them and for those who care for them.

What to Look For When Visiting Your Elderly Loved One:

• How do they look? Well fed, relatively steady on their feet with the proper assistive equipment (canes, walkers)?
• How much food is in the house and is it edible?
• Are they wearing clean clothes in good repair?
• What is your loved one’s mood? Are they essentially the same or is there a change in personality? Are they exhibiting signs of depression, including withdrawal? Are they becoming angry or aggressive? Confused? Are they acting out verbally, physically or sexually? Any of these personality changes or significant new behaviors need to be investigated by a geriatric psychiatrist and/or a neurologist.
• Do they have any recent injuries or scars? How do they explain them?
• How do they smell? Does their body and hair seem clean? Can they still brush their teeth or do they need assistance? Who is helping them with self care items and are they getting enough assistance?
• Are there any new people hanging about whom you never knew before? Who are these people, what is their role and are they getting paid or asking for/receiving money from your loved one? Follow up to make sure they are not taking money from your loved one, taking advantage of their naivete.
• Check the mail. If the number of charitable solicitations, sweepstakes or credit card offers seems especially high, this is cause for great concern. This should lead to someone talking to them about who they are giving money to, and in what amount. Charitable organizations are notorious for upping the amount of solicitations based upon regular, small amounts of donations, which is very enticing to older people, who are often not only generous, but forgetful of when they last donated.
• What is the quality of their help? Do they seem honest? How are they compensated? Do they know too much about how to access funds? Are they working hard enough and giving enough attention?
• What is the state of your loved one’s belongings, especially jewelry and furniture as well as cars? Take a picture of their environment, especially their valuables so you can help them keep track of what’s significant. If items are missing, follow up immediately with their paid help, or with nursing home supervisors.
• If they wear glasses or dentures, are they wearing them regularly and do they fit properly? Losing dentures is a serious problem for the elderly. Once they have lost their false teeth, they lose interest in eating, including the sociability of meals. If they don’t wear their dentures for an extended time, getting new ones to fit comfortably is difficult, so this “edentulous” state can become permanent and depressing.
• For seniors living in communal housing, what are the other residents like? Do any of them wander into your loved ones’ rooms? Are any of them violent? Who controls the situation? Is your loved one safe or do they need to find a safer new place to live?

Visiting loved ones serves a dual purpose. Firstly our visits ideally provide some companionship, diversion and comfort to them. But we also have to use these encounters to gently investigate how they are doing, if they are well-cared for or if more assistance is needed to keep them safe and prevent elder abuse in all of its varieties.

There are different types of elder abuse: physical abuse, emotional abuse, sexual abuse, neglect and financial abuse.

Financial abuse can be more difficult to track, but it can deplete the funds of the older person, making their future care unaffordable, and stealing the money that they planned to use for themselves or their family members.

A Metlife Mature Market Institute study found that $2.9 billion is stolen from older adults each year as a result of elder financial abuse or financial exploitation. Financial exploitation occurs when someone illegally takes or misuses the funds or possessions of an elderly person (often a car), or conceals funds, property or assets, or takes advantage of their vulnerabilities to convince them to liquidate or turn over property or monies.

How can you spot elder financial abuse?

• Be aware of changes in the standard of living of the elderly person. If they are known to have money for their care and suddenly, they are living like a pauper, this is cause for concern.
• Are there signs that their finances aren’t being properly managed, even when arrangements have been made to pay bills? Look out for past due notices, eviction notices or even the elderly person’s refusal to answer the phone, because of fear of being hassled by bill collectors.
• Are there funds missing or transferred and the elderly person can’t explain what has occurred?
• Are bank statements no longer coming to their house?
• Does the elderly person have a new roommate, a new caregiver or a new best friend? Does this person seem to have undue access to property or money, including always accompanying the elderly person to the bank or knowing their PIN numbers for debit cards?
• Are there recent changes to their power of attorney, their wills or other significant documents?
• Do the signatures on their checks look different than normal?
• Does their living environment look significantly different, with missing property, like large furniture or even favorite jewelry or electronics no longer there? Can they explain where their belongings are?

Sadly, most elder abuse is committed by family members, and this is particularly the case with financial exploitation. This does not make it right.

If you think your loved one is being taken advantage of, notify law enforcement through your 911 system. You can also activate your local Adult Protective Services, you should notify their health care provider, notify non-abusing family members, and of course, contact an attorney who specializes in elder abuse.

There are some particularly sensitive and unique issues that arise when an aging adult is no longer able to take care of their daily living needs on their own. One problem that we encounter on a regular basis can be particularly stressful for everyone involved. Often our loved seniors emerge from a hospitalization physically frail and mentally confused. Are these new and unsettling symptoms delirium, a temporary confusion, caused by the unusual and sometimes scary world of hospital life? It is clearly understood that large numbers of seniors can experience very negative cognitive side effects from hospitalizations. Or is it dementia (like Alzheimer’ disease) exacerbated by a physical decline?

Changes in cognition such as memory impairment, physical disorientation, rambling or “irrelevant” speech might appear to look similar to dementia, and might be diagnosed or treated as such by the untrained, but to a competent gerontology specialist, the differences are clear. In fact, “Because many of the features of delirium are distinct from those of dementia, detection of delirium is possible in most patients who have preexisting dementia… Although cognitive impairment occurs in both abnormalities, distinct characteristics differentiate them.” (source: Critical Care Nurse, April 2003, vol. 23 no. 2)

If you have a cherished friend or family member who has experienced a cognitive decline during or after a hospitalization, make sure you discuss your concerns and observations with a trusted healthcare professional.  While both new and acute hospitalization related delirium and pre-existing dementia are scary for all involved, with proper diagnostic assessment and appropriate standards of care in place, health care professionals in hospitals and long term care and recovery facilities can make sure that the aging adults in their care are cared for in the most appropriate ways physically and psychologically. If you know of a situation where a senior is not receiving the physical or cognitive care you suspect they require, let us know. Our legal advocates are here to help.

If you are looking online for some general resources on caring for a loved one with either Delirium or Dementia, here are some web sites where you might want to start you search:

For information about Dementia and Alzheimer’s Disease:

• www.alz.org
• www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet

For information on Delirium:

• www.mayoclinic.org/diseases-conditions/delirium/basics/definition/con-20033982
• www.health.harvard.edu/newsletters/Harvard_Womens_Health_Watch/2011/May/when-patients-suddenly-become-confused?utm_source=womens&utm_medium=pressrelease&utm_campaign=womens0511
• well.blogs.nytimes.com/2012/10/01/vigilance-about-the-dangers-of-delirium/?_php=true&_type=blogs&_r=0