Elder Abuse -Who Will Watch the Watchers?

by Wendy Harrison

© Wendy Harrison 2009



Finally!  You have found a care giver for your mom to ensure she takes her medications, bathes regularly, eats well and to generally watch over her –  but who’s watching the care giver?  Most likely, no one.

Lack of monitoring of a care giving situation can lead to elder abuse.  In general, elder abuse falls into four categories:  physical, psychological, financial and neglect.   Physical abuse includes hitting, burning, restraining or giving too much medication or the wrong medication.  Psychological abuse involves shouting, swearing, threatening or humiliating a person.  Financial abuse consists of illegal or unauthorized use of a person’s property, money or other valuables (including changing a person’s will to name the abuser as heir or obtaining power of attorney, followed by deprivation of money or other property).  Neglect includes depriving a person of food, heat, clothing, comfort or essential medication.

It is estimated each year that one million elderly Americans are abused.  Individuals 80 years and older make up the largest category of abuse victims, closely followed by those between 70-79 years of age.  The home is the most common setting for abuse, with perpetrators of elder abuse including anyone in a position of control or authority such as a spouse, relative, neighbor or care giver.

Most care givers are decent, hard-working professionals who do a difficult job for less than stellar wages.  However, there are some who take advantage of the elderly.  The focus of this article is financial abuse by care givers and steps that can be taken to prevent it.

In my work, I have been involved in several cases of financial abuse.  One care giver embezzled $25,000 — all of which was found in cash under her bed!  Another care giver stole a cell phone and ran up $2,000 worth of charges.  One asked for an advance in pay, received it and then left town.

Unfortunately, in many cases, it is difficult to bring the perpetrator to justice.  The care giver is nowhere to be found; the victim’s memory may be impaired; the victim may have “willingly” written checks or donated other valuables to the care giver; the victim may have passed away by the time the case goes to trial (in which event, charges may be dismissed due to the fact that the only witness – the victim – is not able to testify).

The predatory care giver targets seniors who have no family or friends closely involved in their lives.  The senior may suffer from physical impairments such as blindness or hearing loss, or they may have dementia or Alzheimer’s.  Also, there are those who are just plain lonely.  So, if anyone shows any kind of attention or interest in them, they are grateful.

In order to protect your parents, friends or neighbors from this kind of abuse, you must be diligent and take an active part in the selection process of a care giver.  If you are selecting a care giver through an agency, ask for references, insurance information and what background checks, if any, the agency performs on their care givers.  Also inquire if the agency provides case managers who will monitor the care givers and the overall needs of the senior.

Geriatric care managers or case managers may be hired through agencies or privately.   They can be of great help if the family is not living nearby or does not have the time to devote to supervising the senior’s living situation.  They assess how well the senior is functioning and  provide a care plan with specific recommendations, ensuring the senior receives the appropriate medical/psychological attention.  They secure services such as legal and financial counsel and assist in finding home care, nursing care or long-term care, in addition to counseling family members.

If you are interviewing care givers who have come to you through ads or referrals from friends, check all references thoroughly. Have the care giver provide you with (1) a valid California driver’s license or identification card which notes their current address, (2) their car’s license plate number and (3) their Social Security number.  As added protection, you may wish to require that the care giver purchase a business services bond.  A bond acts as insurance against any fraudulent or dishonest act which causes a loss.  Bonds can be purchased in amounts from $2,500 on up.  However, the bonding company does not do background checks on the insured and will only cover the loss upon conviction of the insured.

Once you have selected a person to act as a care giver, you need to agree upon a payment schedule and create a time sheet on which the care giver will log his or her hours.  You should also set up a petty cash fund from which the care giver can take money for groceries, medications, etc.  (having a credit card on file at the pharmacy will eliminate the need for petty cash for medications).  The care giver should submit store receipts for all cash used.  The care giver should not have access to credit/ATM/debit cards or checkbooks.  Periodically review the petty cash fund, credit card statements, checkbook and bank statements for any fraudulent use.  Make it a point to drop in unannounced to check on the senior and the living environment.  These recommendations should also be followed even if using a care giver who has been hired through an agency.

It is unethical (and a sure warning sign) for a care giver to ask for a loan of money or other property, to request an advance in pay or to ask the senior to make purchases for them.  Remember, the senior is not a lending institution!

If you suspect any kind of abuse, report it immediately to your local police department or Adult Protective Services.  All A.P.S. agencies provide a 24-hour/7-day a week hotline to respond to reports of abuse.

Under California law, certain individuals are legally mandated to report known or suspected instances of elder abuse.  These include physicians and medical professionals, clergy, all employees of health care facilities and individuals who assume responsibility for the care or custody of an elderly person.  However, any person who suspects that abuse has occurred should report it.  An elder’s assets, health or life may depend upon your call to the appropriate authorities.  As a person reporting abuse, you are shielded from both criminal and civil liability.

To reiterate, if you are unable to personally monitor your senior’s care giving arrangement, you should contact a geriatric care manager or case manager to do so.  When the care giver knows that someone is closely monitoring their activities and the well-being of the senior, abuse (financial or otherwise) is less likely to occur.

The seniors in our community are members of the same generation who took care of us when we were children.  When they are no longer able to care for themselves, the least we can do is protect them from those who wish to do them harm.

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