Protecting Older Adults From Financial Exploitation

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1 Protecting Older Adults From Financial Exploitation E. Sharee Rines Adult Protective Services, Trainer/Policy Writer Georgia Division of Aging Services Suzette Binford Programs Director, Atlanta Region Alzheimer s Association, GA Chapter 1

2 Learning Objectives: At the Completion of this Presentation You Will: Understand the implications of cognitive functioning in determining financial capacity Know warning signs of diminished financial capacity Know the types of financial exploitation Know risk factors for financial exploitation among older adults Know about screens for determining financial capacity Know the barriers for reporting financial exploitation Know things you can do to help address and prevent financial exploitation 2

3 Financial Exploitation: Financial abuse, or exploitation, is defined as the illegal or improper use of an elder s funds, property, or assets. (NCPEA) It involves the theft or fraudulent use of an older adult s money or material belongings and the use of undue influence to relinquish or gain legal authority over assets. (Brandl et al., Nerenberg, Quinn) Generations, Fall 2012 Scenario: Widowed woman lives in her home. Her adult son lives with her and has spent almost $200,000 of her money on things for himself including trips to Vegas and a new car for his girlfriend. Her brother finally steps in and addresses the situation.

4 The Scope of the Problem Older Americans are losing about $2.9 billion every year to people who take advantage of their vulnerabilities and that's only for the cases that are actually reported. Only one in 44 financial abuse cases are ever reported. One in ten abuse victims turns to Medicaid as a result of financial losses from abuse/exploitation. Who's victimizing older Americans? It could be anyone: Many of the culprits are family, friends, and neighbors. Much elder financial exploitation is perpetrated by strangers. Some is perpetrated by the business sector. A smaller percentage is related to Medicare and Medicaid fraud. The typical victim of financial exploitation is a widowed white female between the ages of 79 and 85, but it occurs across the entire demographic spectrum. 4

5 Financial Capacity An Emerging Concern Older adults are the most vulnerable to impairment and loss of financial skills and capacity not only because of the effects of Alzheimer s disease and other related dementias but also due to normal cognitive aging. (Daniel Marson & Charles Sabatino) The capacity to manage one s financial affairs, known as financial capacity, comprises a broad range of conceptual, pragmatic, and judgment abilities, used across a range of everyday settings, that are critical to the independent functioning of adults in our society. Financial Capacity has been defined in general terms as the capacity to manage money and financial assets in ways that meet a person s needs and which are consistent with his/her values and self interest. (Marson, Hebert, & Solomon) Generations, Summer,

6 Financial Capacity The question becomes: does a person have financial capacity (the capacity to manage one s financial affairs?) Financial capacity comprises a broad range of conceptual, pragmatic, and judgment abilities. Examples include: Having basic monetary skills Carrying out cash transactions Managing a checkbook and a bank statement Exercising financial judgment Daniel Marson and Charles Sabatino Generations, Summer,

7 Cognitive Function and Financial Exploitation: [When financial abuse is suspected] the next step is to determine whether the elder victim s cognitive functioning is in question. (Gibson and Qualls) When cognition is intact, professionals work toward empowering the individual to unhook from victim behavior. (Gibson and Qualls) Interventions such as psycho-education, psychotherapy or skills training can help the elder identify ambivalence related to codependent nature of the relationship and in implementing safety and survival strategies. (Gibson and Qualls) Scenario: A widower in his 80s says his grown son does not work, can t hold a job, lives with him and is verbally abusive and demands money. He finally gets guidance from a church counselor and makes plans to sell his home, move into a retirement home and have his son move out. His house is under-contract. 7

8 More About Cognitive Impairment Normal Aging a natural, progressive process of decline in memory and other cognitive abilities occurring throughout one s life and over time. It is affected by many factors, including environment and genetics. Dementia an umbrella term meaning a decline in cognitive functioning, caused by some medical condition, which is severe enough to interfere with daily life. Alzheimer s a type of dementia that causes declines in memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks. The most common cause of dementia. MCI Mild Cognitive Impairment. MCI causes a slight but noticeable and measurable decline in cognitive abilities, including memory and thinking skills. A person with MCI is at an increased risk of developing Alzheimer's or another dementia. Examples other diseases causing dementia: vascular dementia, Lewy Body dementia, frontotemporal dementia, Parkinson disease 8

9 Financial Capacity: Experts now recognize the importance of training professionals to assess financial capacity Experts know that financial capacity is one of the first abilities to decline as cognitive impairment and early dementia encroach. (Naomi Karp, AARP) Declines in money management skills appear to occur early in the clinical disease process and may even precede a diagnosis of Alzheimer s disease (Triebel, etal.) Individuals with amnestic (memory problems primarily) mild cognitive impairment, which in many cases is a predromal (prior to having symptoms that lead to a diagnosis of AD), are at high risk for declining abilities in complex skills such as checkbook and bank statement management. (Triebel and Marson) Generations, Summer

10 Financial Capacity cont: People with diminished capacity may also be at risk for abuse including financial exploitation, consumer fraud and other financial scams (Marson and Nerenberg) A classic sign that there may be a problem with judgment is a new interest in get-rich-quick schemes. (Triebel and Marson) Generations, Summer

11 Warning Signs of Diminished Financial Capacity: Forgetting to pay bills Paying the same bills several times Misplacement of financial and other documents at home Missing tax and other deadlines Declines in checkbook management skills Problems with math skills like making change Loss of general knowledge regarding financial terms like mortgage Impaired judgment about financial investments and use of money including: Interest in get-rich-schemes Unfounded anxiety about the nature and extent of one s personal wealth (Tribel and Marson) Generations, Summer

12 Baseline for Financial Capacity: It is important to know a person s baseline. If a person was good at managing his/her checkbook before but the checkbook is a mess now, there s a problem. If the person was never good at managing a checkbook, it is not as problematic as someone who managed it well. (Marson) 12

13 Tools for Determining Financial Capacity: Experts agree that tools are needed to determine the financial capacity of a person. This is because people with mild cognitive impairment and early stage dementia have social skills that make it difficult to know that the person has diminished financial capacity. When there is indication that any of the warning signs of diminished financial capacity are evident, the individual should be assessed to determine if the person has financial capacity. 13

14 Financial Capacity Screens: Dr. Daniel Marson, one of the nation s leading experts on financial capacity and his team at the University of Alabama developed two screens for use by the Georgia Adult Protective Services staff and law enforcement. The development of the screens were made possible by a grant from the Administration on Aging and the Georgia Department of Human Resources Division on Aging. DAS and the Alzheimer s Association, Georgia Chapter worked to make these screens available in Georgia. 14

15 The UAB Brief Financial Capacity Screen: Gather: Basic client and referral information Information on client s presenting financial issue/problem Information on the client s prior highest level of financial functioning Report: Rate: Your opinion on the client s financial skills (based on the client s test performance) Client s current financial skills and abilities Your client s current financial judgments Your opinion on the client s current vulnerability to scams and financial exploitation, vulnerability to undue influence Your opinion on if the client s financial skills have declined from the past Your opinion on your clients financial skills and the ability to live successfully Your opinion on the client s capacity to manage his/her own financial affairs Make Recommendations: Ways of Enhancing client s financial capacity Overall recommendations and Action Plan 15

16 The UAB Brief Financial Capacity Screen Supplemental Form to BFCS Form: Testing Basic Financial Abilities Allows You to: Gather information from your client that will help you determine your client s ability to: Count money and make change Calculate percentages for determining taxes Subtract figures for managing a checkbook Define important words related to finances such as income, debt and money order Determine and Rate: Your client s current financial judgments Your opinion on the client s current vulnerability to scams and financial exploitation, vulnerability to undue influence 16

17 Undue Influence: Undue influence is typically accomplished by employing subtle pressures to deceptively gain control over a weaker person s decision making. (Brandl, et al., Nerenberg, Quinn) Within families undue influence might include: Blackmail strategies such as threats of violence or suicide Pilfering money Begging for limited assistance with bill-paying and shopping needs Spending of the elder s money Making poor financial decisions Withholding copies of documents Forging or forcing signatures (Vezina, Ducharme, MacDonald) 17

18 Financial Exploitation Risk Factors/Warning Signs: Cognitive impairment Social and geographical isolation An increased need for assistance with daily activities Recent life changes such as widowhood or divorce Sudden reluctance to discuss financial matters Sudden, atypical or unexplained withdrawals, wire transfers, or other changes in their financial situations Utility or other bills not being paid New best friends and "sweethearts" Onset or worsening of illnesses or disability Behavioral changes, such as fear or submissiveness, social isolation, withdrawn behavior, disheveled appearance, and forgetfulness Changes in the will, especially when they might not fully understand the implications Sudden increase in spending by their family or friends Transfer of title of home or other assets to another person for no apparent reason Large, frequent "gifts" given to a caregiver Personal belongings are missing Large, unexplained loans taken out by the elder 18

19 Risk Factors and Warning Signs cont. Care of the elder is not commensurate with the size of his/her estate Implausible excuses about elder s finances being given by elder or caregiver Caregiver expresses excessive interest or concern over the amount of money being spent on the elder s care New or revised legal documents the elder can t explain Bank statements no longer coming to the elder s home 19

20 Financial Abuse and the Family: Elder financial exploitation: is largely private, occurring often in the context of close relationships. Fifty-five percent of all this abuse occurs within families. (MetLife Mature Market Institute et al.) Family members are a ripe context for financial abuse given the unique array of obligatory norms in caring for each other. (Bengston and Roberts) There is often a sense that the family member/exploitive person is due what is taken from the elder. (Vezina and Ducharme) The elder may eventually become aware of the abuse, but often refrains from informing other family members in order to protect the exploitive person, or for fear of losing daily living support. (MacDonald) The process generally does not end until the older adult dies or all assets are depleted. (MacDonald) 20

21 So What Do We Do About Financial Exploitation? The first step prior to intervention is the recognition that elder financial abuse has occurred, a step met with a host of complications and intense feelings, particularly between the elder and the exploitive person. (Gibson and Qualls) 21

22 Barriers to Reporting Financial Abuse: The elder may hesitate to report abuse for various reasons: Fear of retaliation Loss of independence Feelings of self-blame Increased dependency on the abuser Feeling sympathetic and protective of the exploitative person (Hafemeister, Rabiner, Brown and O Keefe) The elder may hesitate to report abuse especially when: A rescue pattern exists There is a history of alcohol and drug problems There is a history of mental illness (Capezuti, Brush and Lawson) 22

23 Who Can Help Report Financial Exploitation: Professionals and professional organizations may be the first to recognize elder financial abuse. (Gibson and Qualls) These professionals and professional organizations include: Attorneys Physicians Financial institutions Therapists Case managers Adult Protective Services (Gibson and Qualls) 23

24 Legal Action May be Appropriate When the elder suffers from cognitive impairment or the sum of money involved is large, legal action must occur. (Miller) APS may be involved in investigating as well as in shifting financial responsibility to a third party. (Miller) In situations where criminal activity is suspected, local police authorities should be contacted to begin an investigation. (Gibson and Qualls) Generations, Fall

25 What You Can do to Prevent Financial Exploitation: Educate yourself and your staff to recognize signs of financial exploitation, risk factors, and possible diminished financial capacity Help increase awareness and educate the community on these issues 25

26 Assisting with Financial Exploitation Cases Develop a protocol for helping families and individuals who might be facing financial exploitation and diminished financial capacity Including when to refer a person to an elder law attorney for Durable Power of Attorney, conservatorship, guardianship or emergency guardianship When to refer a person to APS when financial exploitation is expected When to involve law enforcement (who may be able to freeze accounts) (Heiler and Stigel Generations Summer 2012) When to notify financial institutions When to involve Ombudsmen 26

27 If We are Going to Significantly Address Financial Exploitation: We need awareness, education and protocol/policies regarding financial exploitation for: Financial institutions Law enforcement Attorneys APS staff Aging network Healthcare, long-term care and other industries Faith-based communities We need better laws against financial exploitation (with monetary penalties) 27

28 Resources StopFraud.gov great resources including an excellent brochure called Protect Your Pocketbook: Tips to Avoid Financial Exploitation Document on protecting vulnerable adults from financial abuse: df Wells Fargo: Eldercare Locator - Find local services and resources by either ZIP code or city. You can also narrow your search by topic, such as caregiver, elder abuse, etc. National Center on Elder Abuse (Administration on Aging) Find state agencies, resources, and statistics. National Committee for the Prevention of Elder Abuse - Find resources to learn more about various forms of elder abuse and financial exploitation. National Association of Area Agencies on Aging - This agency advocates for member agencies, the elderly, and caregivers. 28

29 Questions? Sharee Rines Suzette Binford

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