1 Investigating Elder Abuse Expanded Course Outline and Hourly Distribution For One-Day, 8 Hour Course INSTRUCTOR: Andrea Higgens Third Degree Communications Learners: In-Service Police Officers and Investigators, APS Social Workers, Public Guardians, and Prosecutors. Length of Instruction One 8-Hour Day: 8 Hours Total Objective: The student will learn to identify and investigate elder financial abuse, physical abuse, neglect, and sexual abuse by understanding each of the following topic areas: Elder Financial Abuse - I. Elder Abuse overview Financial Abuse A. Why are elders vulnerable? 1. Judgment can be compromised. 2. Reluctant to report crimes against them. 3. Lonely, trusting, polite. 4. Seniors control 70% of the nation s wealth. B. Who commits most elder abuse? 1. 90% of all crimes against the elderly are committed by loved ones or trusted caregivers. C. Dementia, Mild Cognitive Impairment 1. Elders with dementia are three times more likely to be abused. D. Overview of PC 368 Financial Abuse Sections 1. Highlight sections related to financial abuse 2. Review CALJIC and CALCRIM jury instructions 3. Benefits of submitting cases for review rather than on-view arrests 4. On-view arrest starts the clock ticking. E. Financial Decision Making Capacity - 1. What it means for financial cases 2. If a victim lacks financial capacity, they can no longer consent to changing wills, trusts, deeds, or powers of attorney.
2 3. Introduce the Lichtenberg Financial Decision-making Scale 4. Provides a framework for assessing capacity in the field. II. Most Common Instrumentalities of Elder Financial Abuse: Wills, Trusts, Deeds, Powers of Attorney A. Investment Fraud- 1. Using the Howie test to determine if an offering is a security 2. What securities sections to use and how to use them 3. Suspicious Activity Reports (SARs) what they are and how to request and use them B. Money Laundering- 1. What are the elements of the crime i. What code sections apply? III. The White Collar Crime Enhancement- A. A big stick adds significant time, helps encourage a plea, consider asset forfeiture 1. Aggregate losses across counts and victims to reach the threshold B. Regulatory Agencies and How They Can Help You- 1. FINRA, California Dept. of Insurance, Dept. of Business Oversight, SEC 2. Search warrants, working with experts, and managing bank records IV. Scenarios The learner will apply skills gained during the morning s sessions by splitting into three small groups. Each group will spend 30 minutes discussing its topic and developing answers to each of the questions. Then the class will come back together, and each group will have 10 minutes to discuss its findings. This exercise is an interactive opportunity to practice developing creative solutions for challenging, real-world cases. A. Scenario 1 Potential investment fraud case 3. What other agencies and resources should you consider collaborating with? B. Scenario 2 Potential real estate fraud 3. What other agencies and resources should you consider collaborating with? C. Scenario 3 Potential conservator fraud 3. What is your theory of the theft/fraud/embezzlement? 4. What other agencies and resources should you consider collaborating with? D. Materials provided: 1. The Howie test for securities and securities fraud statutes
3 2. Money Laundering Statutes 3. Search warrant appendices for bank records, employment records, wills, trusts, and powers of attorney 4. DOJ form to request SARs 5. Lichtenberg screen Elder Physical Abuse, Neglect, and Sexual Abuse - V. Elder Abuse overview Physical, Neglect, Sexual Abuse A. Why are elders vulnerable to neglect, physical abuse, and sexual assault? 1. Decreased mental capacity means increased risk of abuse and neglect. 2. Disability means increased reliance on others for activities of daily living; increased reliance leads to increased risk of abuse and neglect. B. Who commits most elder abuse? 1. How does dementia affect vulnerability? 2. Co-occurrence of abuse C. Overview of PC368 neglect/physical abuse sections 1. Review CALJIC and CALCRIM jury instructions 2. Benefits of submitting cases for review rather than on-view arrests D. Physical Abuse 1. Bruising 2. 90% of elders with dementia can identify intentionally inflicted injuries. E. Bone Breaks 1. Pattern of breaks can indicate neglect. 2. Falls F. Financial context 1. What s the motive for abuse G. Neglect 1. Red Flags/Harbingers of Neglect Context is everything 2. Pressure sores 3. Malnutrition/dehydration i. Both prevent elders from healing wounds and fighting infection. 4. Bone breaks 5. Bruising H. The importance of the autopsy, blood testing, and your coroner s level of education on neglect 1. Test for albumen and pre-albumen, building blocks of protein 2. Call in an expert it s only neglect when a doctor says it s neglect VI. Sexual Abuse 1. Link between dependence and vulnerability to abuse 2. Use your SART teams, but consider involving a gerontologist or dementia expert to help you assess capacity and conduct 3. Challenges related to capacity VII. Forensic Interviewing of Elders with Dementia- A. How to increase reliability of statements 1. Steps of the forensic interview B. Aid in Dying requirements, red flags-
4 1. Strict procedure for acquiring the drugs. 2. Patient has to be able to self-administer the medications. C. The value of a multi-disciplinary approach - Agency Resources 1. APS 2. Public Guardian 3. County Counsel 4. Coroner s Office 5. Ombudsman 6. Legal Aid 7. DA s Office VIII. Scenarios The learner will apply skills gained during the afternoon s sessions by splitting into three small groups. Each group will spend 30 minutes discussing its topic and developing answers to the questions. Then the class will come back together, and each group will have 10 minutes to discuss its findings. This exercise is an interactive opportunity to practice developing creative solutions for challenging, real-world cases. A. Scenario One APS referral of an elder who has been repeatedly hospitalized with malnutrition, dehydration, and pressure sores. Family member caregivers have been trained on proper techniques for caring for the elder. 1. What section of 368 has been violated? 2. What elements do you need to meet to prove the elder is being neglected? 3. What evidence do you collect? 4. What documents do you need? 5. Who do you need to interview? 6. What outside help would you call on? B. Scenario 2 Coroner calls you to the scene of an elder death. The decedent is found emaciated, covered in his feces, with numerous sores. The caregiving family members say the victim refused to see the doctor, fought them when they tried to clean or change him, and they were simply respecting his wishes. 1. What section of 368 has been violated 2. What elements do you need to meet to prove the elder was neglected? 3. What evidence do you collect 4. What documents do you need? 5. Who do you need to interview? 6. What outside help would you call on? C. Scenario 3 An elderly female with severe dementia disclosed to her family that a male caregiver touched her inappropriately and had her perform sexual acts on him. 1. Does the victim s dementia preclude a criminal investigation or prosecution? 2. What section of 368 has been violated? 3. What elements do you need to meet to prove the elder is a victim? 4. What evidence do you collect?
5 5. What documents or records do you need? 6. Who do you need to interview? 7. What outside help would you call on? D. Materials provided 1. Bruising chart 2. Neglect checklist 3. Definitions of terms and jury instructions Facilities, Materials, Personnel Needed: Class time is from 0800-1700 hours Dry Erase Board Laptop Computer (PowerPoint Presentation) with HDMI Cable LCD Projector Handout Packets