Elder Abuse

IMPORTANT NOTE

MANDATORY REPORTING:  It’s important for you to know that there are certain people who are required to make a report to authorities whenever they believe or even suspect that someone might be a victim of elder abuse. They have to make this report even if you think your conversation with them is confidential, and even if you ask them not to make it. You should keep this in mind whenever you are talking to these people.

In Michigan, these people (called mandatory reporters) include[1]:

• A person who is employed, licensed, registered, or certified to provide health care, educational, social welfare, mental health, or other human services

• An employee of an agency licensed to provide health care, educational, social welfare, mental health, or other human services

• A nursing home administrator or nursing director

• A law enforcement officer

• An employee of the office of the county medical examiner

WHAT IS ELDER ABUSE?

Elder abuse is a general term that refers to many different types of harm inflicted on an older adult. Usually people think of abuse as elder abuse when an older adult is hurt by someone he or she knows and trusts, or when an older adult is targeted because of his or her age.

Among the different types of elder abuse are[2]:

• Physical abuse. This includes things like hitting, pushing, shoving, shaking, beating, burning, and using drugs and physical restraints in an inappropriate way.

• Sexual abuse. This includes unwanted touching, rape, sodomy, coerced nudity, sexually explicit photographing, and sexual contact with someone who can’t give consent.

• Emotional abuse. This includes verbal assaults, insults, threats, intimidation, humiliation, harassment, treating an older person like a baby, and isolating an older person.

• Neglect. This is when someone who has a legal obligation or responsibility to care for an older adult and provide him or her with life necessities refuses or fails to do so.

• Exploitation. This includes a variety of scams (you can read more about some common scams below), misusing or stealing an older adult’s money or possessions, coercing an older person into signing a document, cashing an older adult’s checks without permission, and forging an older adult’s signature.

Often when someone is a victim of one kind of abuse, he or she is also a victim of another kind of abuse.

In Michigan, there are state laws that make “vulnerable adult abuse” a crime, and someone can go to jail if they commit vulnerable adult abuse. In this criminal law context, there are very specific definitions of vulnerable adult abuse which may be different from the explanations of types of abuse included above.

SCAMS

There are many scams that often target older adults, among others. Here are some of the most common:

• Grandparent scams.[3] In these scams, someone will call or email you pretending to be one of your grandchildren in trouble, and asking you to immediately wire money and not tell any family members for fear of upsetting them. (This person may or may not know your grandchild’s name.) The person is usually crying so it is hard to recognize the voice.

• Lottery and sweepstakes scams.[4] In these scams, you will usually get a phone call or an email congratulating you on winning a lottery, drawing, or sweepstakes that usually you haven’t even entered. You will be asked to make an upfront payment (maybe to cover a processing fee or taxes), or to give your bank account information to collect your winnings. In some scams, you may get a letter with a “claim certificate” or “check” that looks real.

• Sweepstakes recovery scam.[5] In these scams, you may get another call from someone saying he or she is an attorney representing sweepstakes winners. This person will offer to collect your winnings for you if you give him or her an upfront fee, but really this person is affiliated with the original sweepstakes scammer.

• “Nigerian” email or phone scams.[6] In these scams, you get a letter, phone call, or email offering you a chance to share a percentage of millions of dollars that the person says he or she is transferring out of Nigeria or other countries. You will be asked to make an advance payment before receiving your “share.”

• Government money scams.[7] In these scams, you will get a call or letter that seems to be from a government agency. You will be told that if you give a credit card number or send a money order that you can apply for government help with housing, home repairs, utilities, or taxes.

• Fake “official” mail scams.[8] In these scams, you will get letters or emails that look like they are from legitimate banks, businesses, or agencies to try to get your personal information or bank account number.

• Cashier’s check scams.[9] There are a variety of scams that involve cashier’s checks. In these scams, for one reason or another you are given a fake cashier’s check which you think is legitimate. You deposit the cashier’s check and then send money to someone from your account, relying on the deposited cashier’s check. Because it takes a few days for cashier’s checks to clear, you won’t realize the check is fake until after the money you sent is gone.

• Telemarketing or charity scams.[10] In these scams, someone gets you to buy a worthless product or a product that doesn’t exist at all, donate to a bogus charity, or invest in something that doesn’t exist. The scam might require multiple phone calls and the development of a trusting relationship.

• Pigeon drop scams.[11] In these scams, someone you don’t know will offer to share a large sum of money with you that he or she recently found. This person will ask for “good faith” money from you and offer to go with you to the bank to withdraw money. He or she will then give you an envelope or bag with blank pieces of paper rather than money.

• Free lunch scams.[12] In these scams, you will be invited to a free lunch and seminar. There you will be pressured to give information about your money and to invest your money with the scammers. You will be offered “tips” or “guaranteed returns.”

• Sweetheart scams.[13] In these scams, someone will come into your life romantically to gain influence and financial control over you.

• Unsolicited work scams.[14] In these scams, someone will get you to pay a lot for services like roofing, paving, car body work, etc. Often the person will go with you to the bank to withdraw cash to pay for the work. Often you pay for the work in full, but the work is never started or is of such bad quality that you have to pay legitimate contractors to repair it. Sometimes only part of the work is done and the person insists that you must pay more money for the job to be finished, the person will break something to create more work, or the person will say that things need work when they don’t. What you should know:

  • Many states and local jurisdictions have laws regulating door-to-door sales.

• Foreclosure rescue scams.[15] In these scams, someone claims to be able to instantly stop your house from being foreclosed upon. Often this person will get you to deed your house to him or her and says you can rent your house until some date in the future when the property will be deeded back to you. In other versions of this scam, the person may offer you a loan, but the paperwork you sign deeds your house to the person. Your house will soon fall back into foreclosure, and you are evicted from your home.

• Reverse mortgage scams.[16] Reverse mortgages can be legitimate, but may also be associated with high fees and aggressive marketing. Just be aware of this possibility and review all documents associated with reverse mortgages carefully.

• Debt relief scams.[17] In these scams, companies promise to repair your bad credit report or renegotiate your debt. These companies ask for upfront fees for services that are often provided at little or no cost by the government. The companies may tell you to redirect payments to them, not your creditors. Then they either keep the payment entirely or charge really high fees as service charges.

• Veterans’ pension benefits filing scams.[18] These scams, which usually offer a free seminar, involve someone trying to convince veterans to transfer their assets to a trust or to invest in insurance products so they can qualify for Aid and Attendance benefits. What you should know:

  • Generally, an individual must be accredited by the Department of Veterans Affairs to assist a veteran in preparing and filing a claim.

  • Shifting your assets into certain types of investments in order to meet eligibility thresholds for VA pension benefits could make you ineligible for Medicaid for a period of time.

  • Some transfers of assets can disqualify you for Aid and Attendance benefits and require you to return any Aid and Attendance benefits already paid to you.

  • You may face problems with annuities since you may not have access to your funds, should you need them, without paying a costly surrender fee.

• Lump-sum payment for future benefits scams.[19] These scams target veterans who receive either monthly disability compensation or pension payments, and usually offer an up-front cash payment in return for several years of the veteran’s monthly benefit. These lump sum payment arrangements are very costly, often the equivalent of a 60 to 70 percent annual interest rate. What you should know:

  • Federal law prohibits assigning benefits to a third party, but many scammers – who usually identify themselves as corporate entities – get around this limitation by representing the lump sum as an advance.

  • Military benefits cannot be garnished by a creditor. Some lump-sum providers know this and may ask for additional collateral.

You can read about how to reduce your risk of becoming a victim of these scams below, at “How Can I Try to Prevent Becoming a Victim of Elder Abuse?”. You can read about what to do if you have become a victim of a scam at “What Should I Do If I’m Being Abused or I Have Recently Been Abused?”.

WHO ARE VICTIMS OF ELDER ABUSE?

Any older adult can be a victim of elder abuse, regardless of gender, financial status, physical and mental health status, etc. However, depending on your circumstances, you might be at a higher risk of elder abuse. You can read more about this under “How Can I Tell If I or Someone I Know May Be at Risk for Elder Abuse?” below.

WHO ARE PERPETRATORS OF ELDER ABUSE?

Anyone can be a perpetrator of elder abuse. Here are some examples of the types of people in some older adults’ lives who may engage in elder abuse:

• Strangers (this may be most common with certain forms of financial exploitation)

• Staff at nursing facilities or other long-term care facilities

• In-home caregivers

• Guardians

• Spouses

• Adult children

• Friends

• Neighbors

• Other residents in a long-term care facility

HOW CAN I TELL IF I OR SOMEONE I KNOW MAY BE AT RISK FOR ELDER ABUSE?

There are certain things that can increase your risk of suffering certain kinds of elder abuse.

In general, the following things increase your risk of suffering any kind of elder abuse:

• Isolation

• Loneliness

• Physical or mental frailties or disabilities, including cognitive impairment

• Dependence or reliance on others

• The loss of someone who supported you emotionally, physically, or financially

• Your own tendency to be verbally or physically aggressive[20]

• Having a caregiver who is unable to cope with stress, is depressed, lacks support from other potential caregivers, or perceives taking care of you as burdensome[21]

• Having a caregiver, family members, or friends who have substance use problems or mental health challenges[22]

In general, the following things increase your risk of suffering physical abuse:

• A history of violence or exploitation in your relationship with someone

• Ending your relationship with or leaving your abuser

• Getting help (because your abuser fears losing control)

• Living with your abuser

• Living with someone who has a medical condition that makes him or her be aggressive sometimes

In general, the following things increase your risk of suffering sexual abuse:

• Contact with a sexual offender

• Sexual threats or unwelcome comments

• Someone cultivating personal intimacy with you (“grooming” you for an inappropriate sexual relationship)

In general, the following things increase your risk of suffering neglect

• Not having enough help and support with everyday tasks and health care

• Having a caregiver who is overwhelmed and/or doesn’t have enough time to care for you properly

• Living in a nursing home, home for the aged, or adult foster care home that is understaffed

• Not speaking up when you don’t get what you need

• Speaking up so much that you’re labeled a “trouble maker”

In general, the following things increase your risk of suffering financial exploitation

• Being trusting and polite

• Lack of familiarity with or difficulty handling financial matters

• Lack of preparation for the potential loss of financial decisionmaking capacity

• Getting a lump-sum payout from a lawsuit or an insurance payment from a deceased relative

HOW CAN I TRY TO PREVENT BECOMING A VICTIM OF ELDER ABUSE?

General Prevention Strategies

While there is no way to guarantee that you won’t become a victim of elder abuse, there are some steps you can take to try to prevent becoming a victim of elder abuse.

Here are some strategies you can take to reduce your risk of being abused, neglected, or exploited by someone you know, like your caregiver(s), guardian(s), and others you interact with regularly:

• Stay connected to your community and other people. Social isolation increases your risk of becoming a victim of abuse, neglect, or exploitation.

• Ask family members and friends to check in and visit you often. You are less likely to be abused, neglected, or exploited if potential perpetrators fear being caught and if caregivers, guardians, and others you interact with often are held accountable.

• Develop positive relationships with your caregiver(s), guardian(s), and others you interact with often. You are less likely to be abused, neglected, or exploited if you have good relationships with the people providing your care, making decisions for you, and otherwise in a position to harm you.

• Make sure that anyone hired to help you in your home has been screened and had criminal background checks completed, and ask for certifications when appropriate.

• Choose a long-term care option (whether a nursing home, adult foster care home, home for the aged, assisted living facility, or some kind of home and community-based care) that seems to have a lower risk of abuse, neglect, and exploitation. You can read more about long-term care options under the Long-Term Care topic.

• Choose a long-term supports and services option that has the ability to meet your specific needs. If a facility or caregiver has little experience with your specific needs and conditions, there is a higher risk that you will be neglected or mistreated. You can read more about long-term supports and services options under the Long-Term Care topic.

• If you don’t think you need a guardian, try not to let the court appoint a guardian for you. Guardianship takes away your right to make some of the most basic and important decisions in your life. Unfortunately, guardians can also use their power under guardianship to abuse, neglect, or exploit you. Preventing the imposition of a guardianship when it is not necessary will therefore protect your rights and prevent a guardianship from being used to harm you.

• If you do need a guardian or the court will almost certainly appoint one, try to get the court to appoint the best possible guardian for you. You can help reduce your risk of abuse, neglect, or exploitation by trying to ensure that the person who is appointed as your guardian seems to have the lowest risk of harming you and will act in your best interests.

Financial Exploitation Prevention Strategies

In addition to the strategies discussed above under “General Prevention Strategies”, here are some more general strategies you can take to reduce your risk of being financially exploited[23]

• Execute a durable power of attorney. A durable power of attorney (DPOA) is a document that gives someone that you choose authority to handle your financial and other affairs. Once you execute a DPOA, it stays in effect if and when your capacity diminishes. A DPOA can be a powerful tool to avoid guardianship and ensure that your personal, medical and financial wishes are honored if and when you lose capacity. However, there is always a risk that the person you name as your agent under a DPOA can use his or her power to abuse or exploit the client, so you should only execute a DPOA if there is someone you really trust to serve as your agent.

• Appoint a representative payee (“rep payee”). This is a way to allow someone that you choose to receive your federal benefits (like Social Security or VA benefits), and it can make it easier to make sure your benefits are deposited and your bills paid. However, there is always a risk that your rep payee could abuse his or her authority and exploit you, so you should only appoint a rep payee if there is someone you really trust with this responsibility.

• Do NOT open a joint account. A joint account may be appealing because it can make it easy for someone else to help you with your finances, but it carries a high risk of exploitation because the other person on the account can empty the account and there may be nothing you can do if that happens. Fortunately, there are other, safer ways you can allow someone to help with your finances (like a durable power of attorney or a representative payee, which you can read more about above). If you want someone to be able to have the money in your account after you die, you can open a POD (“payable on death”) account, which has a lower risk of financial exploitation.

• Set up “direct deposit,” so your income is deposited automatically into your account. This eliminates the risk of someone stealing your check, and you also won’t have to worry about forgetting to deposit your income.

• Set up “automatic bill pay,” so that your bills are paid automatically and on-time. This way you won’t have to give anyone else access to your accounts just to pay your bills, which may increase your risk of financial exploitation, and you won’t have to worry about forgetting to pay your bills.

• Cancel an ATM card if you rarely use it.

• Keep your valuables and private financial documents (like checks, bank statements, and credit cards) in a safe and secure place.

• Do NOT sign blank checks and allow another person to fill in the amount.

• Ask your caregivers or other helpers for receipts for any purchases that they make for you.

• Monitor your bank accounts for anything that seems strange.

• Have your bank send copies of your statements to someone you trust, or ask someone you trust to review your financial documents. This person can help look out for anything strange that may be an indicator of financial exploitation.

• Set up transaction alerts that are monitored by a family member or other third party that you trust. This person can watch to see if any transactions in your account(s) are unusual or suspicious and may be indicators of financial exploitation.

• Put all financial instructions, arrangements, and transactions in writing and keep records of everything.

• Make sure to understand all provisions and terms of agreements, contracts, or other documents before you sign them.

• Do NOT give into pressure to make purchases, sign contracts, or commit funds. These decisions are yours alone and you should take your time making them.

• Ask someone you trust before acting on financial matters, agreements, contracts, products, etc. about which you are unsure.

• Get second opinions before making purchases or other decisions.

• Register for the National Do Not Call Registry and/or state no-call lists and credit marketing lists.

• More generally, you should keep your financial house in order. It is easier for someone to conduct financial fraud and harder to detect it if your finances are not in good order and your wishes are not clearly stated. You should keep up-to-date copies of:

• Advance directives (for example, powers of attorney, health care proxies, living wills)

• Wills

• Bank account numbers

• Safe deposit information

• Pension or retirement savings documents

• Insurance beneficiary information

• All insurance policies (for example, health, homeowners, and car insurance policies)

• Tax returns

• Birth, marriage and death certificates

In addition to many of the strategies discussed above, here are some more strategies you can take to reduce your risk of being financially exploited by a salesperson

• Get a salesperson’s name, business identity, telephone number, street address, mailing address, and business license number before transacting business.

• Pay by check, which can be traced.

• Beware of high fees.

• Be careful regarding anything that could put your house on the line (for example, reverse mortgages).

In addition to many of the strategies discussed above, here are some things you should be cautious about if you want to reduce your risk of being financially exploited

• Lending employees money or personal property.

• Promising money or assets to someone when you die in exchange for care provided now.

• Letting hired caregivers or helpers open your mail, pay your bills, or manage your finances. You should only allow them to do so if you trust them completely.

• Letting caregivers or others use your credit or debit cards to run errands or make purchases for you. You should only allow them to do so if you trust them completely.

• Family members or caregivers who might have a need for financial assistance or who have substance use issues.

Here is a financial health checklist that you can use to keep in mind some of the things that will reduce your risk of being financially exploited:

• Do not let anyone pressure you into signing a power of attorney or other documents

• Put all financial instructions, arrangements and transactions in writing

• Use a direct deposit service for checks you receive

• Keep valuables, checkbooks, credit card statements, and other personal information out of sight when strangers or anyone you do not trust completely visits your home

• If you give money to family members or friends to make payments or purchases for you, ask that person to provide you with a receipt when he or she makes the payment or purchase

• Never sign a blank check and allow another person to fill in the amount

• Cancel your ATM card if you do not use it

• Register with the National Do Not Call Registry

• Do not make purchases from unfamiliar companies

• Make payments by check so that the payment can be traced

• Do not share your passwords or personal numbers, such as your Social Security Number or ATM PIN

• Destroy all financial statements before throwing them away

• Do not let incoming mail sit in the mailbox for a long time

• When sending out sensitive mail, use a secure collection box or the post office

• If you think someone may have taken advantage of you financially, seek help as soon as possible. If you delay seeking help because of embarrassment or other reasons, it may be harder to get your money back or stop additional exploitation.

Strategies to Avoid Scams

You can read about different kinds of scams above, at “Scams,” under “What Is Elder Abuse?”.

In addition to many of the strategies discussed above, here are some things you can do to reduce your risk of being the victim of a scam[24]

• Learn to spot a scam, looking for things like:

• Pressure to sign up immediately

• Someone saying there will be dire consequences if you don’t buy what is being sold or do what is being requested

• Scare tactics

• Something that sounds too good to be true

• Sign paperwork and meet at a legitimate business, not in your home

• Be suspicious of any pressure to send funds via wire transfer or a pre-paid reloadable card

• Before offering help to a relative or friend, be sure to call family members or friends at a number you know to be valid to find out if the request is legitimate

• If a caller claims to be from an established organization such as a hospital or law enforcement agency, look up the number of the organization yourself before taking action

• Always ask for and wait to receive written material about any offer or charity

In addition to many of the strategies discussed above, here are some things you should NOT do if you want to reduce your risk of being the victim of a scam:[25]

• Never let anyone isolate or discourage you from seeking information, verification, support and advice from someone you trust before making any financial transaction.

• Do not let any door-to-door solicitors in your house and do not accept their offered “services” or products.

• Never give out personal identifying information (including your Social Security Number, credit card number, ATM PIN, or Medicare number) over the phone unless you initiated the phone call and know with whom you are speaking.

• Do not send anyone personal information to collect a prize or reward.

• Never “pay to play.” A legitimate sweepstakes will not ask for money upfront.

In addition to many of the strategies discussed above, here are some strategies to reduce your risk of becoming the victim of a pension benefits filing scam (which targets veterans)[26]

• Never pay a fee to anyone for preparing and filing your initial claim. (Although an attorney can charge a consulting fee for advising a veteran about the benefits for which he or she may be eligible, the clock stops running as soon as he or she indicates his or her intention to file.)

• Avoid attorneys or claims agents who try to market financial products, such as trusts and annuities, in connection with filing your VA claim.

• Find an accredited attorney, claims agent, or Veterans Service Organization (VSO) if you need help applying for VA benefits. To do so, see the Department of Veterans Affairs Accreditation Search, at http://www.va.gov/ogc/apps/accreditation/index.asp

In addition to many of the strategies discussed above, here are some strategies to reduce your risk of becoming the victim of a lump-sum payment for future benefits scam (which targets veterans)[27]

• Say no to arrangements that allow a creditor to access the account where you receive your benefits or that require you to sign over rights to your pension payments.

• Seek advice from a trusted financial expert if you need emergency funds.

In addition to many of the strategies discussed above, here are some strategies to reduce your risk of becoming the victim of an internet scam[28]

• Delete emails and text messages that ask you to confirm or provide personal information such as credit card and bank account numbers, Social Security numbers, passwords, etc. Legitimate companies never ask for this information via email or text.

• Do not open any message that comes from an unfamiliar source. Do not click on links or call telephone numbers provided in the message.

• Be cautious about opening attachments and downloading files from emails, regardless of who sent them. These files can contain viruses or other malware that can compromise your computer’s security.

• If you open a suspicious message, delete it.

• If you receive an email that looks like it is from a friend or relative asking you to send money, call to verify that the email really came from your friend or relative.

• Do not email financial information or account numbers. Email is not a secure method of transmitting personal information.

• If you are concerned about your account or need to reach an organization that you do business with, call the number on your financial statements, on the back of your credit card, or in the phone book, not the number that the caller or spoof website provides.

• Use trusted security software and make sure it is updated frequently.

• Use passwords that will be hard to guess. For example, use a mix of numbers, symbols, and letters instead of easily guessed words.

• Do not leave your computer on when you are not using it.

In addition to many of the strategies discussed above, here are some strategies to reduce your risk of becoming the victim of unsolicited work scams or contractor fraud[29]

• Avoid contractors who are working door-to-door or call you on the phone, come from out of state, and/or do not provide an address and telephone number, or refuse to show identification

• Ask to see identification for anyone representing him or herself as a government official.

• Call the government agency to verify the identity if there is any payment of money involved.

• Before you hire a contractor, get bids from several local, established contractors. Obtain at least three legible bids in writing and do not sign anything before carefully reading it.

• Before you hire a contractor, get several references from neighbors or other people you know, or from previous customers. If possible, visit them to see the work done.

• When considering a contractor, ask if he/she has the required licenses (you should note the license numbers) and is bonded. Check with your state licensing agency’s website or hotline to make sure the licenses are valid. Ask the licensing agencies if the contractor has a history of complaints.

• Require the contractor you choose to provide you with a contract that contains clearly written payment terms.

• Do not pay in advance.

• Never pay with cash.

• If you need to borrow money to pay for repairs, do not let the contractor steer you toward a particular lender.

• If a contractor shows up at your door and pressures you to go to the bank with him to get cash to pay for a job you do not want done, ask to speak with the branch manager. The manager can call the police for you, who can show up at the branch. Being in a public place with video cameras and witnesses should reduce your risk of harm.

• Do not make a final payment until you are satisfied with the job, all debris is removed from your property, and any necessary building inspections have been completed.

Strategies to Prevent Identity Theft

In addition to many of the strategies discussed above, here are some things you can do to reduce your risk of identity theft[30]

• Protect your Social Security Number, credit and debit card numbers, PINs, passwords, and other personal information.

• Protect incoming and outgoing mail. Do not let incoming mail sit in your mailbox for a long time, and use a secure collection box or the post office to send any mail with sensitive information.

• Destroy all documents containing personal or financial information before throwing them away.

• Have your income directly deposited in your account.

• Keep a close watch on bank account statements and credit card bills.

• Review your credit report annually and report fraudulent activity.

WHAT ARE SOME SIGNS THAT I OR SOMEONE I KNOW MIGHT BE OR HAVE BEEN A VICTIM OF ELDER ABUSE?

In general, the following things could be signs of any kind of elder abuse:

• Signs or the presence of another kind of abuse (because often when someone is a victim of one kind of abuse, he or she is also a victim of another kind of abuse)

• Sudden changes in behavior or routines, without explanation

• Providing inconsistent explanations for mistreatment

• Being afraid to speak in the presence of the suspected abuser

• Deferring to the suspected abuser to answer questions, converse with others

• Seeming hesitant to talk or seek help

• Denying, minimizing, or blaming oneself for mistreatment

• A pattern of missed appointments

• A deterioration or significant change in health condition or cognitive functioning

• Signs that the older adult is not taking prescribed drugs

• Improper administration of medication

• Absence of necessary medical equipment

• Seeming fearful, embarrassed, ashamed, humiliated, withdrawn, or depressed

• Seeming timid or confused

• Someone using assumed characteristics of old age to discredit the older adult (ageism)

• Behavior by a suspected abuser that leads the older adult to doubt his or her own perceptions (“Crazy-making” or “gaslighting”)

In addition to the general signs listed above, here are some signs of physical abuse:

• Bruises, lacerations, welts, or burns

• Bone fractures or sprains

• Dislocations (which can be caused by yanking)

• Medication overdose

• A pattern of repeated or unexplained injuries

• Injuries in various degrees of healing

• Repeated, unexplained, or untreated injuries

• Injuries in locations not usually associated with accidents (like inside of legs, inside mouth, bottom of feet, etc.)

• Frequently changing doctors or hospitals

• Saying things like “she doesn’t know her own strength” or “my son has a temper”

• Threats by a suspected abuser

• Deliberate isolation of the older adult (like preventing visitors, canceling engagements, etc.)

• The suspected abuser’s ridicule of the older adult’s personal and cultural values

• Inappropriate (“enmeshed”) relationship between the older adult and the suspected abuser

In addition to the general signs listed above, here are some signs of sexual abuse:

• Pain or bleeding in genital areas

• Genital infections, especially if unexplained

• Difficulty walking or sitting

• Inappropriate sexual or “enmeshed” relationship between the older adult and a suspected abuser

• Bruises to the older adult’s outer arms, chest, mouth, genitals, abdomen, pelvis, or inside thighs

• Bite marks

• Torn, stained, and/or bloody clothing and/or bedding

• Statements like “She/He makes me do bad things” or “I don’t like it when (s)he visits”

• Threats by a suspected abuser

• Deliberate isolation of the older adult (like preventing visitors, canceling engagements, etc.)

• The suspected abuser’s ridicule of the older adult’s personal and cultural values

In addition to the general signs listed above, here are some signs of neglect:

• Malnutrition

• Sudden weight loss

• Dehydration

• Poor hygiene

• Bedsores

• Inappropriate or inadequate clothing

• Unsafe or unsanitary living conditions (like bugs, soiled bedding, no heat or running water, fire hazards)[31]

In addition to the general signs listed above, here are some signs of exploitation:

Things You Might See in Financial Documents

• Financial activity that is unusual or inconsistent with the older adult’s financial history

• VSignificant, unexplained withdrawals, including unusual ATM withdrawals

• Attempts to wire large sums of money

• Frequent transfers between accounts

• Opening or closing accounts

• Newly authorized signers on accounts

• Account use or activity shortly after the addition of a newly authorized signer

• Insufficient funds when there should be enough money in the older adult’s account to cover his or her needs

• A sudden flurry of bounced checks and/or overdraft fees

• Unpaid bills

• Payments to someone the older adult and/or the older adult’s family members do not know

• Recent and/or abrupt changes to legal documents

Things You Might See in Other Documents

• The execution of or changes to legal documents, such as a power of attorney, especially if the older adult does not understand or did not authorize the action(s)

• Altered documents

• Forged or suspicious signatures

• Documents signed under duress

• Collection notices

• Notices of eviction or utility shutoff

Things You Might See in An Older Adult’s Behavior

• The older adult is confused or anxious about his or her financial status, transactions, and arrangements

• A sudden reluctance to discuss financial matters

• Implausible explanations given by the older adult about his or her finances

• The older adult seems fearful or wary of a caregiver

• Changes in the older adult’s behavior, including indications of fear, shame, or humiliation

• The older adult seems hesitant to talk or seek help or seems timid or confused

• The older adult becomes reclusive, fails to participate in activities he or she regularly engaged in previously, or appears hesitant or embarrassed to be involved in activities

• The older adult seems unusually forgetful or changes his or her mind frequently

• A deterioration or significant change in health condition or cognitive functioning

• Untreated medical conditions

• Unusual or unnecessary purchases

• New or unusual gifts or transfers of money to family or others, such as a “new best friend”

Things You Might See in An Older Adult’s Relationships

• New “best friends”

• The older adult limits contact with people with whom he or she has an existing relationship and invests time and attention in new associations with other “friends” or strangers

• The older adult becomes very connected to a much younger person or a person whose sudden and intense relationship with the older adult seems surprising, unusual, or suspicious

• The older adult associates with people with unusual behavior, those who appear to control the older adult’s actions, those who exhibit an odd or extreme level of care, concern, or knowledge about the older adult, or those who actively try to isolate the older adult

• The sudden appearance of previously uninvolved relatives claiming their rights to an older adult’s affairs and possessions

Things You Might See in The Behavior of Other People

• A caregiver, family member, or friend expresses excessive interest in the amount of money the older adult is spending or the amount of money being spent on the older adult

• Implausible explanations given by a “friend,” family member, or caregiver about the older adult’s finances

• A caregiver seems to be getting paid too much or too often

• A new caregiver, relative, or friend suddenly begins conducting financial transactions on behalf of the older adult without proper documentation

• A caregiver, family member, or friend will not allow others access to the older adult, does not let the older adult speak for him- or herself, or seems to be controlling the older adult’s decisions or activities

• A caregiver or fiduciary refuses to use funds for necessary care and treatment of the older adult

• The older adult has been threatened with harm, neglect, or abandonment if he or she does not agree to financial arrangements presented by others

• Threats to place the older adult in a long-term care facility unless the older adult gives control of his or her finances to others or agrees to financial arrangements presented by others

• Food or medication that seems to have been manipulated or withheld so the older adult becomes weak and compliant

Other Miscellaneous Things You Might See

• Belongings, property, or money are missing

• Bank statements, bills, or other financial documents no longer come to the older adult’s home

• Absence of documentation about financial arrangements

• Missed appointments

WHAT SHOULD I DO IF I'M BEING ABUSED OR I HAVE RECENTLY BEEN ABUSED?

If you are being abused or have been abused, there are many things you can do to respond to, escape, or otherwise address the abuse.

You should think carefully about how each of these options will affect your safety and quality of life. Depending on your specific situation, some of the options discussed here may be more appropriate than others. You can also consider doing more than one of the things listed here at the same time.

General Responses and Remedies

Here are some general things you can consider doing if you are being or have been abused:

• Document problems and incidents so there is a record of what happened.

• Keep documents and other evidence of the abuse, neglect, or exploitation in a safe place.

• Talk with the person who is or has abused, neglected, or exploited you to try to solve the problem informally.

• If the abuser is someone who visits you…

  • Ask a family member, your caregiver, or someone else you trust to be there whenever the abuser visits you.

  • Don’t allow the abuser into your home or room.

  • Ask your facility, caregiver, neighbors, etc. not to let the abuser into your home or room.

• Get a restraining order against the abuser.

• Report the abuse to law enforcement and/or Adult Protective Services.

• Get help from others, including:

  • Your trustworthy family, friends, neighbors, etc.

    • For example, they may be able to help you figure out what has happened, help you contact and communicate with other people, help you assess risks and/or consequences, help you take actions to stop the abuse, and help you take actions to prevent future abuse.

  • Your trustworthy caregivers, staff at the place where you live, guardians, supports coordinators, care managers, social workers, doctors, etc.

• Do nothing. You don’t have to do anything about abuse you have or are suffering if you don’t want to.

• The State or Local Long Term Care Ombudsman, if you live in a nursing home, home for the aged, adult foster care home, or some other long term care facility. Your Ombudsman can be reached toll-free at 1-866-485-9393.

• Your local Area Agency on Aging (AAA) - You can find contact information for your local AAA here: https://www.michigan.gov/osa/1,4635,7-234-64081-295815--,00.html

• A lawyer

  • You may be able to find a lawyer who represents low-income people in your community for no charge. See Michigan Legal Help’s Find A Lawyer tool: http://michiganlegalhelp.org/organizations-courts/find-lawyer.

• Michigan Protection and Advocacy Service

• Law enforcement

  • This includes 911 if you are in immediate danger, the police, the sheriff, the local prosecutor, and the Michigan Attorney General.

• Adult Protective Services (APS) - Call toll-free 1-855-444-3911 any time day or night.

  • Note that APS workers are required to take certain actions if they find that you are the victim of abuse, even if you would prefer that they not do so.

• State agencies, including:

  • The Michigan Department of Licensing and Regulatory Affairs (LARA)

    • LARA’s Long Term Care Division certifies and regulates nursing homes

      • You can find contact information at: http://www.michigan.gov/lara/0,4601,7-154-35299_63294_63384---,00.html

  • LARA's Adult Foster Care and Homes for the Aged Licensing Division licenses and regulates adult foster care homes and homes for the aged

    • You can find contact information at: https://www.michigan.gov/lara/0,4601,7-154-89334_63294_27717---,00.html

  • Michigan Attorney General

    • You can report some forms of financial exploitation to the Michigan Attorney General’s Office

    • You can find more information about making a complaint to the Attorney General at: https://www.michigan.gov/ag/0,4534,7-359-82917_92157---,00.html

• Federal agencies such as the Consumer Financial Protection Bureau (CFPB), Federal Bureau of Investigation (FBI), Federal Trade Commission (FTC), or United States Postal Inspection Service (USPIS), if you have been scammed by someone in another state or country

• The local Senior Medicare Patrol at MMAP (800-803-7174), if health care fraud has occurred

Responses to and Remedies for Abuse in Long-Term Care Facilities

In addition to the general responses and remedies discussed above, here are some more options you can consider if you have suffered abuse, neglect, or exploitation in a nursing home, home for the aged, adult foster care home, or some other assisted living facility

• Talk with the facility’s administration about the abuse and try to remedy it informally. For example:

  • If you are being abused by a staff member…

    • Ask that he or she be assigned to another floor and allowed to have no more contact with you.

  • If you are being abused by another resident…

    • Ask that the facility take steps to shield you from the abuser, for example by allowing you to lock your door or moving you to a different area of the facility.

    • Ask if the abuser’s care plan may need to be adjusted to solve any underlying problems that may be the cause of the abuse or exploitation.

    • Ask that the abuser be moved to a different floor or area of the facility.

  • If you are being abused by a family member or other visitor…

    • Ask the facility not to let the abuser visit you.

    • Ask the facility for closely supervised visits with the abuser.

    • Ask the facility to help mediate between you and the abusive visitor.

• File a complaint or grievance with the facility. You can read more about this under the Long-Term Care Topic, under “What Do I Do If I Have a Problem With My Long-Term Care Provider?”.

• File a complaint with the state regulatory agency. You can read more about this under the Long-Term Care Topic, under “What Do I Do If I Have a Problem With My Long-Term Care Provider?”.

• Bring a civil action against the facility and/or abuser. A lawyer at your local legal services organization may be able to help you with this.

• Leave the facility and move to another facility or choose a different long-term care option such as home and community based services.

• Contact your local long-term care ombudsman, who can help with many of the above options. Long-term care ombudsmen are advocates for residents of long-term care facilities and help them deal with any problems that arise in those facilities. (Note that while ombudsmen don’t usually make regular visits to unlicensed assisted living facilities, they can work with you to resolve problems that occur in these facilities.)

Responses to and Remedies for Abuse By In-Home Caregivers

In addition to the general responses and remedies discussed above, here are some more options you can consider if you have suffered abuse, neglect, or exploitation by someone who is caring for you in your home:

• Talk with your caregiver about the abuse and try to remedy it informally. For example:

• Ask your supports coordinator or care manager to work with you to remedy the abuse.

• If your caregiver is a family member or someone you hired…

  • Hire a different caregiver.

  • See if a different family member can provide care.

  • Choose professional caregivers to provide your care through a caregiving agency.

• If your caregiver works for an agency…

  • Request that the agency assign you a different caregiver.

  • File a complaint or grievance with the agency, if it has a process for you to do so.

  • Choose a different agency to provide your care.

  • Hire your own caregiver through self-determination. You can read more about self-direction in the Long-Term Care Topic, under “What Is the MI Choice Waiver Program All About?”.

• File a complaint with the state regulatory agency.

• Bring a civil action against the caregiver and/or agency. A lawyer at your local legal services organization may be able to help you with this.

• Choose a different long-term care option, such as a different caregiver, a different caregiving agency, a different waiver agency, a home for the aged, an adult foster care home, or a nursing facility.

Responses to and Remedies for Abuse in Guardianship

In addition to the general responses and remedies discussed above, here are some more options you can consider if you have suffered abuse, neglect, or exploitation and you have a guardian:

• Talk to and work with your guardian to stop and/or address the abuse. (This may be more appropriate if you are being abused by someone other than your guardian.)

• Ask the court to appoint a court visitor or a court investigator to look into the guardianship and any abuse that is occurring and swiftly take appropriate action. A lawyer at your local legal services organization may be able to help you with this.

• Petition to modify the guardianship to have a different guardian appointed. A lawyer at your local legal services organization may be able to help you with this.

• Petition to terminate the guardianship if a guardianship is no longer necessary. A lawyer at your local legal services organization may be able to help you with this.

Responses to and Remedies for Financial Exploitation

In addition to the general responses and remedies discussed above, here are some more options you can consider if you have suffered exploitation:

Strategies to Determine the Extent of the Financial Exploitation and Risk of Future Exploitation

• For example, you may want to:

  • Review your bills, credit card statements, and bank statements to look for unusual transactions and other indicators of exploitation.

  • Review your credit reports

  • Check for property transfers. A lawyer at your local legal services organization may be able to help you with this.

  • File an action for an accounting if there is a concern that your power of attorney or guardian is mishandling his or her responsibilities. A lawyer at your local legal services organization may be able to help you with this.

  • Consider whether you have:

    • Signed a power of attorney naming someone who might be exploiting you.

    • A joint checking account with someone who might be exploiting you.

    • Provided financial information or access to information or assets to a possible exploiter.

    • Allowed a possible exploiter to use your credit or ATM card

    • Taken other action that is likely to have put you in jeopardy.

  • Be alert for communications from creditors or collection agencies or anything else that seems unusual.

Options to Stop the Financial Exploitation and Prevent Its Recurrence

• Remove guardians or attorneys in fact under powers of attorney who are exploiting your and/or not fulfilling their obligations or duties.

• File a motion for a temporary restraining order (TRO) or a protective order. A lawyer at your local legal services organization may be able to help you with this.

  • These orders can be obtained quickly when there is an urgent situation.

• Call your banks, credit card companies, other financial institutions, and/or other creditors to report and try to resolve problems.

• Freeze your assets.

• Reset passwords or PINs.

• Cancel any debit or credit cards linked to a compromised account.

• Contact fraud departments at the three major credit reporting companies (Equifax, Experian, and Transunion). Request that they flag your file with an initial fraud alert, including a statement that creditors should get your permission before opening any new accounts in your name.

• Place an extended fraud alert or security freeze on your credit report to limit circumstances under which a credit reporting company may release your credit report.

• Create an identity theft report.

Options to Recover Lost Property or Funds and/or Get Compensation

Depending on your situation, some or all of the following options may be available to you. Many of these options may be difficult for you to pursue without a lawyer, but a lawyer at your local legal services organization may be able to help you with them.

• File a motion with the court to change or undo a transaction on the basis of incapacity, undue influence, fraud, deception, or misrepresentation.

  • However, consider whether claiming incapacity or undue influence will lead APS, a family member, or someone else to file a petition for guardianship because they believe that you are no longer able to manage your own affairs.

• File a civil claim against the person who exploited you to recover your assets or undo transactions.

  • However, consider whether the perpetrator is likely to have enough assets to pay any damage award that you manage to win, and whether you feel physically, mentally, and emotionally prepared for litigation.

• Use any federal or state consumer protection laws that apply to your situation.

• File a civil suit against businesses, organizations, banks, or other institutions if they failed to prevent the financial exploitation or made it possible.

• Enforce restitution orders.

  • If the person who exploited you was prosecuted and required to pay you back as part of his or her sentence (this is called “restitution”), you will have to have this order enforced to actually receive restitution.

• Check to see if a government entity (for example, the Michigan Attorney General) has taken any action against the person who exploited you and if there is an opportunity for you to file a claim to get back what you lost.

• If there is a criminal case by the prosecutor related to the exploitation that you suffered, find out if there is any fund for victims of crimes that might be available to compensate you.

Address Collateral Consequences of Financial Exploitation

• Depending on your situation, you may be forced to consider:

  • Preventing eviction, foreclosure, or other loss of shelter.

  • Preventing utility shutoff.

  • If the financial exploitation or a response to it results in the loss of a caregiver, finding alternative, trustworthy caregivers.

  • Making sure your healthcare needs are met, since exploitation and abuse often have a negative effect on victims’ health.

  • If you have lost much of your assets due to the exploitation, establishing a financial plan.

  • Repairing your credit

  • Dealing with the consequences of identity theft, including:

    • Handling issues with government-issued identification and/or Social Security Numbers

    • Handling issues with utilities

    • Dealing with debt collectors

    • Clearing the client’s name of criminal charges

    • Dealing with bankruptcy filed in the client’s name

    • Addressing mail theft

• Some resources that may be available to assist you with the above actions include:

  • Additional government benefits given a change in your economic status.

  • Programs that can help you get goods and services that you can no longer afford to purchase.

  • Emergency funds that are available to remedy problems associated with financial exploitation. For example:

    • If you have been evicted from your home as a result of financial exploitation, you may be able to get help with security deposits or moving.

  • Resources or services to help you with financial planning.

Prevent a Future Occurrence of Financial Exploitation or Other Harm

• Get credit counseling.

• Execute a durable power of attorney or designate a representative payee if there is someone you trust completely to act on your behalf.

  • A durable power of attorney is a document in which you give someone authority to handle your financial and other affairs. You must execute a durable power of attorney while you still have capacity, and then it will stay in effect even after your capacity diminishes. A durable power of attorney can be a powerful tool to avoid guardianship and ensure that your personal, medical and financial wishes are honored after you lose capacity.

  • A representative payee (sometimes called a rep payee) is someone that you allow to receive your federal benefits (like Social Security or VA benefits). This is an easy way for someone to get your benefits each month and then use the money to pay your bills and expenses.

  • If you were exploited because you are having trouble handling your finances, you may be less likely to be exploited in the future if you appoint someone trustworthy to have authority over your finances.

  • Also, appointing a trustworthy agent under a durable power of attorney will ensure that there is someone to make financial decisions for you in the event of any future incapacity.

  • It is important that you only appoint an agent or representative if you trust the person completely, because a power of attorney or representative payee arrangement will make it easier for the agent to exploit you.

• Separate your assets if they are commingled with the assets of someone who financially exploited you.

  • However, consider the possibility that separating assets may strain your relationships or lead to some form of retaliation by the person who exploited you.

• Get help if you are at risk of or are experiencing some other form of abuse or neglect.

  • Remember that often when someone is a victim of one kind of abuse, he or she is also a victim of another kind of abuse.

RESOURCES

For resources relevant to abuse in long-term care or guardianship, see the topics on Long-Term Care and Guardianship.

General Resources

• Elder Abuse. Office for Victims of Crime Training and Technical Assistance Center.
• Abuse of the elderly. World Health Organization.
• Abuse in Later Life Wheel. National Clearinghouse on Abuse in Later Life (NCALL).
• Elder Abuse Risk Factors Podcast,Part 1 and Part 2. G. Anetzberger and C. Dayton.
• Screening for Adult Abuse and Neglect: Suggestions for Health Professionals. Center of Excellence on Elder Abuse & Neglect, University of California, Irvine School of Medicine.
• Michigan. Office for Victims of Crime.
• Elder Abuse Resource Guide. National Center for State Courts.

Financial Exploitation

General Financial Exploitation Resources

• Money Smart for Older Adults. Consumer Financial Protection Bureau and Federal Deposit Insurance Corporation (FDIC).
• Taking Action: An Advocate’s Guide to Assisting Victims of Financial Fraud. The National Center for Victims of Crime, SaveAndInvest.org, and FINRA.
• COMMENTS to the Consumer Financial Protection Bureau. National Consumer Law Center.
• No Higher Calling — Representing Victims of Financial Exploitation. Denis Culley, Jaye Martin, BiFocal, Volume: 34 Issue: 5.
• Managing Someone Else’s Money. Consumer Financial Protection Bureau.
• Lost or Stolen Credit, ATM, and Debit Cards. Federal Trade Commission.
• Protecting Your Mother from Financial Fraud and Abuse. Women’s Institute for a Secure Retirement and the Center for American Nurses.
• Protecting the Elderly and Vulnerable from Financial Fraud and Exploitation. BITS.
• What You Should Know About Your Credit Report: Fact Sheet. National Consumer Law Center.
• Order Credit Reports. Federal Trade Commission.
• Place a Fraud Alert. Federal Trade Commission.
• Extended Fraud Alerts and Credit Freezes. Federal Trade Commission.
• Advisory to Financial Institutions on Filing Suspicious Activity Reports Regarding Elder Financial Exploitation. Financial Crimes Enforcement Network.
• The Role of Undue Influence in Elder Abuse. National Consumer Law Center.
• Undue Influence: The Criminal Justice Response. Bonnie Brandl, M.S.W., Candace Heisler, J.D., Lori Stiegel, J.D.
• Assessment of Older Adults with Diminished Capacity: A Handbook for Lawyers. American Bar Association Commission on Law and Aging and the American Psychological Association. See especially “Legal Standards of Diminished Capacity” (p. 5-8).
• Assessment of Older Adults with Diminished Capacity: A Handbook for Psychologists. American Bar Association Commission on Law and Aging and the American Psychological Association. See especially “Standards of Capacity for Specific Legal Transactions” (p. 16-20).
• Psychological Aspects of Undue Influence. Ira Daniel Turkat.
• Nursing Home Abuse Support Hotline.

Resources Specific to Scams

• Top 8 Ways to Protect Yourself from Scams. National Council on Aging.
• 22 Tips for Avoiding Scams & Swindles. National Council on Aging.
• Home Improvement Scams Alert. National Consumer Law Center.
• Veterans’ Pensions: Protect Your Money From Poachers. Federal Trade Commission.
• Avoiding Living Trust Scams: A Quick Guide for Advocates. National Consumer Law Center.

Resources Related to Collateral Consequences of Financial Exploitation

• Steps That Advocates Can Take to Help Prevent Foreclosure. National Consumer Law Center.
• What to do when Utility Service is Disconnected? National Consumer Law Center.
• DEALING WITH UTILITY COMPANIES: Disputes, Making Payments Affordable, Bills, Deposits, and Service Shut-Offs. National Consumer Law Center.
• How to Help Older Americans Avoid Loss of Utility Service. National Consumer Law Center.

Identity Theft Resources

• Protect Yourself from Identity Theft. National Consumer Law Center.
• Taking Charge: What to Do If Your Identity is Stolen. Federal Trade Commission (FTC).
• Immediate Steps to Repair Identity Theft. Federal Trade Commission.
• Create an Identity Theft Report. Federal Trade Commission.
• Do You Need a New Social Security Number? Federal Trade Commission.

Domestic Violence and Sexual Assault

• Special Collection: Preventing and Responding to Domestic & Sexual Violence in Later Life. National Online Resource Center on Violence Against Women.
• Sexual Violence in Later Life: A Technical Assistance Guide for Advocates. Holly Ramsey-Klawsnik, PhD, National Sexual Violence Resource Center.
• The National Domestic Violence Hotline.
• National Sexual Assault Hotline. Rape, Abuse & Incest National Network.
• National Sexual Violence Resource Center.
• Stalking Resource Center.