Financial exploitation of seniors is a growing problem and often goes unreported. Many seniors are embarrassed to report scams or exploitation and fear losing independence if they admit they have been victimized. All too often, family members are the exploiters (Florida elder exploitation statistics indicate about 27% of cases were committed by a son or daughter.)

Some common Florida elderly scams and abuses include:

• Durable Power of Attorney Misuse
• Identity Theft
• Imposter Fraud
• Moving Scams
• Investment Fraud
• Annuity Fraud
• Home Repair Scams
• Charity Fraud
• Telemarketing or sweepstakes Fraud

Some examples of scams that are frequently targeted to elderly individuals living at home alone include: excessive or unnecessary home repair work or devices (water softeners for example) or work paid for but not completed; sweepstakes and lottery scams; “fishing” for personal information over the phone or email for identity theft purposes; distraction techniques (coming in to the home for a stated purpose and stealing items while the person is distracted).

Reducing social isolation and having trusted parties checking in on someone as they age can help reduce the likelihood of being a victim of a scam, or assist in quickly identifying concerns and stopping any ongoing fraud.

Resources for elder exploitation:

Safeguard Our Seniors http://www.flseniors.net/
National Center on Elder Abuse http://www.ncea.aoa.gov
Florida Abuse Hotline: 1-800-96ABUSE
Florida Elder Help Line: 1-800-96ELDER

Additional senior safety tips:

• Elders should talk with legal and financial advisors about how to prepare for aging and possible incapacity-what legal documents are needed, how to set up financial accounts and especially share any concerns about family members or family conflicts to be taken in to consideration when planning.
• Open conversations about wishes, paying for care, priorities and beliefs help families to better handle their loved one’s needs and possibly to be more aware of changes in patterns. A neutral party may help in facilitating these conversations.
• Families at a distance should consider having a trusted party(ies) to check in on a loved one who lives alone. A geriatric care manager can visit to provide some oversight and help to pick up on any changes that might be cause for concern.
• Always check out any parties hired to do work for an elder. It is best to use reputable companies/licensed agencies or providers. You can at least check to ensure it is a legitimate business and does not have a history of complaints. Talk to your loved one about some of the common scams and remind them that they should not hire unknown parties or let individuals in to the home.
• For in-home care in Florida, use a licensed home care agency which must adhere to state-required rules and standards. If your loved one has private caregivers, see our handout Caregiver Concerns to learn more and be aware of signs that might be red flags.
• Professional advisors can help families by being aware of major changes or red flags. In discussing future planning, discuss procedures and options if the professional has concerns and seek to open communications between family members. Help clients with alternatives and protective measures when family conflict exists or there is a concern raised about a particular family member. Be aware of mandatory reporting statutes and report possible abuse to the state hotline.

We’re here to help if you have concerns or questions about help for elderly loved ones in Florida. Contact Aging Wisely for elder advice, geriatric care management assessments, family caregiver consultations.

In our previous post honoring World Elder Abuse Awareness Day, we covered some of the factors in elder abuse, neglect and exploitation.

The issue of abuse and exploitation is too often hidden. Many seniors are reluctant to report abuse for reasons of fear and intimidation and especially fears that reporting abuse may result in worse consequences such as being removed from home or prosecution of a family member. Exploitation cases tend to be hampered by embarrassment and fears that others will think the senior is no longer capable. These are not easy issues to overcome, but the more support and interaction an elderly person has, the less likely abuses are to occur or at minimum, are more likely to be uncovered (more quickly).

Here are some considerations for protecting your elderly loved ones or clients:

• Reduce isolation. Visitors and a variety of people checking in can reduce risk. Scammers may be less likely to prey on someone when they see others involved or hear from the person that friends and family regularly visit and have open discussions. If you live at a distance, consider having a geriatric care manager check in who can be your “eyes and ears” and has the professional training to spot potential concerns.

• Try to start an open dialogue early…about issues of care, preferences and financial issues. An open dialogue will make it more likely your loved one will share changes or concerns with you. It is so much better to get the call, “Someone came over today and I signed something I am not feeling comfortable about now” than to find out months or years later or never about a long pattern of exploitation.

• Watch for patterns and changes. As a family member or professional working with a client, something may be amiss when the person wants to change long-held patterns (i.e. drastic changes to estate plans, cutting off communications with family members, no longer participating in any activities).

• Talk to professional advisors about potential family concerns and conflicts. Your parent’s estate planning attorney and financial advisor should know about family conflicts, if your loved one is willing to disclose that or allow you to share information. The more information given to professional advisors, the better they can prepare a plan that is most appropriate. Consider a consultation with a geriatric care manager also to discuss concerns and potential preventative measures. A family mediator can specifically help families talk through conflicts and reach compromises as well.

• Services and supports can help improve quality of life, but also reduce isolation and risk. In-home caregivers can visit with loved ones; meals on wheels volunteers not only bring nutrition to your loved one but a friendly visitor who checks in; getting out to senior nutrition programs, adult day care, senior center programs or escorted activities reduces your loved one’s time at home alone where he/she is particularly vulnerable to scammers. Healthy interaction with others may help a senior to be more comfortable confiding concerns.

• Be aware of major changes in relationships with family members and keep connected even if you are the loved one at a distance. Has your cousin become unemployed and moved in to help out with Mom? That may be a wonderful solution and he could help to be your eyes and ears, but it is important to retain your relationship and call and visit as you are able. If you have a vague feeling of concern (whether about a family member or professional caregiver), do not underestimate your gut. Keep a closer eye on things or consider bringing in a care manager to help monitor the situation (the care manager can offer ways to do so while not offending the person about whom you have concerns).

Contact us at 727-447-5845 for help with any eldercare concerns, advice and monitoring for family caregivers at a distance.

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The International Network for the Prevention of Elder Abuse (INPEA) was founded in 1997 and since 2002, the United Nations International Action Plan has focused on elder abuse among the broader framework of human rights. This led to the creation of World Elder Abuse Awareness Day in 2006, designated each year on June 15th. The theme is “My World…Your World… Our World – Free of Elder Abuse”. This is an important day to bring awareness to abuses against the elderly, and you can honor it by wearing purple and helping to spread the word about elder abuse and prevention.

The INPEA offers a message and some important information about elderly abuse:

• Most elder abuse is hidden.
• Ageism (age discrimination) is a major cause of elder abuse.
• Ageism and disempowerment lead to elder abuse being hidden.
• Empowering older persons is the most effective tool in the response to elder abuse.

Elder abuse comes in all forms: physical abuse, verbal abuse and coercion/harassment, neglect and isolation. Abusers can be spouses, adult children, other family members, caregivers in the home or in a care facility, professionals (attorneys, financial advisors, guardians, etc.) or strangers.

Because elder abuse is so hidden and often unreported, statistics are probably not accurate but studies suggest between 4-6% of elders have experienced abuse in the home. In a U.S. study, 36 % of nursing-home staff reported having witnessed at least one incident of physical abuse of an elderly patient in the previous year, 10% admitted having committed at least one act of physical abuse themselves, and 40% said that they had psychologically abused patients. There is also a great deal of (and often unreported) exploitation of seniors, particularly financial.

In Florida elderly exploitation cases, a son or daughter is the most likely exploiter (about 27%), followed by another relative (13%), an institution employee (10.5%), with smaller percentage of cases where a neighbor or friend or sibling did the exploiting.

A number of situations appear to put seniors at risk. In some cases, strained family relationships may worsen as a result of caregiving stress as the older person becomes more dependent. In others, a caregiver’s dependence on an older person for accommodation or financial support may be a source of conflict and may increase the chances of exploitation. Social isolation is a significant risk factor. Many elderly people become isolated because of infirmities, or through the loss of friends and family members. Cultural and socioeconomic factors can play a role also, and strong social services and healthcare systems and reducing ageism and marginalization help in prevention.

Medical and eldercare professional may spot signs of potential abuse, such as:

• delays between injuries or illness and seeking medical attention
• implausible or vague explanations for injuries, from either patient or caregiver
• differing case histories from patient and caregiver
• frequent visits to emergency departments
• functionally-impaired older patients who arrive without the main caregiver
• lab findings that are inconsistent with history provided

Other signs, especially in financial exploitation, may include:

• drastic changes to plans or the person’s financial situation
• controlling caregiver/family member and isolation of the elder

*For more information on signs of potential concerns regarding caregivers, read our Concerns About Hired Caregivers.

We will continue our posts on elder abuse and exploitation with more on prevention and common scams against the elderly, as well as how to protect loved ones who have already been victims of exploitation in the future.

If you have concerns about abuse of an elderly individual in Florida, contact 1-800-96ABUSE.

For help with Florida eldercare issues & elderly advice, contact us today.

We have covered many tips about natural disaster planning for seniors and caregivers and offer a hurricane preparedness checklist for elders, but an important consideration in disaster planning for older individuals is to determine risk and alternatives. Disaster planning is designed to minimize risk, to be better prepared to deal with the challenges that disasters bring. While no plan can cover all situations, a well-thought out plan helps anyone to be better able to respond. Early warning systems, communications/media have improved our ability to survive some disasters, but only with proper planning and heeding those warnings appropriately.

During hurricane season, one of the key decisions is whether or not to evacuate as a particular storm is predicted to hit. Some people feel they must stay with their homes, or argue that they’ve “lived here for 50 years and nothing has happened yet so I’m staying”, but this can be especially dangerous logic for elders and those suffering from health issues or disabilities.

An important component of Aging Wisely’s hurricane planning is completing a “physical and environmental assessment” (which we do at the beginning of the season for general planning purposes and update as things change and particular storms approach). The assessment looks at some issues about the home itself, such as having hurricane shutters (and the ability to place them, or someone to help) and adequate supplies. But, more importantly, we look at the client’s status and abilities to assess possible risk during/after a storm. For example, can the person ambulate on his/her own, can he/she self-administer medications, does he/she have good judgment of safety and well-being? For couples living together, it is important to take in to account the challenges a caregiver may face trying to survive the storm and carry out normal caregiving duties. Especially if caring for a loved one with dementia, the care recipient may be unusually anxious, act out and wander.

One of the benefits of such an assessment is to paint a picture of the specific problem areas and concerns instead of having the illogical discussion as mentioned above (I’ve never left before, why should I now?). While we cannot make anyone evacuate, our goal is to provide the information needed to help families make a good decision (whether or not the person ultimately makes a good or bad choice). As part of this, we communicate that our staff cannot be put in harm’s way either and therefore will not be available up to 72 hours prior to a storm’s approach, as they prepare themselves and their families. We also remind clients and families that even emergency services stop during extremely high winds and dangerous weather. If you are trying to convince a loved one to consider alternatives, these ideas might help you too.

Here are some examples of questions to ask when putting together an emergency plan:

• What is the home’s evacuation zone? (Mobile homes must evacuate regardless of location.)
• Has the home been prepared for hurricanes (windows, garage doors secured, trees trimmed, debris and loose items removed, an available safe room in the interior without windows)?
• Does your loved one rely on home health caregivers? What arrangements have they made for emergency care?
• Does your loved one rely on medical equipment that requires electricity?
• Does your loved one have memory impairments/cognitive decline?
• Does your parent have respiratory or heart problems? Conditions that would be exacerbated by extreme heat, stress, poor diet?

Create a plan. Individuals with special needs who may need assistance should register with the county emergency services (see our checklist for contact information in Pinellas, Pasco & Hillsborough counties in Florida) but should not rely on emergency services and shelters as the primary plan. Here are some alternative options:

• Consider evacuating older relatives to stay with out-of-town family or local family and friends who are in safer locations (i.e. your Mom lives in a mobile home park and has good friends who live further inland in a newer home).
• Some Assisted Living Facilities and Skilled Nursing Facilities accept short-term respite stays during storms.
• If your loved one has a home in a relatively safe area that has been fitted with hurricane windows and other wind-mitigation devices, consider stocking emergency supplies and having someone stay in the home with your loved one to assist, especially in the aftermath. (However, be realistic about the person’s needs while dealing with the storm and time after. See our EasyLiving blog post about special precautions for persons with Alzheimer’s Disease/dementia.)

We cannot overstate the need for caution when dealing with an elderly or frail individual. If you are a family caregiver, especially one who lives at a distance and has a senior family member in Tampa Bay, realistic planning is essential. In addition to basic safety, think of the comfort level (and health/hygiene) of your loved one, who may have to manage with no electricity or water and limited support services for weeks.

For additional assistance with hurricane planning for seniors in Florida, contact us. We offer planning services in addition to comprehensive geriatric assessments and care management oversight for out-of-town relatives.

June 1st marks the start of Florida hurricane season and a vital planning time for those who live in vulnerable areas. Our focus during this time is on planning for our care management clients and educating family caregivers about the importance of making realistic plans to minimize risk for elders and those with special needs.

If you live in a different area, you can apply much of this information to general disaster planning for an aging loved one. Our checklists and tips may apply to those facing issues such as potential flooding, winter storms and other natural disasters. While some disasters provide less warning, it is important to review emergency plans and make provisions for emergency supplies. Hopefully some of our tips and ideas will also help you to consider your loved one’s potential vulnerabilities in various types of emergencies and consider this as well in an overall home safety evaluation.

Aging Wisely’s Elderly Disaster Preparedness and Florida Senior Hurricane Planning Information and Checklist

Click here for some important insider tips that you may not have considered when planning for an elderly or disabled loved one. Basics for building your senior disaster plan:

• Every household needs to prepare by purchasing supplies and preparing an emergency kit in case of even minor storms (power outages are common even with tropical storms and lesser storms that arrive during summer season).

• Prepare an evacuation kit as well, with important contact #s, basic medical history and medication list, insurance information, necessary medications, medical supplies and equipment, clothing and other needed items. Plan to evacuate early to avoid heavy traffic and get out safely well in advance of the storm. Consider the safety and special needs of elderly persons in options for evacuation.

• Individuals with special needs should register with the county emergency services, in case they need assistance. Do not use emergency services or special needs shelters as your primary hurricane plan, but as a backup option only.

• Be realistic about the ability to manage at home alone during and after a storm. Aging Wisely uses a special assessment to gauge a client’s ability to self-preserve at home, which is also influenced by the expected level of storm impact. This helps paint a picture of the situation, which may also be useful in convincing an elder that he or she should consider alternative arrangements.

• Remember the aftermath of the storm is a vulnerable time for those with special needs. Electricity and water may not be available for weeks. All but the most basic services may be unavailable. Supplies such as ice and water may be difficult to reach. Stores and infrastructure may be limited for weeks to months. Imagine your loved one in this situation and not only how unpleasant the situation may be, but how potentially life threatening.

• Contact eldercare providers as part of your elderly hurricane planning. For example, our sister company, EasyLiving, Inc. home care, provides assistance with shopping for hurricane supplies and preparing an emergency kit. An Aging Wisely care manager can be hired to complete an assessment and create a care plan for your elderly loved one. Local assisted living facilities and nursing homes may serve as receiving facilities for those needing a safer place to stay during approaching storms, but arrangements should be made in advance for the necessary admissions procedures.

Contact Aging Wisely for assistance or questions about Florida senior hurricane preparedness and all of your eldercare concerns.

Aging Wisely: advice for elder caregivers, Florida senior care resources, professional patient advocates.