Legal advice for both the caregiver and the early-stage patient as they prepare for the future.

Detecting the red flags of fraud

Detecting the red flags of fraud


In 2011, 90-year-old iconic actor Mickey Rooney testified before the Senate Special Committee on Aging.

“You can’t believe that it’s happening to you,” said the now-deceased star, “you feel overwhelmed.”

Rooney, if you can believe it, was referring to his own stepson, accused of withholding food and medicine and meddling in Rooney’s personal finances. Tragically, the actor died before the judge awarded him $2.8 billion — in his bank account was a mere $18,000.

Most of us won’t ever see wealth as great as a Hollywood star, but many seniors — if they’re careful and wise with their money — have accumulated significant savings. With more money, sadly, comes the risk of financial abuse.

“There’s a plethora of reasons why this devastating crime goes relatively unchecked. The biggest one is that the victim is often impaired by dementia or Alzheimer’s, unable to recall exactly what happened,” said Deborah Louise Robinson, the filmmaker who made the Rooney documentary Last Will and Embezzlement, in interviews.

Current resources exist for patients only after someone’s been defrauded, but little is available to prevent it.

Of all elder abuse cases (physical, emotional, sexual) financial exploitation is actually the most common: 30 percent of all elder abuse cases are estimated to be financial. A 2009 study by the MetLife Mature Market Institute estimates $2.9 billion are exploited from seniors annually, making the prevalence of elder financial exploitation somewhere between 5 and 20 percent. (For comparison, that means a senior’s risk of financial abuse is greater than that of systolic heart failure.)

Unlike physical or sexual abuse, however, financial exploitation can be harder to spot and even define. It includes abuse by caregivers and family members using the older adult’s material for personal gain; trusted financial advisors selling inappropriate products; and stranger scams by mail, email or phone.

“Current resources exist for patients only after someone’s been defrauded,” explains Dr. Robert Roush of the Baylor College of Medicine in Houston, “but little is available to prevent it.”

The Elder Investment Fraud and Financial Exploitation program (EIFFE) hopes to change all that. Dr. Roush’s pilot project began in Texas in 2009. “Our goal was simply to raise your level of awareness,” he said to a group of industry professionals. Funding was provided by the Investor Protection Trust.

The plan was to develop a simple, office-based tool for clinicians that could help detect “red flags” in a patient that might identify a risk for financial exploitation — stopping abuse in early stages or even before it happens at all.

In the “pocket guide”, as it’s called, is a list of both physical and emotional factors. Dementia, stokes, accidents to the orbitofrontal cortex and Alzheimer’s all increase a person’s risk to be a victim of fraud. In fact, mild cognitive impairment makes a person four times more likely to make financial errors than those without the condition. A 2008 study found about 35 percent of seniors in the U.S. have either cognitive impairment or Alzheimer’s.

Also in the pocket guide is a list of the oft-ignored emotional and behavioral risks: social isolation, depression, alcohol and drug abuse. Among many questions in the EIFFE pocket guide, Dr. Roush asks:

  • Does the patient show signs of self-neglect?
  • Has the patient recently lost a spouse?
  • Has anyone asked the patient to change their will?
  • Do patients have someone living with them who is financially dependent upon them?

Reception by healthcare workers has generally been good, but there are some issues. “There is the legitimate concern by busy primary care providers that this checklist is yet another addition to the ever increasing number of items one must do in an office visit,” says Dr. Roush. (The checklist, he adds, only takes between 1 and 3 minutes and can be done by anyone in a doctor’s office.)

Then there’s the problem of perceived liability. What happens if physicians missed fraud cases despite the checklist? Would they be held accountable?

Nonetheless, when it comes to elder financial abuse, awareness is the most important thing. EIFFE has been presented many times at the American Society on Aging and the Gerontological Society of America, and is currently active in 27 U.S. states and jurisdictions, with plans to move into Illinois, Washington D.C. and Puerto Rico soon.

Rosemary Counter is a Toronto-based writer.

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