ELDER ABUSE

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					Elder Abuse Crimes

   2004 Area III Elder Abuse
          Conference
         April 1, 2004
    Midwest City, Oklahoma
     Presented by
     Paul Greenwood,
 Deputy District Attorney,
San Diego County, California
            WARNING!


   The views expressed by the
    presenter are not necessarily
    those of the San Diego
    District Attorney‟s Office
      ELDER ABUSE IS……...
   A Crime
   Affecting both urban & rural areas
   Going unpunished
   Predictable
   Being committed in homes where
    there are also other forms of abuse
ELDER ABUSE IS EXPLODING
   Fastest growing age group
   No known cure for dementia etc.
   Victims often do not report
   Third fastest growth job is home care
   Minimal background checks
   High temptation, low risk factors
      UNDERSTANDING THE
          DYNAMICS
   Fears of many seniors
   Leads to underreporting
   Feelings of shame
   Concern that exposure will lead to
    loss of independence
   Sometimes accompanied by threats
    from perpetrator
    LESSONS LEARNED FROM
      DOMESTIC VIOLENCE
   Self -determination is not the answer
   If not punished, the perp WILL abuse
    again
   We CAN convict even without the
    assistance of the victim
   Abuse is a crime against NOT JUST
    the abused
    AVOID STEREOTYPING OF
           SENIORS
   Forgetful
   Senile
   Longwinded
   Fragile
   Grumpy
   Disabled
               As a result :
   Lack of investigation by police
   Lack of prosecution by DA‟s
   Lack of awareness by public
    Prior to our Elder Abuse Unit:
   Elder Abuse statute existing for 10
    years
   Average of 2 or 3 cases a year
   Police received no special training
   Public unaware of reporting
    procedure
   Prosecutors rejected most financial
    cases
    Since our unit began in 1/96:
   Increased awareness of public
   Increase in referral calls to APS
   Mandatory training for police
   Vertical prosecutions of all Elder
    Abuse
   Prosecution of over 300 felony cases
   Increase from 1 to 5 prosecutors
    Building awareness level [1]
   Speaking to community groups
    • Kiwanis, Lions & Rotary
   Arranging senior forums
    • Day time, door prizes
   Training the police
    • Include counter & telephone
      staff
      Awareness level cont’d [2]
   Reaching first responders
    • Paramedics & Fire personnel
   Educating the E.R. nurses & doctors
    • Reminder of mandatory
      reporting
   Encourage banks to train their staff
    • Adopt Oregon method
      Awareness level cont’d [3]
   Use the media to communicate
    • TV, Radio talk show,
      newspaper articles
   Form a multi-disciplinary team
    • F.A.S.T
Creating/promoting referral line:
   Every County must have a reporting
    line
   Billboards
   Posters
   Radio and TV PSA‟s
   # of calls WILL increase
     Physical and Mental Abuse:
   Assaults and batteries
   Aggravated Assaults/Attempted
    murder
   Sexual assault
   Neglect
     Physical and mental abuse
               cont’d
   Manslaughter - neglect causes death
   Murder
   Intimidation/Mental & Psychological
    Abuse
   False Imprisonment
   Torture
   Robbery and extortion
         Classic neglect cases
   Deprivation of medical attention
   Deprivation of food
   Lack of hygiene
   Lack of ventilation, heat or light
   Over-medicated
   Under-medicated
    The classic neglected victim
   Malnourished
   Semi-comatose
   Dehydrated
   Bed sores, rashes, lice
   Coated with fecal matter/ urine
    stained
   Inadequately clothed
   Untrimmed toenails, matted hair
            Signs of neglect
   Dry lips, pallor or excessive weight
    loss
   Dirty or inappropriate clothing for
    weather
   Shivering or low body temperature
    which might indicate hypothermia
   Lack of dentures, glasses or hearing
    aid
   Signs of infrequent bathing
      Signs of neglect cont’d
   Physical or mental deterioration
    with no medical reason
   Confinement
   Elderly person is seen wandering
    dangerously
   Lack of groceries
   Inadequate or over medication
   Cooking and housekeeping
    standards that could lead to illness
    or accidents
    Reasons for undermedicating
   Thinks that person should not need
    medication
   Thinks that patient‟s mental state is
    deteriorating because of medication
   Thinks that withholding of meds
    might hasten patient‟s death
   Wants patient to suffer
   Is using meds for own use
          Evidence Collection
   Photos / video of living conditions
   Include photos of kitchen, fridge etc
   Bed sheets and mattress
   Diapers
   Clothing
   Prescription meds
         Evidence Collection
   Dangerous/ exposed items putting V
    at risk
   Non-working call button
   Proof of V‟s disorientation -
    unopened mail, bills unpaid
   Signs of alcohol/drug/gambling
    abuse by D
   Any living will?
        Key persons to contact
   V‟s family members
   Neighbors
   V‟s doctor / dentist
   V‟s pharmacist
   V‟s pastor
   V‟s attorney
   V‟s bank / financial adviser
    Key persons to contact cont’d
   APS to check on prior history
   Paramedic who first arrived on scene
   E.R. nurse/ physician who first
    triages and treats victim
   911 dispatcher
         Interviewing suspect
   Length of relationship
   Type of relationship
   Description of duties
   For pay or love?
   Knowledge of V‟s age & medical
    condition
   Reasons for non-action
          Interviewing victim
   Questions to determine orientation
   Mini-mental assessment
   Last time you ate, bathed, visited
    doctor or dentist
   What meds are you taking
   Your relationship with suspect
    careprovider
    Cross reference with financial
               abuse
   Look for signs of financial
    exploitation
   Documents giving control to suspect
           - POA
           - Quitclaim deed
           - New will
                 - Correspondence, bank
    statements
   Check book, ATM, pawn slips
              Resources
   Poison Center: 1-800-876-4766
   Internet - www.safemedication.com
    Profile of the physical abuser:
   Son in his late 30‟s or early 40‟s
   Living at home with Mom
   Divorced/ returns or single and
    unmotivated
   Lazy and unemployed
   Drugs, alcohol or gambling
   Feeds habit off Mom
           Financial Abuse:
   Theft
   Credit card fraud
   Real Property transfers
   Home Improvement scams
   Telemarketing & sweepstakes scams
   Investment fraud
             Forms of theft
   By larceny - a taking of property
   By trick - consent is based on deceit
    or fraud
   By embezzlement - property is
    entrusted to thief
   By undue influence
        Typical theft scenarios
   Jewelry
   Checks
   ATM card
   Credit card & identity theft
   Transfer of title - POA & quitclaim
    deed
   Bogus investment scams
   Sweepstakes/telemarketing frauds
    Typical theft scenarios cont’d
   Home improvement scams
   Excessive charging by unlicensed
    contractors & other merchants
   Theft by undue influence
    HOW TO PROVE STEALING?
   Taking property
    belonging to another
   without consent &
    with intent to permanently deprive
    Three prosecutable scenarios
   Classic case of theft from a
    competent victim
   Theft from an incompetent victim
   Theft from a marginally competent
    victim [by undue influence]
            SCENARIO # 1
   Victim testifies
   Did not give permission
   Did not owe monies to suspect
   Victim is credible
            SCENARIO # 2
   Victim cannot testify
   Medical testimony that victim suffers
    from dementia/ Alzheimer‟s/
    Parkinson's or some other illness that
    deprives victim of necessary
    understanding
   Incapacity was present at time of
    transaction
            SCENARIO # 3
   Is it theft, a loan, or a gift?
   Victim is marginally competent
   Suspect exploited victim‟s
    vulnerability
   Victim was unduly influenced or was
    defrauded
            Undue Influence
   Victim „was pushed in a direction that
    he did not want to go.‟
   The influence by suspect was
    sufficient to remove the
    voluntariness of the transaction
   No longer free will
   Victim has been evaluated by a
    geriatric psychiatrist/psychologist
      Significance of evaluation
   Need to assess status of mental
    capacity
   But distinguish from scenario #2
   Opportunity for evaluator to render
    opinion of “susceptibility”
   Looking for vulnerabilty factors
   Opinion is not whether victim WAS
    unduly influenced - that is for jury
How to prove undue influence?
   Length of relationship
   Place of first meeting
   Prior spending habits
   Prior “charitability”
   What is left?
   Multiple escalating transactions
   Statements by suspect
        Statements of suspect
   How did they affect & influence
    victim?
   Can we prove that the statements
    were false?
   Look for reasons why suspect chose
    those particular statements
   Examples - need, emergency,
    opportunity, hint of a threat…...
     Look at conduct of suspect
   The “meeting”
   The cultivating of a friendship
   The outward gestures of affection
   The “other” side - the dark character
    traits of greed, manipulation, control
   Who can testify to such traits?
               Witnesses
   Bank teller
   Pastor
   Neighbor
   Doctor, pharmacist, optometrist of V
   Family
   Ex- spouse of suspect
   Business contacts of suspect
          Evidence collection
   Best evidence is the video interview
   Bank, credit card statements
   Bank surveillance tapes
   Prior medical records
   Look for the inappropriate purchases
   Ask questions, questions,
    questions!!!
         Be careful about …...
   Obtaining a consent release form
   If V has mental capacity problems,
    then do NOT get a release
   Obtain through search warrant or if
    after case has been issued, through
    subpoena
     How banks can help in the
     fight against financial elder
                abuse
   Adopt the Oregon model [Senior &
    Disabled Services Division: Aileen
    Kaye 503-945-6399]
   Offer to conduct the training
   Highlight the bad examples and
    praise the courageous
    How to get the most out of the
                bank
   Contact the chief fraud investigator
    for the bank before serving the
    search warrant
   Remind them that time is critical -
    put them on written notice
   Where appropriate, also remind them
    that this crime could have been
    avoided
    What happens if you discover
      theft after victim dies?
   This may still be prosecutable if the
    case falls within scenario # 2.
   Is there a documented medical
    history of V‟s lack of capacity prior to
    death and before date of
    transaction?
     What happens if victim dies
    after investigation begins and
    before prosecution finishes?
   Do you have victim on video?
   If scenario #2, the death should
    not affect the proceedings
   Did the victim testify at a
    preliminary hearing?
           Credit Card fraud:
   Filling out unsolicited application
   Adding perp‟s name as authorized
    user
   Controlling the mail
   Paying monthly payment by
    telephone banking
          Real Estate scams:
   Deadly weapon - the POA
   Quitclaim Deed
   Mortgage rip offs
   Living trust sucker - getting to the
    portfolio
        Telemarketing scams:
   Paul Bell
   Just say No
   Sucker lists
   Use AARP
     Home Improvement scams
   Roofs, driveways, painting
   “Just in the area”
   Work in pairs
   Pick-up truck
   Want cash
   Use inferior materials
   Leave without trace
          Remember that ...
   Some cases are simply not
    prosecutable
   But you will never know until you
    try
    Seniors and the court process:
   Getting them to court
   Bringing the court to them
   Waiting at court
   Testifying in court
   After court - to prevent further
    victimization
    Interviewing an elderly victim
   Venue is important
   Build a rapport
   Look for achievements
   Try to identify areas of vulnerability
   Preserve the interview on video
     Elder Abuse case hurdles:
   The recanting victim
   The “consent” defense
   The “incompetent” victim
   The deceased victim
   Old people die
     Red Flags To Keep in Mind
   Implausible/vague explanations
   Delay in seeking care
   Unexplained injuries - past or
    present
   Inconsistent stories
   Change in behavior
    Seniors and the Court Process
   Getting them to court
   Bringing court to them
   Waiting at court
   Testifying in court
   After court - to prevent further
    victimization
Assess the impact of the crime


            Financial
           Emotional

            Residual
     RESOURCES AVAILABLE
   Internet
   Elder Abuse Listserve run by ABA
    [contact is :
    lstiegel@staff.abanet.org]
   AARP
   Oregon Bank project [Dept. of
    Human Resources : Aileen Kaye 503-
    945-6399]
   Evidence Code section 1380
     EVIDENCE CODE S. 1380
   Video tape ALL elder abuse victim
    interviews by law enforcement
   Judge has discretion to allow if victim
    dies or becomes incapacitated
   Interview has indicia of reliability
   Other corroborative evidence
  THE
GOLDEN
 YEARS
        A Message to Seniors:
   We respect and honor you!
   We commit to seeking justice for you
   We prosecute with:
   Passion
   Purpose
   Perseverance
Please feel free to contact me:
       Paul Greenwood
        619-531-3464

 paul.greenwood@sdcda.org

				
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