Tuesday, February 1, 2011

Elder abuse, often unnoticed, growing at alarming rate

By Elizabeth Aguilera

The golden years for many seniors slip away under a dark shadow of financial and physical abuse, most often caused by the hands they trust most to care for them.

It usually happens behind closed doors. It usually goes unreported.

Law enforcement and elder advocates said the rate of elder abuse is growing at an alarming speed as people live longer, baby boomers reach retirement age and the economy remains shaky.

On Tuesday near El Cajon, sheriff’s deputies discovered 93-year-old Pearl Harbor survivor Arnold V. “Max” Bauer in his squalid house clutching a photo of his war-era ship. They saw rat feces, rotting food, a sink filled with unwashed dishes and trash strewed about. Bauer’s live-in caretaker, who is now in custody, allegedly bilked him for thousands of dollars.

Bauer would hardly be a rare victim.

Experts estimate that only one in 13 elder-abuse cases are reported nationwide, based on various surveys and studies.

“We are only getting the tip of the iceberg,” said San Diego County Sheriff’s Sgt. Mark Varnau, who oversees financial- and elder-abuse crime units for his agency. “It’s a dirty little secret and Mr. Bauer’s case is a very clear example of how someone is isolated and forgotten about.”

In San Diego County, the District Attorney’s Office has seen the number of elder-abuse prosecutions rise in the past five years — from 183 cases in 2006 to 238 last year. The county’s elder-abuse hotline receives nearly 10,000 calls a year; about 40 percent of them directly involve financial abuse.

Many cases have both financial and physical abuse, said Paul Greenwood, deputy district attorney and head of the office’s Elder Abuse Prosecution Unit.

“People are getting more desperate,” he said. “They look around and they see who has the money and they target them.”

While some agencies have worked to educate the public, cooperate with mandatory reporters such as banks and set up hot lines and other reporting systems, elder-abuse experts and law-enforcement officials remain concerned about a lack of resources.

“We are not able to provide the infrastructure to deal with the avalanche of referrals that are going to be coming in the next five years,” Greenwood said.

An addendum to the national Healthcare Reform Act, which Congress approved last year, would provide money for combating elder abuse. But there has been no funding allocation so far.

Nearly 95 percent of seniors live at home and almost all elder abuse occurs there, the majority perpetrated by family members, said Kathleen Quinn, executive director of the Illinois-based National Adult Protective Services Association. “Trusted others” — such as home health-care workers, neighbors and friends — make up the next largest group of abusers.

“It’s absolutely an enormous problem,” Quinn said.

Other cases include abuse in nursing homes, home-improvement scammers preying on seniors, financial planners who fleece older clients, and home-care workers who get paid but do nothing and even steal from their clients.

Seniors may be well enough to hire a home health worker or share their financial records with an adult child or a new friend, but there is no system for ensuring they are safe as they become vulnerable due to frailty or illness, said Greenwood and Varnau.

Amy Waszak sees these situations every day in her job. She is one of 43 investigators for the San Diego County Office of Aging & Independence Services.

Each month, she looks into about 20 reports of possible abuse within her assigned area of Oceanside, including allegations of financial, emotional and sexual abuse, along with incidents of self-neglect.

“Sometimes we walk into some awful situations,” Waszak said. “We’ve been to hoarders’ homes. We’ve been to rodent-infested homes. … We’ve been to homes where there is human waste, like urine soaked into the carpet.”

She makes unannounced visits and if it appears there’s a serious problem, she often refers the matter to law enforcement officials. Waszak’s agency helps victims obtain restraining orders against their abusers and will assist them in tapping into a range of services, including medical care and programs like Meals on Wheels.

“These crimes occur because families are separated by distance and a new “friend” comes into the lives of these elders,” Greenwood said. “They don’t rob elders with guns and knives, they extract the assets through charm and flowers and boxes of chocolates.”

Reporting senior abuse can be difficult for those who may notice something is off: a garden that’s usually lovingly tended becomes overgrown, a once-tidy house falls into disarray, a sociable senior no longer answers the phone or chats over a fence line, an elderly person is confused about the household finances, a caretaker sounds overly defensive.

It is a complex line for neighbors and friends to tread between individual freedoms and pushing for answers about a senior’s treatment. Seniors themselves often don’t speak out because they’re embarrassed by their failings, Varnau said.

The sheriff’s department processes 70 to 150 cases of elder abuse a year. Many of those cases involve home health workers, who are hired by the individual with private or county funds.

Home-care workers, who provide nonmedical assistance such as cleaning, bathing and feeding, aren’t required to undergo a background check unless they are paid through a government program. Health care companies and agencies, which provide nurses or other licensed personnel, operate under different regulations.

Elder-care advocates and law enforcement authorities said the home-care-worker system needs more oversight.

Home-care workers who are paid through San Diego County’s In-Home Supportive Services program do undergo a background check that looks for evidence of child abuse, elder abuse and fraud against a government agency, said Ellen Schmeding, assistant deputy director for the county’s office of Aging & Independence Services.

Starting Feb. 1, the check also will encompass felony and violent convictions. But seniors can still choose to hire individuals with a criminal past, because the law recognizes them as the final employer.

This worries law enforcement officials, who want more safeguards in place to monitor seniors as they age.

“It’s not a question of if they are going to fail,” Varnau said. “It’s a matter of when. People slip away and become completely vulnerable to being victimized.”


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