Aging and Money: Reducing Risk of Financial Exploitation and Protecting Financial Resources

Preface
Acknowledgments
Contents
Contributors
Chapter 1: Facts and Figures
	Overview
	Aging in the United States and Risk of Financial Exploitation
	Definitions of Elder Abuse and Financial Exploitation
	Landmark US Studies of Elder Abuse Prevalence and Incidence
	The Many Faces of Financial Exploitation – A Profile of the Victims
	The National Impact of Elderly Financial Exploitation
	Conclusions and Future Directions in Curbing Financial Exploitation in the Elderly
	References
Chapter 2: One Piece of the Puzzle – Financial Exploitation and Elder Abuse
	Introduction
	Scope of the Problem
	Pure Financial Abuse Versus Hybrid Financial Abuse
	Types of Elder Financial Abuse
	Victims and Perpetrators
		Victims
		Perpetrators
	Undue Influence and the Psychodynamics of Exploitation
	Combatting Elder Financial Abuse as Part of an Overall Strategy Against Elder Abuse
		Detection
		Protection
	Conclusion
	References
Chapter 3: Barriers to Recognition
	Who Reports
	Barriers to Self-Reporting
	Barriers to Reporting
	Eliminating Barriers
	References
Chapter 4: Risk Factors for Patient and Caregiver
	Risk Factor Recognition
	Victim’s Risk Factors
		Age: Ms. Jones Is an 82-Year-Old Frail Woman…
		Gender: Ms. Jones Is an 82-Year-Old Frail Woman…
		Race and Ethnicity
		Frailty: …as Ms. Jones Became More Dependent…
		Cognitive Impairment: ...as Ms. Jones Became More…Cognitively Impaired…
		Physical Dependency: ….as Ms. Jones Became More …Disabled
		Mental Illness
		Lack of Social Support: …She Had Been Living Alone…
		Substance Abuse
		Fear
		Low Income
	Perpetrator Characteristics
		Personality of the Abuser
		Victim Perpetrator Relationship
		Financial Dependence
		Substance Abuse
		Social Stressors
		Mental Illness
	The Environment
		Living Situation
		Awareness of the Modern World
	Into Action: A Team-Based Approach
	Conclusion
	References
Chapter 5: Aging and Financial Exploitation Risk
	Financial Exploitation Risk in Older Adulthood: Scope of the Problem
	Determinants of Financial Risk
	Social Cognitive Neuroscience Model of Financial Exploitation
	Financial Risk: Assessment and Surveillance
	Conclusions and Future Directions
	References
Chapter 6: Assessing Older Patients’ Risk Factors of Being Financially Exploited
	Introduction
	Overview of the Literature
	What Clinicians Can Do
	Assessing Patients’ Vulnerability to Financial Exploitation
	Referral and Reporting
	EIFFE and Investor Education Resources
	References
Chapter 7: Clinical Assessment of Financial Decision-Making Capacity
	Introduction
	The Clinician’s Dilemma
	Screening for FDMC
	Red Flags
	Dementia and FDMC
	Risk Assessment of Financial Decision-Making Capacity
	Mitigation of Risk
	Conclusion
	References
Chapter 8: Financial Exploitation: The Legal Perspective
	Introduction
	Financial Exploitation: A Blurred Line
		The Concept of Undue Influence as a Mechanism to Exploit
			The Role of the Clinician
			The Legal System: A Focus on Victim or Perpetrator
			Civil Justice and the Concept of Protection for the Elderly
			The Role of the Medical Profession in the Civil Context
			The Criminal Justice System at Work
	The Case of L.S.: The Need for Multidisciplinary Awareness and Interaction to Protect the Vulnerable from Devastating Loss
	Recommendations and Conclusions
	References
Chapter 9: Perspectives from Financial Institutions
	Identifying Cognitive Decline Through Financial Interactions
	What Can Financial Institutions Do and Not Do?
	Who Are the Relevant Federal and State Regulators?
	What Are Federal and State Regulators Doing?
	What Is SIFMA Doing?
	What Doctors Can Do: Case Revisited
	References
Chapter 10: Documentation Practices
	The Role of Healthcare Professionals in Addressing Financial Exploitation
	Importance of Documentation by Healthcare Professionals
	Key Qualities of Effective Documentation
	Content of Documentation
	Documentation Across the Five Phases of Clinical Management
		Detection
		Assessment
		Planning
		Intervention
		Follow-Up
	Examples of Tools to Detect and Assess Financial Exploitation
	Challenges in Clinical Settings
	Case Example: Visiting Nurse Documents Financial Exploitation
		First Skilled Nursing Visit
		Subsequent Skilled Nursing Visits
	References
Chapter 11: Addressing Senior Financial Abuse: Adult Protective Services and Other Community Resources
	Chapter Overview
	Financial Abuse at a Glance
		Scenario 1
		Scenario 2
	Community Resources and Networks
		Adult Protective Services
			Purpose
			Financial Abuse Definitions
			Allegation Reporting
			Intake and Investigations
			Resource Linkage and Service Delivery
			APS Case 1
			APS Case 2
		Law Enforcement
		Protecting and Serving Seniors of Financial Abuse Through Triads
		Elder Abuse Multidisciplinary Teams
		Elder Abuse Forensic Centers
		Enhanced MDTs
		Financial Abuse Specialist Teams
	Community-Based Senior Resources
		Area Agencies on Aging
		American Association of Retired Persons (AARP)
		Better Business Bureaus
		Daily Money Management Programs
		Faith Organizations
		Financial Institutions
		Guardianship Programs
		Legal Services: Prosecutorial, Civil, and Asset Protection
		Meals on Wheels
	Federal Agencies and Resources
	Conclusion
	Appendix A: Federal Agencies
	Appendix B: Legal Services
	Appendix C: Accounting Services
	References
Chapter 12: Elder Abuse Multidisciplinary Teams
	Multidisciplinary Teams—History and Overview
		Origin and Diffusion of Multidisciplinary Teams
		Multidisciplinary Team Variation
			Teams Addressing Financial Exploitation
		Activities and Structure
			Formalization and Leadership Structures
			Membership
	Considerations for the Development of MDTs
		Teams in Action: A Case Study
		Other Multidisciplinary Groups
	Benefits, Challenges, and Measuring Success
		Benefits and Victim Outcomes
		Challenges Faced by Multidisciplinary Teams
		Complexity of Evaluating MDTs
	Final Thoughts
	References
Chapter 13: Public Policy and Advocacy
	Historical Perspective of US Policy
	Current Policy Initiatives
	Defining a Research Agenda
	Professional Advocacy
	Self-Advocacy
	The Future
	References
Chapter 14: Critical Documents Associated with Aging
	Introduction
	Outline
	Medical and Privacy Issues
		Medicare
		Glossary of Levels of Care
	Caregivers, Care Managers, and Financial Concerns
		Managing Care in the Home
		Financial Concerns
	Legal Issues and Advance Directives: End-of-Life Care
		Advance Directives: Glossary of Terms
		POST (Physician’s Orders for Scope of Treatment) Form
		Ethical Will
		Living Will
		Last Will and Testament
		Probate: Briefly Explained
		Attorney-in-Fact (AIF)
		Power of Attorney (POA)
		Durable Power of Attorney (DPOA)
		Guardian/Conservator
		Capacity
		Competence/Incompetence
		Undue Influence
		Privacy
		HIPAA Standards
	Disclaimer
	References
		Resources
Chapter 15: Methods to Protect Individuals from Financial Exploitation
	Introduction
	Who Is at Risk?
	Who Are the Perpetrators?
	Examples of Types of Fraud
	Action Plans
		Setting Up Protections from Financial Abuse
		Setting Up Protections for the Home
		Caregiver/Family Interventions
	Benefits of Preventative Interventions
	Available Resources
	Future Directions
Index