Advisory Council April 2015 Meeting Presentation: Elder Abuse and Financial Exploitation

Tuesday, April 28, 2015

DOJ EFFORTS TO COMBAT ELDER ABUSE AND FINANCIAL EXPLOITATIONAND SOME ADDITIONAL CHALLENGES DEMENTIA Presents

United States Department of Justice

AGENDA

• DOJ Efforts to Implement the EJCC Elder Abuse Prevention Recommendations
• Alzheimer’s and Other Dementias Put Older Americans at Higher Risk of Elder Abuse
• Older Americans with Dementia are More Vulnerable to Financial Exploitation
• Alzheimer’s and Other Dementias Can Make it More Challenging to Prosecute Elder Abuse Cases
• We Need More Research on Dementia to Support Prosecution
• Where to Find Existing Research About Elder Abuse and Dementia on the Elder Justice Website

RECOMMENDATION #1:SUPPORTING THE INVESTIGATION AND PROSECUTION OF ELDER ABUSE CASES

• Prosecuting criminal schemes
  • Protecting seniors from financial, lottery, and mass marketing scams
• Pursuing civil “failure of care” cases
  • Ensuring that Medicare and Medicaid are not overbilled for substandard nursing home services
• Providing critical resources to victims, families, investigators and prosecutors
  • Launching the Elder Justice Website
  • Leveraging other Department of Justice Resources

THE ELDER JUSTICE WEBSITE:PROVIDING RESOURCES TO PROSECUTORS, VICTIMS, FAMILIES, AND PRACTITIONERS

http://www.justice.gov/elderjustice/

RECOMMENDATION #1:PROVIDING TRAINING TO FEDERAL, STATE, AND LOCAL PROSECUTORS

http://www.justice.gov/elderjustice/prosecutors/statutes.html

RECOMMENDATION #2:ENHANCING RESOURCES FOR ELDER ABUSE VICTIMS

http://www.justice.gov/elderjustice/support/common-scenarios.html

RECOMMENDATION #7:COMBAT ELDER FINANCIAL EXPLOITATION

http://www.justice.gov/elderjustice/financial/training.html

OTHER DOJ RESOURCES FOR RECOMMENDATION #4:DEVELOPING A FEDERAL RESEARCH AGENDA

Research funding from DOJ's National Institute of Justice

http://www.nij.gov/topics/crime/elder-abuse/Pages/financial-exploitation.aspx

OTHER DOJ RESOURCES FOR RECOMMENDATION #6:Training FOR LAW ENFORCEMENT

Bureau of Justice Assistance pocket guide:

https://www.bja.gov/Publications.aspx

OTHER DOJ RESOURCES FOR RECOMMENDATION #6:TRAINING FOR LEGAL AID PROVIDERS

Office of Victims of Crime online training:

http://ojp.gov/ovc/training/index.html

ALZHEIMER'S AND OTHER DEMENTIAS PUT OLDER AMERICANS AT HIGHER RISK OF ELDER ABUSE

• In a U.S. study, caregiver abuse and neglect of people with dementia by their caregivers was detected in 47% of caregivers surveyed
• One study shows 60% of caregivers had been verbally abusive to the person for whom they were providing care.
• 5 to 10% of caregivers reported that they were physically abusive toward their care recipients.

A. Wiglesworth, A, Mosqueda, L, Mulnard, R, et al. (2010), Screening for Abuse and Neglect of People with Dementia. Journal of the American Geriatrics Society, Volume 58, Issue 3, 493–500. VandeWeerd, C. V., & Paveza, G. J. (2005). Verbal mistreatment in older adults: A look at persons with Alzheimer’s disease and their caregivers in the State of Florida. Journal of Elder Abuse, 17(4), 11-30.
Paveza, G. J., Cohen, D., Eisdorfer, C., Freels, S., Semla, T., Ashford, J. W., et al. (1992). Severe family violence and Alzheimer's disease: Prevalence and risk factors. The Gerontologist, 32(4), 493-97.

• Characteristics associated with mistreatment of people with dementia include:
  • The caregiver's anxiety, depressive symptoms, perceived burden, emotional status, and role limitations due to emotional problems.
  • The care recipient's psychological aggression and physical assault behaviors. These behaviors were the best indicators for elder mistreatment as defined by the expert panel convened for this research study.

A. Wiglesworth, A, Mosqueda, L, Mulnard, R, et al. (2010), Screening for Abuse and Neglect of People with Dementia. Journal of the American Geriatrics Society, Volume 58, Issue 3, 493–500.

OLDER AMERICANS WITH DEMENTIA ARE MORE VULNERABLE TO FINANCIAL EXPLOITATION

• Cognitive Deficits including Dementia - Studies have found that financial exploitation is related to cognitive deficits.

Acierno, R., Hernandez, M. A., Amstadter A. B., Resnick, H. S., Steve, K., Muzzy, W., & Kilpatrick, D. G. (2010). Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: The National Elder Mistreatment Study. American Journal of Public Health, 100(2), 292-297.

ALZHEIMER'S AND OTHER DEMENTIAS CAN MAKE IT MORE CHALLENGING TO PROSECUTE ELDER ABUSE CASE

• Individuals with Dementia can make less credible witnesses
• Cognitive Capacity can be used by the defense to discredit allegations
• More research is needed to support expert testimony on issues of elder abuse and capacity

WE NEED MORE RESEARCH ON DEMENTIA TO SUPPORT PROSECUTION AND ELDER ABUSE INTERVENTIONS

• Event-based studies to examine contexts and situations that create a high risk for abuse
• Longitudinal research with a primary focus on elder mistreatment

WHERE TO FIND EXISTING RESEARCH ABOUT ELDER ABUSE AND DEMENTIA ON THE ELDER JUSTICE WEBSITE

http://www.justice.gov/elderjustice/research/database.html

WHERE TO FIND EXISTING RESEARCH ABOUT ELDER ABUSE AND DEMENTIA ON THE ELDER JUSTICE WEBSITE

http://www.justice.gov/elderjustice/research/database.html?author=&keyword=dementia&yearbegin=&yearend=&pubtype=&search-type=and&aso=&page=1