Elder Abuse Forensics

Way to go Los Angeles county!

In the general field of forensics, Los Angeles has led the way in innovation and training officers and investigators. They had the first forensic crime lab in 1924 and set the standard for future American crime labs. Forensics exists because such detailed specialization is needed in all crimes to properly collect evidence so that investigators can find out "who done it" and so that evidence may be eventually admitted in court. It's very good to see the specialization taking a turn into the world of elder abuse.

"The Los Angeles County Elder Abuse Forensic Center is a multidisciplinary team of professionals that provides expert and comprehensive case examination, documentation, consultation and prosecution of elder and dependent adult abuse cases. Partnered with the University of Southern California, the Los Angeles County Forensic Center is funded by the Archstone Foundation and the UniHealth Foundation."

The best thing is they are not just about legality and evidence. They also offer support services to vicims and their families! This is the kind of change we need in this country. Hopefully, it won't take too much longer for this crime to be taken seriously and handled with professionalism across the country.

Please check out The Los Angeles County Elder Abuse Forensic Center's full website.

Only Two Years?

Woman sent to prison for stealing from mother (click for original link)

Akron -- An unrepentant daughter.

An unforgiving mother.

A breach of love and trust led Wednesday to a two-year prison sentence for Jerelyn Sue Estright, who sold her mother's house without her knowledge and spent up to $94,000 on travel to Irish festivals and gifts to herself and others.

Estright, 60, of Barberton, had been convicted of theft. Estright apologized but indicated to Summit County Common Pleas Judge Thomas Teodosio she deserved the money for all she had done for her mother.

"For many, many years I was the only person on her side," she said. "My life revolved around her. I was the only one to care about her. I still am."

Estright's mother, Leora Harrison, didn't buy it.

"The whole ordeal has touched on every emotion a mother could have," she told the judge. "Jeri had no thought except for her own greed.

"It hurts for me to say this but Jeri needs to spend some time in prison to think about all the people she has affected," said Harrison, 85.

Scott Shaw/The Plain Dealer Leora Harrison reads her wishes for the sentencing of her daughter, Jerelyn Sue Estright, who was convicted of stealing money from her. The attorneys are Mike Todd and Joy Wagner.

Estright's daughter, Katie Estright, sobbed as her mother was led away in handcuffs. Estright's mother showed no emotion.

Harrison gave Estright power of attorney in 2002 to handle her affairs, prosecutors said. In 2005, when Harrison was hospitalized, Estright sold her Barberton home for $104,000, putting the money in a joint checking account. She stored furniture, sold items on Ebay and kept jewelry and other personal items.

Harrison, who lived in an assisted living facility, initially was unaware the home was sold.

Scott Shaw/The Plain DealerJerelyn Sue Estright waits to leave the courtroom after sentencing at the Summit County Courthouse in Akron.

In December 2005, Estright moved $94,000 to a personal account. Harrison and another daughter wondered how Estright, who was unemployed, could afford to eat out, take trips and buy gifts, including a digital camera and a copy machine.

They sought bank records and filed a police report in December 2006. Estright was convicted after a five-day trial.

Her attorney, Joy Wagner, asked Teodosio to place Estright on probation, saying she had no prior convictions and would pay restitution.

Assistant prosecutor Mike Todd said Estright continued to spend money even after she was charged and had shown no remorse until she told Teodosio she was sorry.

Teodosio ordered Estright to return her mother's personal items and set a hearing to determine how much she owes.

(Click title for original link. Published in the Plain Dealer. 08-06-08)

Really? Only 2 years?

Sorry for the break

We've had a very busy couple weeks. From recovering from the blow of a court hearing ending up in yet another delay to the change of the seasons and back to school, we've had a couple weeks away. This week, there will be two posts to hopefully make up for it.

I'm going to deviate from the misdiagnosis segment and briefly mention a program recently being aired on most PBS stations. It is called "The Forgetting: a portrait of Alzheimer's," and it is very good, as most PBS programs are. If you don't see it scheduled in your area you can watch it online!

Please take some time away from "reality tv" and watch real tv.

PBS, The Forgetting, website

Misdiagnosis Part 3

Poisoning

Yes, poisoning can mimic as Alzheimer's. In particular I'm referring to poisoning from heavy metals like arsenic, and lead.

"There are 35 metals that concern us because of occupational or residential exposure; 23 of these are the heavy elements or "heavy metals": antimony, arsenic, bismuth, cadmium, cerium, chromium, cobalt, copper, gallium, gold, iron, lead, manganese, mercury, nickel, platinum, silver, tellurium, thallium, tin, uranium, vanadium, and zinc (Glanze 1996). Interestingly, small amounts of these elements are common in our environment and diet and are actually necessary for good health, but large amounts of any of them may cause acute or chronic toxicity (poisoning). Heavy metal toxicity can result in damaged or reduced mental and central nervous function, lower energy levels, and damage to blood composition, lungs, kidneys, liver, and other vital organs. Long-term exposure may result in slowly progressing physical, muscular, and neurological degenerative processes that mimic Alzheimer's disease, Parkinson's disease, muscular dystrophy, and multiple sclerosis. Allergies are not uncommon and repeated long-term contact with some metals or their compounds may even cause cancer (International Occupational Safety and Health Information Centre 1999)."

Read more here about heavy metal poisoning. http://www.lef.org/protocols/prtcl-156.shtml

Misdiagnosis Part 2

Here's the first condition that can present as Alzheimer's. It's something most people wouldn't think of either.

"Depression. Because depression is often part of Alzheimer's disease, it can be tricky to sort out what's going on. Depression by itself can mimic dementia; a situation sometimes called pseudodementia. When people are depressed, they can have difficulty concentrating, and this leads to forgetfulness. Making matters worse, many people are reluctant to seek help because they fear they are developing dementia, when in fact they are delaying a diagnosis for a treatable condition. For this reason, it makes sense for any person who is being evaluated for Alzheimer's to also be evaluated for depression, and perhaps treated for possible depression to see if the signs of dementia are alleviated."

http://www.genetichealth.com/ALZ_When_it_Isnt_Alzheimers_Disease.shtml

"The most common pseudodementia and the most easily misdiagnosed is that associated with depression. General internists and family practitioners fail to recognize major depression in up to 20% of their outpatients with the disorder, either as depression misdiagnosed as dementia or vice versa. The ability of primary-care physicians to recognize and correctly treat depression is important since only approximately 20% of people with depression are treated by mental health professionals. This is especially crucial since both disorders especially depression, are treatable and misdiagnosis may cause an individual with potential full cognitive function to be unnecessarily confined in long-term care faculties (Yesavage, 1993). While cognitive and behavioral difficulties (e.g., forgetfulness, sad mood, slowed thinking) in depression are similar to those with suspected dementia, performance on neuropsychological tests offers a distinct profile. To diagnose dementia, a complete medical and neuropsychological evaluation is recommended and a complete patient history is very important. It is of vital importance that the physician understands the differences between depression and dementia."

http://www.neuropsychconsultant.com/memory.html

Perhaps seeing a neuropsychologist or other behavioral specialist along with your regular doctor is a good strategy for narrowing down possible conditions.

Misdiagnosis Part 1

For the next few posts, I'm going to be researching other diseases and conditions that have the same or similar symptoms to Alzheimer's. Alzheimer's seems to be the catch all diagnosis over the past few years for almost elderly person who exhibits signs of dementia. The medical community really doesn't know that much about Alzheimer's yet. They can't even tell you for sure if someone has it. The only way to make a positive diagnosis is to perform a brain inspection.... which cannot be done while the patient is still alive. So, really doctors should be testing for the possible conditions that have been and can be misdiagnosed for Alzheimer's.

In our family's situation there was this sudden Alzheimer's diagnosis from Grandma's doctor but he had not done any tests. It seemed like he hadn't investigated it at all. The only things he did were asking her memory types of questions to test her cognitive ability. Here's one for you: count backwards from 100 by 7's. Then there was the standard "who's the president" and "what's today's date." That was it though and no other possible conditions were explored.

Now that Grandma has been back with us she's been getting better over the past year or so. When she first came "home" (her actual house is still not back in her name yet.) she was zombie like. Now she's lively, wants to walk around the yard, makes much more sense when she talks, has moments where she asks directly "How did I get here," and makes statements like "I think there's something wrong with me. I don't remember." Does that sound like Alzheimer's to you? She is getting better, and new doctors think so too. We are working with them to see what we can find and if she can possibly regain more memory. The more we find out from our personal situation, the more we will share with you. Until then, look over the next few weeks for comparisons of similar diseases. Remember you should ALWAYS get a second opinion, especially with dementia related conditions.

Risk Factors

Here's a list of risk factors that your elderly family member may be at risk of financial exploitation and abuse from those around him or her. Also, characteristics of male and female abusers, and signs that a person may be suffering abuse. Hindsight is 20/20, and looking back gives me the chills on how much of this is exactly true from our situation. Please heed these warnings and signs. (Following excerpts from article by the National Center for State Courts. Click here for PDF article.)

"Factors Predisposing to Financial Exploitation

• Advanced age (> 75)
• Female
• Unmarried/widowed/divorced
• Organic brain damage
• Cognitive impairment
• Physical, mental, or emotional dysfunction (especially depression)
• Recent loss of a spouse or divorce
• Living with abuser
• Dependence on abuser
• Living alone
• Social isolation
• Estranged from children
• Financially independent with no designated financial caretakers
• Middle- or upper-income bracket
• Taking multiple medications
• Frailty
• Fear of change of living situation (ie, transfer from home to institution)
• Implied promise by perpetrator to care for elderly person if funds or material goods are transferred
• Elderly person subject to deception (misrepresentation/concealment of information for selfish gain)
• Elderly person subject to intimidation (perpetrator induces dependency with fear of rejection if demands not met, or creates fear by threat of physical or emotional harm or abandonment)"

"Characteristics of Male Perpetrators who Exploit Elderly

• Sociopathic or antisocial character disorder
• Developing a caregiver role
• Living with victim
• Being economically dependent on victim
• History of mental illness or substance abuse
• Often related to victim
• Has health problems"

"Characteristics of Female Perpetrators who Exploit Elderly

• Has some caregiving relationship to elderly person
• Instills sense of helplessness and dependency
• Isolates the elderly person from family members and other social contacts
• Presents herself as protector of the elderly victim while isolating them from others
• Enhances inadequacy and diminished self-worth in victim, making him or her more vulnerable
  
• Often has history of multiple unstable relationships
• Often falsifies credentials or embellishes personal power, role, or position
• Opportunistic
• Psychologically dysfunctional
• Predatory
• Antisocial with little regard for rights of others
• Methodically identifies victims and establishes power and total control over them
• Gains control of assets through deceit, intimidation, and psychological abuse"

"Signs and Symptoms Suggesting Undue Influence

• Elderly person’s actions inconsistent with past longstanding values/beliefs
• Older person making sudden changes in financial management that enrich one individual
• Elderly persons changing their will or disposition of assets, belongings, property, and direct assets toward one who is not natural “object of their bounty”
  
• Caretaker dismisses previous professionals and directs older person to new ones (eg, bankers, stockbrokers, attorneys, physicians, realtors)
  
• Elderly person isolated from family, friends, community, and other stable relationships
• Nonfamily caretaker has moved into the home or taken control of daily schedule
• Older person directs income flow to caretaker (eg, Social Security, pensions, trust distributions)
• Wills, living wills, trusts altered with new caretaker or friend as beneficiary/executor
• Elderly person develops mistrust of family members, particularly about financial affairs, with this view supported by new friend, acquaintance, caretaker
  
• Older person finds new caretaker guaranteeing lifelong care if he or she gives the caretaker his or her assets
• Elderly person in relationship characterized by power imbalance between parties, with caretaker assuming restrictive control and dominance
  
• Caretaker or friend accompanies elder to most important transactions, not leaving him or her alone to speak for himself or herself
  
• Elderly person writes checks for cash, in round numbers or large amounts, or gives cash gifts to caretaker or caretaker’s family
  
• Older person increasingly helpless, frightened, despondent, feeling that only the caretaker can prevent his or her further decline
  
• Elderly person sees acquaintance or caretaker as exalted, with unusual powers or influence"

Why You Should Care

Here I have reposted a section of SaveGrandma/org's webpage. It's called why you should care. It's easy for everyone to go through their day to day lives and be unaware that elder abuse happens. Even if they are aware, it's easy to forget and to think it doesn't affect me.... until the day it does. So, even if something like this is not directly in your life you should care. Please take a moment to read the following.

"In Germany, they first came from the Communists,
and I didn't speak up because I wasn't a Communist.
Then they came for the Jews,
and I didn't speak up because I wasn't a Jew.
Then they came for the trade unionists,
and I didn't speak up because I wasn't a trade unionist.
Then they came for the Catholics,
and I didn't speak up because I was a Protestant.
Then they came for me,
and by that time no one was left to speak up.

-MARTIN NIEMOELLER , PASTOR AND SOCIAL ACTIVIST"

Comments:
We all have parents, grandparents, great-grandparents, a disabled or elderly friend or neighbor, or someone in our lives who can be put into a situation falling under the broad category of elder abuse and exploitation. We also will all be part of the senior citizen community some day. This needs to stop now. This is about the security of your families and friends, and the security of your future and future generations. Trust me, this crime hurts families at their core and scars people for life. Make sure there is always people to speak up by speaking up.

You Really Can't Trust Anyone

One of the things we hope to accomplish on The Elder Advocate blog is to bring people together. One of the main problems with the crimes surrounding elder abuse and exploitation is the lack of a central group fighting it. There are tons of people and families, like us, who are fighting back and that certainly helps. It's not just that there's strength in numbers, there's also something to be said for knowing you're not alone. We all know this happens constantly but not hearing about it much, or not connecting with others who are fighting the same fight, can make you feel like you're alone.

Here's a connection to SaveGrandma.Org. Their struggle is a bit different but none is worse than any other. They are all horrifying. In this case, it is the Iowa Department of Human Services and their legally appointed guardians who are abusing the elders they have been entrusted to protect. Please go read about it. We're all in this together.

Politics on Our Side

Go New York! Get the ball rolling on this!

Protect elders, Schumer urges during Staten Island visit
Originally published by Staten Island Advance
on Thursday February 21, 2008, 12:00 AM

Staten Island Advance/Frank JohnsU.S. Senator Charles Schumer told his audience at the New Lane Senior center in Rosebank that stricter federal penalties are needed for those suspected of elder abuse.

As baby boomers age and become ever more vulnerable to the scourge of elder abuse, U.S. Sen. Charles Schumer called for stricter federal penalties for those who physically harm or financially take advantage of senior citizens on Staten Island and across the country.

"It's a growing problem on Staten Island," Schumer (D-N.Y.) told his audience at the New Lane Senior Center in Rosebank, where he was joined earlier Wednesday by borough Democratic lawmakers. "You don't hear as much about it as you should. It's being swept under the rug."

Quoting city figures, Schumer said there are 100 investigations of elder abuse currently open on the Island, but with an estimated 80 percent of cases going unreported nationwide, according to statistics, he said, "the real number could be a lot higher."

Many cases go unreported, Schumer said, because they often involve a family member preying on a relative, or because the victim may be too ashamed to admit that he or she has been physically abused or swindled by a family member or health aide.

"Senior citizens across Staten Island and New York shouldn't fear being scammed out of their savings or having their health care jeopardized by negligent caretakers," Schumer said.

Schumer said that financial exploitation, including the illegal or improper use of an elder's funds, property or assets "is now one of the most prevalent forms of elder abuse." Referring to city Department for the Aging numbers, Schumer said that financial exploitation is a component in approximately 34 percent of elder abuse cases in New York City.

"That's a despicable act," Schumer said. "We have to have much more severe penalties."

Schumer called on Congress to pass the Elder Justice Act to help combat the problem.

The bill would beef up prosecution efforts by instituting new penalties for failure to report crimes in elder-care facilities, and would increase training for those charged with identifying when abuse occurs.

It also calls for a study on the establishment of a national nurse-aide abuse directory, and also would provide a consistent funding stream and national coordination for adult protective service agencies across the country.

It also would form public-private advisory panels to coordinate federal, state and local anti-abuse efforts.

"This could go a long way toward curbing elder abuse," said Schumer.

The Senate version of the bill is currently before the Finance Committee, of which Schumer is a member. Schumer gave no estimate of what the program would cost.

An Idea to Protect the Elderly

"There are more crimes committed today with Power of Attorneys than with .38 specials". That is a direct quote from a lawyer who is currently representing my mom, an 84 year old lady with Alzheimers, in an exploitation case currently being heard in the Cuyahoga County Probate Court. My mom was a victim of a cowardly predator who took advantage of her condition and tricked her into giving him Power of Attorney over her and then he conned her into "selling" him her valuable lakefront property at a fraction of its worth. Even though we have a letter from her doctor stating that she was not competent at the time that she signed either document we are having a tough time in the Probate court. This type of crime is reaching epidemic proportions and the courts don't even know how to rule because it is so difficult to prove.

I have come up with a very simple solution. I am proposing that it be required by law that all Power of Attorney and real estate transactions involving an elderly (65 or older) or disabled person be videoed. This would insure that the person understood what he or she was signing and it would also prove that they were not being tricked, pressured, or manipulated into signing something against their will. We are all video taped every day when we buy gas or even a gallon of milk and so it should only be logical that such major transactions such as Power of Attorney signings and real estate transfers especially involving the elderly should also be recorded. I cannot imagine that anyone other than would-be criminals and scam artists would oppose this but if there is someone out there who has a problem with it I'd like to hear from you and hear your reasons. I'd also like to hear from anyone who agrees and if you have any other suggestions that might accompany this proposal. I would also like to hear from anyone that might be willing to help me get this off the ground.

Chances are most of us know or will know someone who has some form of dementia. Chances are even greater that we all know someone who is elderly or disabled and that means we all know someone who is a potential victim of one of these cowardly predators who choose to prey on the most vulnerable members of society. The sad part is these predators are often family members or friends of the elderly person. If this simple idea that I mention here today could one day become law it would help protect a lot of innocent people and discourage a lot of would-be criminals.