Seniors Often Are Easy Prey For Abusers

Holding a photo of the ship he served on during the attack on Pearl Harbor, 93-year old Arnold "Max" Bauer was found last week, in what authorities describe as squalid conditions. His El Cajon home is said to have been filled with trash and rotting food. Mr. Bauer was described as frail, sick and confused.

Authorities say they also found more than 50 checks Bauer's caregiver had written to herself. His caregiver has been charged with Theft From an Elder/dependent Adult.

What makes this story even more disturbing is that it is not isolated. As the US population ages, the number of elder abuse cases is increasing as well.

Guests

Paul Greenwood is San Diego County deputy district attorney and head of the elder abuse prosecution unit.

Pam Smith is director of the County's Aging and Independent Services.

Laurie Edwards Tate is President and Founder of At Your Home Familycare.

Read Transcript

I'm Maureen Cavanaugh you're listening to These Days on KPBS. Holding a photo of the ship he served on during pearl harbor, 93-year-old Arnold max bower was found last week in what authorities describe as squalid conditions. [CHECK AUDIO] they also found more than 50 checks Bower's caregiver had written to herself. Of his caregiver has been charged with theft from an elder dependent adult. Of what makes this story even more disturbing is that it is not isolated. As the U.S. population ages, the number of elder abuse cases is increasing. Joining me now to talk about elder abuse in San Diego are my guests. Paul green wood is deputy district attorney for San Diego, and head of the elder abuse prosecution unit. Paul, good morning.

GREENWOOD: Good morning, Maureen.

CAVANAUGH: Pam Smith is head of the [CHECK AUDIO].

EDWARDS-TATE: Good morning, Maureen.

CAVANAUGH: And Lori Edwards Tate is president and founder of at your home family care. Lori good morning.

EDWARDS-TATE: Good morning, Maureen.

CAVANAUGH: Now we invite our listeners to join this conversation. Are you concerned about the care your elderly relatives are receiving in San Diego? Do you susceptible elderly person you know is being abused? Give us a call with your questions and your comments issue our number here is 1-888-895-5727. Of that's 1-888-895-KPBS. Paul green wood, how many cases are there of elder and dependent adult abuse that come through your office each year?

GREENWOOD: Well, just in the last year, 2010, we actually prosecuted 240 primarily felony cases ranging from homicides down to petty thefts. But of course that doesn't include other cases that we considered and for whatever reasons, evidentiary reasons we rejected. Even though that doesn't sound like a whole lot, it clearly is unfortunately just the tip of the iceberg. Many membership more case, unfortunately never get to our office for several reasons that are being discussed.

CAVANAUGH: And what types of cases do you prosecute? What are the charges?

GREENWOOD: Well, they range from your typical, classic case of a way ward son in his '40s living at home with a mother, pushing, slapping, and punching her after stealing her jewelry and she confronts him about that. So that's your typical case that we get on a very regular basis. To neglect cases which can be abhorrent, where an elderly person is found in terrible conditions, to other forms of abandonment or emotional abuse, to then financial exploitation. Which covers the gamut from family members stealing to opportunistic crooks, to telemarketers, to professionals.

CAVANAUGH: Now, Pam Smith, with San Diego County aging and dependent services, you must see measure the tip of the iceberg that Paul green wood was talking about, people call into your office and I wonder what kinds of cases of abuse and the frequency your office hears about elder abuse.

SMITH: Right. So we park -- one of the programs that we administer at aging and independent services is adult protective serves of so we go out and we're the place where the call comes into, and we go out and investigate. Now, we're not emergency responders. If someone sees an emergency, they should call 911 of but if they suspect there's some abuse, if they haven't seen a neighbor, we have a lot of man dated reporters, anybody who has direct work with seniors issue financial institutions, banks, senior centers, but we get about 10000 calls a year reporting potential elder abuse. So we have a staff, 43-case carrying investigators throughout the County that go out and do that initial contact to see what's there and what can we do. Now, some of these are unfounded, somebody, you know, was just worried about somebody and we go in, and it's okay. Some we're able to shore up, some of them are just neglect or a senior that is really struggling and on their own. I think one of the things that we see is if a senior gets off alone and isolated, that's when they're the most vulnerable. And sometimes it may be a neglectful situation, and there hasn't been a call for help because they're afraid someone may come and take them away. But our whole direction is to support them in their home, support them in their services. [CHECK AUDIO].

CAVANAUGH: Tell me what you mean by isolated.

SMITH: Well, losing contact with the community, maybe living alone, and it starts getting difficult to get out. Maybe they no longer drive. And maybe they have had a fall. So they're hesitant to go out again, so they're more home bound. Or they're just reluctant. They do stay often contacted with their financial institution, their banks or credit unions, often a neighborhood grocery store, some of those ways, but if they start losing contact with that, we try to encourage them a lot to link with a local senior center, their role library, a congregate meal sight, we could do home delivered meals, we have a variety of ways to keep them connected, and that way if this is a scam artist or there is someone that's taking advantage of them, they've got someone to talk to on that. But we do work, we investigate with there's cases, we work closely, sometimes we usually call it a three legged stool, but [CHECK AUDIO] we are very lucky that they have taken such an aggressive position, Paul is very passionate, knowledgeable on this topic. And really sends the message out that wee not going to tolerate it. But we do need the community on there. That's the other leg. We need the people to be the eyes and ears, because that senior that became isolated, is that your neighbor that you no longer see, is that someone that used to come to your church that doesn't come anymore? And sometimes as Paul said, sadly, it's the family member.

CAVANAUGH: Right. In fact, more often like any kind of domestic violence or problems there. So thinking that there is somebody there or a -- in some cases a caregiver that's in there, they're -- they can be too. And that we still need to check on these folks.

CAVANAUGH: Let me remind our listeners, we're asking if are your participation. You can join this conversation at 1-888-895-5727. Lori Edwards Tate, you're president and founder of at your home family care. I would imagine, however, sometimes care givers can notice a situation in which an elderly or dependent adult is vulnerable.

EDWARDS-TATE: That is correct, Maureen. And we really feel that what happened to Mr. Bower could have been prevented, as tragic as this situation is. Our care givers become an extended family member and help to supplement what a family would be able to do. So by working with a responsible, certified, well established organization, it could really have made all the difference in terms of protection and security, the over sight that we provide, the care management, the due diligence. It would have made all the difference in the world in the outcome of this.

CAVANAUGH: I'm wondering, Pam, how do people select their care givers when indeed they have to -- they have to start relying on somebody? Are there ways to go about doing that in a correct method? And are those ways observed most of the time?

SMITH: Well, I think people don't know how to go about looking for a caregiver. And sometimes they ask or run an ad or do something, and we try to give tips for that. There are a lot of agencies such as Lori's that are bonded agencies that are very reliable, that have professional caregivers. So we often would refer them to that list of agencies that they can start with. But beyond that, we need to, if you're just going to hire somebody individually, we encourage people to do background check, look into their credit history, get, you know, a reference checks on them. There's a number of tips that we can give, drug testing, you could require drug testing, and often a family member, you know, we're a mobile society anymore, so family members may listen in another city or state. But it's worth the investment of time to help get a good caregiver, do that background check, do your homework, but then they still have to connected, visit regularly, visit different days, different times of the di. Get your -- people, up, eyes in there. And if they live out of state, find a neighbor find somebody from that church group or we have ways that we can connect people with someone to do checkups on them.

CAVANAUGH: And -- but just to be clear, Paul green wood, is it true that most of the problems with elder abuse come from family members themselves?

GREENWOOD: Well, certainly with the physical abuse cases, the classic case that I mentioned at the beginning of program with the son or the granddaughter or a nephew who's addicted to drugs, alcohol, or gambling. Yeah, that is very much a common factor. But with financial exploitation, no. I see all kinds of suspects from family members to professionals to the next door neighbor to the new best friend who just happened to meet them in the super market. It covers a whole variety.

CAVANAUGH: We are taking your calls at 1-888-895-5727. Susan is calling from Del Cerro, good morning, Susan welcome to These Days.

NEW SPEAKER: Oh, hi. Good morning. Yes, my comment is that we have a situation actually very similar to what the District Attorney -- assistant district attorney was describing of we have an elderly neighbor, a widow who's middle aged drug dealing son was living with her, bleeding her dry. She caused the suffering -- suffering from dementia, everything was deteriorating. And over the course of the two years that this occurred, every neighbor, every their called the police, adult protection services, and they said they'd come out, and since she wouldn't file a complaint they couldn't do anything. I mean it was a awful situation and what finally happened is about a year ago her son was dead, found dead. She found him, he had been dead for several days and she didn't even realize it. And it was a neighbor who checked in that discovered this. Even the postal person had reported the situation, had been monitoring it, but nothing was done. And the neighbors finally stopped calling because we felt that -- we did I understand, and we don't understand why. It was clear there was a problem here, it was clear this person was being abused.

CAVANAUGH: Right. Let me get a response, Susan, let me get a response to the tale that you told us and a very sad story. I'm wondering, Pam, are your -- is your agency, do you find your hands tied on occasion because you respond to a report? What do you need -- what's the next step to actually doing something about it?

SMITH: Well, I think we have to realize, you know, the rules and the laws under adult protective services are very different than child protective services. Because an adult has a lot of rights that a child -- we have to protect a child. But an adult has a right, in fact, to make mistakes. They have a right to give their money away. They have a right to buy things that we think might be silly or frivolous. They have a right to have someone live with them that we -- someone else might not agree with. Now, if they're no longer capable, you know, that they can make decisions in their own best interest, but that has to be determined by a court. And that's a pretty narrow definition. And what we see is a whole lot of gray area. Where indeed, in the caller's case is a good example that's a real struggle. Of people are concerned, will go in and check, the senior will be okay, clearly in a clear state of mind but feels okay with the situation. And as Paul mentioned, often when they're family members, they're hesitant to say anything. It's difficult. These are proud people. It's difficult to say this is the son I raised, this is my grand child, and they don't want action to take place. Of so it's complicated. We do have to work with the community on it. We have to look at a Broadway and try to get in and keep talking. Of but it shouldn't stop people from letting us know and getting out there.

CAVANAUGH: And Paul, what are some of the ways that law enforcement over comes these hurdles to actually protect seniors who need it.

GREENWOOD: Well, thank you, in fact, Susan from Del Cerro has really described what it is 0 often a frustrating scenario for me. And in the situations where a victim is clearly competent and is able to make decisions on their own and says to AP S or lawyer enforcement, I know what I'm doing, goodbye, go away, it's none of your business. That that basically is the end of the road. But in many situations, I do see this very differently. Even if the victim says oh, yeah, my son doing this, but I don't want anything to happen to him, I will still push ahead wherever possible. If I can prove this case beyond a reasonable doubt, despite the victim not wanting me to, and there have been many times in the last 15 years where that has happened, where a mother has come to me and grabbed me by the arm and saying oh, Mr. Green wood, you're taking away my only friend in my- please do not prosecute him. But of course if I don't prosecute him, and I feel like I can prove it beyond a reasonable doubt, then I'm not doing that victim any justice at all. So we have to look at this and try to get law enforcement to gather the facts and bring them to me. I mean, the scenario that Susan has depicted, if it hasn't reached my desk, then we'd like to know about it, issue in case there are some angles that we can look at and go from which pas the traditional law enforcement response that they don't have sort of. And that is why working in San Diego, it is actually very affective, we have APS caseworkers calling me, we have police officers calling the specially trained elder abuse detectives unit in San Diego, and together, hopefully, not too many of these cases that Susan has shared with us will fall through the cracks. And one final point I want to say, even though she and the neighbors felt scourged by this, I don't want citizens of San Diego to think, well, there's no point in me calling of there is every point in calling. Keep calling of because hopefully, you know, we can make efforts to bring about some sense of justice. Ultimately, though, if the victim is competent and knows what they're doing, as Pam said, they're free to make mistakes.

SMITH: I just wanted to add also, the vast majority of cases we are able to offer assistance and help or at least get in there and check. And we might see a senior that's headed for trouble, and we can get some services in there and prevent is from becoming something very serious. And we have teamed with Paul and his office to do some preventative work in the community as well. In fact, we have a wonderful series of classes that we're offering called self defense courses to protect yourself and your wallet. And this was actually funded when these short financial days of public dollars, this was funded by the Barona and Sycuan tribes, but Paul himself, and we have a wonderful 70-year-old black belt, Mary who goes out. And we really train people on basic common sense, self defense, caution things, things that can really make a difference, but then Paul really educates themselves about scams, how to protect their wallet. [CHECK AUDIO] great information. We do a lot of things. Work with the community, preventative things, educate people before because we'd rather stop these things than deal with them after.

CAVANAUGH: And I've just been informed it is on our website right now. Of KPBS.org/These Days. Lori?

EDWARDS-TATE: Yes, well, what I'm hearing brings to mind several thoughts, first of all, we seriously recommend against hiring a private caregiver in the 50 place. Through a list, through friends of a friend, because that does create more opportunity for the kinds of things we're talking about. We would really like to prevent. The other thing is that we have posted for your listeners today at your home family care.com, an extensive list, [CHECK AUDIO] a variety of questions they should be asking when they decide they need to choose home care. But there's no substitute for a quality organization with long standing in the community to provide that additional protection and over sight. And I'm very proud to say that we have actually prevented things like suicides with our nonfiduciary money management service, we have identified as we help a senior citizen or disabled adult pay for bills, situations where too many checks are going to a family member or a neighbor or friend. So then what we can do is connect into resources such as adult protective service and call on behalf of our client.

CAVANAUGH: We have to take a short break, but when we return, we will continue to talk about preventing elder abuse in San Diego and taking your calls. Of our number is 1-888-895-5727. That's 1-888-895-KPBS. You're listening to These Days on KPBS.

I'm Maureen Cavanaugh, and you're listening to These Days on KPBS. Our topic is protecting against elder abuse in San Diego. We all heard the terrible story left week of a pearl harbor survivor who was found in what authorities found as a squalid dirty house, frail, sick and condition fused, his caregiver has now been charged and is in jail awaiting trial. And my guests are Paul green wood, he is deputy district attorney for San Diego County, he's head of the elder abuse prosecution unit. Pam myth is director of the county's aging and independent services, Lori Edwards Tate is president and founder of at your home family care. Lori, I did want to ask you, what is the screenings about that care givers undergo? And what kinds of things do you look for to sort of eliminate people.

EDWARDS-TATE: Well, that's a very good question. First of all, we begin with being certified by our state association, which is the most well respected vetting for nonmedical private duty home care. What that means is that we screen for tuberculin test, we personally interview all of our care givers, we conduct extensive [CHECK AUDIO] worker's comp insurance and so forth. Beyond that, we also need to look for things such as are these organizations well established, what does the community say about them, are they part of any sort of national organizations? Members of PDHCA, part of our knack association based in Washington DC? [CHECK AUDIO] participating, developing standards which will do nothing but continue to improve and meet the needs of what is our silver tsunami.

CAVANAUGH: That is as people get older, the elderly population increases in the United States.

EDWARDS-TATE: 10000 people a day are turning 65, and it's going to be that way for the next 20 years. So being able to be on programs like this, and share this type of thing. So we are also available 247 which means if there is an emergency, is it a medical emergency? What is the situation? Do we need to report it? So we're also available during the week on weekends on holidays. So we have to first start with our position that hiring a caregiver on your own can actually be dangerous and a reputable organization, home care organization will be certified or vetted in some way through a very well respected institution. And then have standards of practice. Of the other thick that's really fortunate Maureen, I need to say here, is that families, individuals need to feel that it is okay to ask questions of any home care agency they may choose to access. Of the agency should be open to that process, should have really good answers to those questions.

CAVANAUGH: I just -- and I did want to -- before we take phone calls, because flower a lot of people who want to get in on this conversation. Pam, do you get reports coming from nursing homes and facilities of that sort that accusations, alleges of elder abuse and how do you go about chasing those down?

SMITH: Well, that's kind of a separate issue. But we are involved with that, because we have an ombudsman office in aging and independent services. Now, we're not the actual investigation of abuse is done by the state, department of public health, and the investigation's there, but we're kind of the in between. So we have ombudsman that we train, they're volunteers, and we're always looking for people who would like to have a meaningful, good volunteer opportunity. We train them extensively. [CHECK AUDIO] in all, I believe there's 750 in this county. And they go there regularly, and they walk around with residents, talk, check the eyes and ears, resolve disputes, but if there's anything they spot that they think might be a problem, have gone they alert both the facility but call the state licensing office. So that that's an extra step, if any of the listeners are interested in that, that's a [CHECK AUDIO] over 70 percent of people at nursing homes never have anyone visit them. It's very sad.

CAVANAUGH: Right. Let's take a call. Barbara is calling from Encinitas. Good morning, Barbara, and welcome to These Days.

NEW SPEAKER: Thank you. Yes, I have a comment based on five years of experience with air family member out of state. And I just want to say how very helpful the adult protective services was in the other state. Where my brother lived. And I look with another brother and a sister, the three of us had Power of Attorney, and it was hugely helpful to have this -- the network of resources that were available to us. And I just don't know what we would have done without them. He was married, his wife was addicted to gambling, so all of the money that came into the house immediately went out. And we had to take advantage of every resource we could just to keep -- be able to pay the bills, etc. And that social network -- I'll not ever complain about paying taxes again.

CAVANAUGH: Okay. Barbara, thank you for that. Thank you for sharing that story with us am I'm wondering, Pam, how often do you have to coordinate somebody calling from out of state to check on a senior here in San Diego?

SMITH: Very frequently. A lot of the times the call is coming from someone, they haven't been able to connect, they're worried about their grandfather, their father. There are -- as we talk about, some of the problems are family members issue but the best and the most loving people sometimes are family members.

CAVANAUGH: Sure, sure.

SMITH: [CHECK AUDIO] when their daughter calls from New York, they say oh, I'm fine.

CAVANAUGH: Right.

SMITH: So there are a lot of other signs to look at. We do encourage out of state family members if they can to be part of a joint bank account so that they can monitor, if there's unusual checks written regularly to call us. And the issue of investigating elder abuse has really been a kind of a state to state issue. [CHECK AUDIO] just last year was the first time ever, they passed legislation, the elder justice act, to really start looking at, getting some national standards on this, but it hasn't been funded yet. So, you know, the state of things there. But it's because, you know, never before have we ever had this many people live this long. And our fastest growing segment of the population is over 85. And -- and we're a mobile society. We've -- communities have never been like this before. So we are really writing the new laws, creating this and in the meantime, we have to say, how can we best protect so that our seniors can live with dignity and respect and a long and safe life.

CAVANAUGH: I really want to get in a couple more phone calls. Karen is calling from Carlsbad. Good morning, Karen, welcome to These Days.

NEW SPEAKER: Thank you for having me on the air.

CAVANAUGH: Yes.

NEW SPEAKER: Yes, I wanted to make a comment about people, you know my neighbor and landlord passed away, and I did everything I even called his family knowing he was passing away at that time, and nobody ever came. And he ended up being with me. And I was at least -- he had someone with him when he passed away. But you know, I feel bad for all these people that no one ever checks on them, then they find them days later that they passed away in a trailer park that happened. And I right now am taking care of a neighbor that used on -- that I've known for 20 years in Solana beach when I lived there, buzz he has no one else that he trusts or even knows. So it would be great to get help, but sometimes it is difficult. And I just wanted to make that comment of thank you so much.

CAVANAUGH: I appreciate it. Beth is calling us from university city. Good morning, Beth, and welcome to These Days.

NEW SPEAKER: Oh, thank you for having me on.

CAVANAUGH: Yes.

NEW SPEAKER: My problem concerns abuse in terms of emotional abuse I've come down recently from San Francisco California, and we had a huge elder abuse department up there. My mother was calling me, called me in January frantic because it hurts -- the system, they have been in America 20 years, and her husband had -- had Alzheimer's disease. Of and they took him from her house. Kidnapped him from her house last January.

THE COURT: Who did?

NEW SPEAKER: The son, the stepson.

CAVANAUGH: Uh-huh.

NEW SPEAKER: And the neighbors saw him in the streets crying in the car, and hitting his head against the window. And my brother didn't see this, the neighbors told her this. And took him away, and my mother didn't know what happened. She call would me up and says they've taken George. So I was going other calling people, so finally she did call the police. The and, well, she called her attorney first, it was her church, she -- not a litigation, but she called an attorney, and called apparently the son's attorney of what they were doing was trying to get her to sign a release of the trust. In other words that she wouldn't contest the trust when he died.

CAVANAUGH: Beth, what a terrible story. I --

NEW SPEAKER: And so basically the police did come and he told her he couldn't go get George because, you be, he couldn't do that to --

CAVANAUGH: Beth, I'm sorry, we're gonna have to stop it there. Of it's a very, very sad story that you're telling us. And Paul, I want to ask you, so many of these cases are so sad. Of and they're so tragic, and I wonder if there's ever a good resolution? I mean, do you ever have a case where you say, you know, now the person that I worked for that I tried to help is doing much better?

GREENWOOD: You mean the defendant?

CAVANAUGH: Yes.

GREENWOOD: Well, sometimes that may help, and the only times I hear that is if we place somebody on probation, and they come back for a review hearing in, say, six months time, they have been through a course of residential drug rehabilitation or alcohol rehabilitation, and you see them in court, ands physically, they've changed their appearance, they've gained weight, they have got their self respect back, and they show remorse. Yes, there are some success stories like that.

CAVANAUGH: And Pam, for the elderly person, who is in a terrible situation that you might uncover, do you have some success stories where a person is now in a much better situation because of this intervention?

SMITH: We have a lot of success stories when we can get in there and we may get the call from an out of state family member from a neighbor who's concerned. And we go in and we can work with this individual. And our best tools are words and our influence and our persuasion, but then it's calling family and friends. It may be rallying around, it may be linking them with other resources this we get resources in there. It might be a neighbor that's concerned, and therefore we call know out of state relative to say, look, this situation is very difficult. And it's -- you need to get here. So we have lots of good resolution. It's like all of these programs, this population's been growing, our funding and our adult protective services has been flat for 8 or 9 years and slash aid year ago. So we're struggling to say how do we do this and how do we follow up? But we work extensively with our community partners. Again, if we can keep seniors connected in their community, there's lots of things going on, lots of seniors still have a lot to offer, stay connected to the program now, the programs at their community library, somebody doing a home visit. And we also have some programs that are very -- that we put together with the community, for instance, we can set up a very nonintrusive watch dog system where they can get a daily phone call to see if they're okay.

CAVANAUGH: Oh.

SMITH: We work with letter carriers, [CHECK AUDIO] often signs, one of which is not picking up their mail. And they alert us. The yard, we look at utility readers.

CAVANAUGH: I want to ask Lori about the idea of a caregiver coming into a bad situation and basically sort of straightening it up.

EDWARDS-TATE: Right. And you know, that's also why we say, you know, don't hire off the streets. We provide a conduit between the caregiver, the client, if there are children, adult children living in other parts of the country we community with them. We have an open, ongoing communication process that I am just so proud of that we have in place. Our care givers will notify us if there's anything that does not seem right, change in the client's emotional status, neighbors over interfering, whatever it happens to be. We have ongoing care management where these reports are done, and then we can also connect. If there's a disease such as Alzheimer's disease, we will refer to the Alzheimer's association or Parkinson's association as part of community network.

CAVANAUGH: And I do want to let everybody know that the tips that Pam and Paul were talking about are on our website, as well as a link to the tips that Lori was talking about. And that is at KPBS.org/These Days. I want to thank Paul green wood, Pam Smith, and Lori Edwards Tate for coming in and speaking with us am thanks so much to all of us.

SMITH: Thank you, thanks for talking about this important subject. Of.

EDWARDS-TATE: Thank you.

GREENWOOD: Thank you.

CAVANAUGH: If you would like to comment please go on-line, KPBS.org/These Days. Stay with us for the next hour of These Days. That's coming up in just a few minutes right here on KPBS.