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An overview of elder abuse from one prosecutor

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Title: An overview of elder abuse from one prosecutor


1
An overview of elder abuse from one prosecutors
perspective
  • Slidell, Louisiana
  • June 15th, 2009
  • World Elder Abuse Awareness Day

2
Presented by
  • Paul Greenwood,
  • Deputy District Attorney,
  • San Diego County, California

3
(No Transcript)
4
WARNING!
  • The views expressed by the presenter are not
    necessarily those of the San Diego District
    Attorneys Office

5
How are we to measure a community?
  • By the way we care for our very young, the
    elderly and the defenseless

6
All victims deserve our utmost response
  • Sadly, some victims are overlooked, ignored,
    disbelieved, or simply are abandoned

7
Why should we care?
  • Our debt to the heroic men and valiant women in
    the service of our country can never be repaid.
    They have earned our undying gratitude. America
    will NEVER forget their sacrifices.
  • President Harry S. Truman
  • Inscription at WWII Memorial

8
Elder Abuse is...
  • A Crime
  • Going unpunished
  • Predictable
  • Affecting both urban rural areas
  • Where child abuse DV were 30 years ago
  • Escalating

9
The aging of America
  • Between 1950 2000, the total population
    increased by 87
  • Age 65 - by 188
  • 85 - by 635
  • By 2030 - 65 will triple to over 70 million

10
Demographics of living longer
  • 71,000 Americans are 100
  • By 2010 there will be 114,000
  • By 2020, there will be 241,000

11
ELDER ABUSE IS EXPLODING
  • Fastest growing age group
  • No known cure for dementia etc.
  • Victims often do not report
  • Third fastest growth job is home care
  • Minimal background checks
  • High temptation, low risk factors

12
We need the passage of the Elder Justice Act
  • Would be first federal legislation on Elder Abuse
  • 110th Congress has introduced S. 795
  • Sen. Hatch R-UT Lincoln D-AK
  • Emphasis on training, awareness prosecution

13
UNDERSTANDING THE DYNAMICS
  • Fears of many seniors
  • Leads to underreporting
  • Feelings of shame
  • Concern that exposure will lead to loss of
    independence
  • Sometimes accompanied by threats from perpetrator

14
Destroying the myths.My top ten.
  • Some of these myths affect all forms of elder
    abuse
  • Some affect only financial elder abuse

15
Myth 1
  • Elderly people make terrible witnesses

16
AVOID STEREOTYPING OF SENIORS
  • Forgetful
  • Senile
  • Longwinded
  • Grumpy
  • Disabled
  • Fragile

17
Myth 2
  • If elderly victim refuses to provide information,
    there is nothing that can be done

18
  • We can still build a case by talking to other key
    witnesses
  • Start on the outside and work your way to the
    middle
  • Let the DA figure out a way to break through
    victims wall of silence

19
LESSONS LEARNED FROM DOMESTIC VIOLENCE
  • Self -determination is not the answer

20
Why self-determination is a problem
  • If not punished, the perp WILL abuse again
  • We CAN convict even without the assistance of the
    victim
  • Abuse is a crime against NOT JUST the abused

21
Myth 3
  • If elderly victim gives the money voluntarily, it
    is not a crime

22
  • There are times when the apparent voluntariness
    has been diluted by fraud, undue influence or by
    exploiting the mental limitations of the victim

23
Myth 4
  • If the financial institution reimburses the
    elderly victim and then declines to seek
    prosecution, we have no victim

24
  • Once a victim, always a victim!
  • Restitution can NEVER remove the stigma

25
Myth 5
  • If victim is deceased before we discover the
    theft, we cannot prosecute

26
  • Wrong!
  • Treat such a case as if it were a murder
  • There are some situations in which we do not need
    the victim for a prosecution

27
Myth 6
  • Any case where the elderly victim is involved in
    a home repair there is a dispute over money
    this is ALWAYS a civil matter.

28
  • Is the contractor licensed?
  • Are there other victims out there?
  • Did he get the money up front?
  • What services did he promise?
  • What did he deliver?

29
Myth 7
  • Suspects of elder abuse crimes NEVER call 911

30
  • Wrong!
  • Dispatchers need training
  • As do paramedics

31
Myth 8
  • There is no point in reporting this incident to
    local law enforcement they wont do anything
    about it.

32
  • The impact of a letter!
  • Persevere

33
Myth 9
  • Elderly people die from natural causes

34
  • The importance of an elder death review team

35
Deaths in San Diego County
  • 20,000 deaths a year
  • 52 are reportable
  • Criteria is not seen by MD in last 20 days/not a
    natural death
  • Out of 11,000 possible cases 7,000 are waived
    automatically.
  • Out of 4,000 cases that come in, only 2,700
    autopsies

36
Lessons to learn from.
  • Dr. Harold Shipman
  • Charles Cullen

37
Myth 10
  • There are more important cases out there that are
    taking up my time

38
Building blocks to form collaborative approach
  • APS/Ombudsman program
  • Law enforcement
  • Prosecutors
  • Coroner
  • Public Health
  • Seniors
  • Public Guardian/Probate Court
  • Elder law attorneys

39
APS/ OmbudsmanCreating/promoting referral line
  • Every County must have a reporting line
  • Billboards
  • Posters
  • Radio and TV PSAs
  • of calls WILL increase

40
Law enforcement
  • Recognize red flags of elder abuse
  • Respond to referral of an elder abuse case
  • Take initial report and make sure case is
    assigned to a detective for follow up

41
Common reactions among law enforcement
  • It is a civil matter - it involves a Power of
    Attorney
  • It cannot be a crime - she gave him the money
  • It cant be filed - he does not want us to
    prosecute
  • The prosecutor wont file the case - the victim
    will make a terrible witness

42
Prosecutors
  • These cases are worthy
  • These cases are provable
  • We should get more creative in our charging
  • We should not be obsessed with a win-loss record
  • We need to talk to APS

43
Coroner /Medical examiner
  • Train ME Investigators who take calls from police
    after a death
  • Establish a protocol for reviewing suspicious
    deaths of elders
  • Can instigate an elder death review team

44
Public health
  • Remind them of their mandated reporter
    obligations
  • Develop training at every hospital, E.R., clinic
  • Watch for unexplained injuries or inconsistent
    explanations

45
Involving seniors
  • Reaching them through day centers, senior fairs
    and other workshops
  • Provide a positive message!
  • Top ten tips for safety
  • Door prizes a free lunch
  • Use them as volunteers - RSVP, DAs office
  • TRIAD

46
Public Guardian Probate Court
  • They see a lot of financial exploitation red
    flags
  • PG can intervene early enough to provide damage
    control
  • Probate Court investigators have access to
    information that other LE agencies will never see
  • LA Times articles .

47
Elder Law attorneys
  • Act for client for many years
  • Replaced without warning by new attorney
  • Obligation to inquire..
  • Consult State Bar over attorney/client privilege
    communications

48
Building the awareness level 1
  • Through public speaking at Rotary, Kiwanis, Lions
    etc
  • Front counter personnel at police/sheriffs
    station
  • 911 dispatcher
  • Banks credit unions Western Union - SB 2010
  • Pharmacies

49
Awareness level 2
  • First responders
  • Paramedics
  • Fire personnel
  • Remember that RP may in fact be suspect
  • Are you walking into a crime scene?
  • Listen, watch, remember, report

50
Awareness level contd 3
  • Train the clergy
  • Most are unaware of the problem
  • Encourage an overhaul in visitation ministry

51
Awareness level contd 4
  • Use the media to communicate
  • TV, Radio talk show, newspaper articles
  • Form a multi-disciplinary team
  • F.A.S.T
  • Elder Abuse Council
  • Adult Services Policy Council

52
Recognizing the red flags
  • Isolation
  • The new friend
  • Disenchantment with family
  • Impaired memory
  • Frequent telephone calls/delivery of mail with
    promises of winning

53
Recognizing the red flags..
  • Switch in doctor or attorney
  • Unexplained loss of weight or health
  • Blocked visits
  • Hovering over client
  • Multiple financial transactions which are
    uncharacteristic

54
Collecting preserving evidence..
  • What is your role?
  • Social worker turned investigator?
  • Are you uncomfortable handling evidence?

55
If you suspect that a crime has been committed,
call in law enforcement immediately
  • Time is of the essence
  • Crawford vs. Washington
  • Preservation of evidence

56
Physical and Mental Abuse
  • Assaults and batteries
  • Aggravated Assaults/Attempted murder
  • Sexual assault

57
Problems associated with sexual abuse of elderly
/dependent adult
  • Delay in reporting
  • Victim often cannot provide history
  • Physical findings may be clouded
  • Resident on resident dementia?
  • Employee on resident eye witness?
  • Victim allegations how to handle?

58
Physical abuse contd
  • Neglect

59
Classic neglect cases
  • Deprivation of medical attention
  • Deprivation of food
  • Lack of hygiene
  • Lack of ventilation, heat or light
  • Over-medicated
  • Under-medicated

60
The classic neglected victim
  • Malnourished
  • Semi-comatose
  • Dehydrated
  • Coated with fecal matter/ urine stained
  • Inadequately clothed
  • Untrimmed toenails, matted hair
  • Bed sores

61
Cross reference with financial abuse
  • Look for signs of financial exploitation
  • Documents giving control to suspect -
    POA - Quitclaim deed - New will -
    Correspondence, bank statements
  • Check book, ATM, pawn slips

62
Physical and mental abuse contd
  • Manslaughter - neglect causes death
  • Murder
  • Intimidation/Mental Psychological Abuse
  • False Imprisonment
  • Torture
  • Robbery and extortion

63
Profile of the physical abuser
  • Son in his late 30s to late 40s
  • Living at home with Mom
  • Divorced/ returns or single and unmotivated or
    just out of jail
  • Lazy and unemployed
  • Drugs, alcohol or gambling
  • Feeds habit off Mom
  • Sometimes history of mental illness

64
Financial Abuse
  • Theft
  • Credit card fraud
  • Real Property transfers
  • Home Improvement scams/burglaries
  • Work by unlicensed contractors/overcharging
  • Telemarketing,sweepstakes e-mail scams
  • Investment fraud

65
Theft of ..
  • Jewelry ends up at pawn shop
  • Check from back of check book
  • ATM card
  • Credit/Debit card
  • Your mail

66
Current top elder financial scams
  • Canadian other foreign lotteries
  • Phishing identity theft
  • Investment Frauds
  • Bogus charities

67
HOW TO PROVE STEALING?
  • Taking property
  • belonging to another
  • without consent
  • with intent to permanently deprive

68
Forms of theft
  • By larceny - a taking of property
  • By trick - consent is based on deceit or fraud
  • By embezzlement - property is entrusted to thief
  • By undue influence

69
Three prosecutable scenarios
  • Classic case of theft from a competent victim
  • Theft from an incompetent victim
  • Theft from a marginally competent victim by
    undue influence

70
SCENARIO 1
  • Victim testifies
  • Did not give permission
  • Did not owe monies to suspect
  • Victim is credible

71
SCENARIO 2
  • Victim cannot testify
  • Medical testimony that victim suffers from
    dementia/ Alzheimers/ Parkinson's or some other
    illness that deprives victim of necessary
    understanding
  • Incapacity was present at time of transaction

72
SCENARIO 3
  • Is it theft, a loan, or a gift?
  • Victim is marginally competent
  • Suspect exploited victims vulnerability
  • Victim was unduly influenced or was defrauded

73
Undue Influence
  • Victim was pushed in a direction that he did not
    want to go.
  • The influence by suspect was sufficient to remove
    the voluntariness of the transaction
  • No longer free will
  • Victim has been evaluated by a geriatric
    psychiatrist/psychologist

74
How to prove undue influence?
  • Length of relationship
  • Place of first meeting
  • Prior spending habits
  • Prior charitability
  • What is left?
  • Multiple escalating transactions
  • Statements conduct by suspect

75
Witnesses
  • Bank teller
  • Pastor
  • Neighbor
  • Doctor, pharmacist, optometrist of V
  • Family
  • Ex- spouse of suspect
  • Business contacts of suspect

76
Evidence collection
  • Bank, credit card statements
  • Bank surveillance tapes
  • Prior medical records
  • Look for the inappropriate purchases
  • Ask questions, questions, questions!!!

77
Crawford v. Washington
  • Creates immediate problems for elder abuse
    prosecutors
  • US Supreme Court fundamentally changed the
    meaning of the Sixth Amendment confrontation
    clause

78
Grand jury or preliminary hearing?
  • Time is of the essence in view of the Crawford
    decision
  • Consideration needs to be given for preliminary
    hearings to be used in ALL cases involving
    elderly victims

79
Seniors and the court process
  • Getting them to court
  • Bringing the court to them
  • Waiting at court
  • Testifying in court
  • After court - to prevent further victimization

80
Assess the impact of the crime
  • Financial
  • Emotional
  • Residual

81
The next step
  • Bringing services to the victim
  • The one stop shop concept

82
A Message to Seniors
  • We respect and honor you!
  • We commit to seeking justice for you
  • We prosecute with
  • Passion
  • Purpose
  • Perseverance

83
Please feel free to contact me
  • Paul Greenwood
  • 619-531-3464
  • paul.greenwood_at_sdcda.org
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