People I want to punch in the face: Part 1
I’m not an angry person (unless I haven’t eaten in a few hours), but I have encountered some situations in senior care that have really made my blood boil. I think one of the worst possible things a person can do is take advantage of a senior citizen, but unfortunately it’s not uncommon - they are an easy target. They are forgetful, trusting, and usually unable to make rational decisions, which basically make them the lowest hanging fruit for scammers. Not to get all statistical on you, but an estimate by the California Advocates for Nursing Home Reform suggested that only one in six cases of financial abuse of a senior is ever reported, which means that this is happening a lot more than we realize.
Already I’ve seen two instances of what I consider elder abuse. They have both been very clever and well planned, which means that there have probably been other instances that I’ve missed. I’ll discuss the first one here, involving a resident we had living here I’ll call Rick, and a home health caregiver I’ll call Sharon. People like Sharon are very common in ALFs – they come in to supplement care for residents who live in an ALF, and typically work with multiple residents at multiple communities. They will do therapy, provide companionship, assist with higher care (taking care of a catheter, for example, which is something our staff cannot do), provide showers, assist with eating, etc. They’re typically a huge asset and take a load off of the ALF’s staff’s plates. Sharon had met Rick at church, and had been working with him ever since. Sharon was Rick’s only visitor as he had no family, and he was devoted to her. In actuality, he was quite in love with her, and proposed several times. Sharon seemed nice enough in the beginning – she chatted with staff, was very personable, and took great care of Rick. But then things started to change.
The first sign of trouble was when staff began catching her in lies. She would tell one staff member she was a dental hygienist and only visited Rick because she felt bad for him, and then tell another staff member that even though she was a certified caregiver she could only find work as Rick’s caregiver, and didn’t have any other residents. Eventually we determined that the latter story was true, that Rick was her only patient and thus only source of income. That was strange, because all of a sudden she had a brand new car, and was telling staff about a lavish vacation she’d taken despite Rick’s fees to her being fairly low.
The next few red flags were all minor on their own, but our Administrator, who has been in the industry for years and, unfortunately, is no stranger to elder abuse put the signs together. Sharon’s visiting hours changed; she stopped coming to the building during the day when management was around, but started dropping by early in the morning, late at night, and on weekends. Her visits were punctuated by sudden appearances of Rick at the front desk. See, Rick is an adult ward of the state, and every month his appointed guardian would give an allowance from Rick’s funds (which he was deemed not capable of managing on his own) to the front desk, and Rick would pick up $5 to go to a movie, or $10 to go to Fred Meyers on the facility bus. The front desk gals could usually predict when he would ask for money (at the last minute before an outing), but all of a sudden that changed. We discovered that he was asking for money right after Sharon called him and right before she visited, or during one of her visits. The receipts that she was supposed to provide from their outings together stopped being delivered despite the fact that he didn’t stop withdrawing money. Whenever he enjoyed something, he would remark to staff that he wanted to share it with Sharon. If he saw a movie he liked, he would want to buy a ticket for Sharon to see it, too. She was his link to the outside world. He was friendly enough with our staff, but no one gave him one-on-one attention like Sharon did, and that made him willing to do anything for her.
It was frustrating, but my Administrator couldn’t take further steps to look into this case of assumed financial abuse until she had what was deemed ‘concrete’ evidence. The catch 22 is that it’s hard to have enough concrete evidence until you’ve investigated a situation more thoroughly, which you can’t do until you have the evidence, and around and around. We are here to care for and protect our residents, but we can’t step into a situation of potential financial abuse without having more than a hunch to go off of. My Administrator was able to connect with Rick’s guardian and explain what she suspected was occurring, and the guardian (fortunately) listened to her, and agreed. She contacted Sharon and informed her that she needed to provide receipts for all of the outings that she and Rick went on that Rick paid for, and that she could only visit him when management was in the building. Sharon, of course, wasn’t thrilled about these limitations, and began having Rick let her in through a side door so that staff wouldn’t know she was in the building with him. We discovered her on accident a few times this way, and that prompted the need for even more aggressive action. Sharon was now required to visit Rick during business office hours only, and in a public location in the building, rather than his room. She also was no longer allowed to take him out of the building without the guardian accompanying them.
Around this time, Rick had a health incident and went to a hospital for a few days, and then to a rehab. Like I’ve said before, part of my job is to visit residents who are out of the building, and I visited Rick a few times. We had nice visits, mostly talking about politics (Donald Trump being his favorite topic), but every conversation was punctuated by questions about Sharon. Was she coming to see him soon? How was she doing? Did she see that movie he’d recommended? I felt so bad for him, because I strongly disliked Sharon at this point and didn’t want her to have anything more to do with Rick, but all he wanted was to be with her. The nurse let me know that Rick’s guardian had filled her in on the Sharon situation and that she wasn’t allowed to visit him, but through talking to Rick and some of the nursing staff, I discovered that Sharon had been coming to see him under a different name. I don’t know if she thought she was really helping Rick, because she continued to ruthlessly fight our staff and the guardian for her continued right to see Rick despite all of our very valid reasons to decline her this right. I would argue, though, that anytime you assume a secret identity to sneak into a hospital to visit someone against the wishes of everyone who knows him, you’re probably up to something bigger than sending your well wishes for a speedy recovery.
I would like to tell you that this story has a happy ending, or even a sad one just to bring the story to a close. But here’s what really happened: Rick discharged from the rehab center to an Adult Foster Home (AFH), which is a house that is state-certified to take care of seniors. There are fewer opportunities to receive care than at an ALF, but Rick was actually quite healthy physically, even if his mind was going. The rehab social worker and I both deemed that a small building was safer for Rick, who didn’t quite qualify for a locked memory care unit, but would benefit from being in a smaller home that could keep an eye on his tendency to wander. So after he left the rehab he never came back to my building, and I don’t know what happened to him. We spoke with his guardian once, and she informed us that he was thriving at the AFH, and while I was thrilled to hear that, I couldn’t help but miss Rick, and wonder if Sharon had managed to find him and continue her extraction of his funds. The last I heard was that the state was pursuing filing a restraining order on Sharon and working to get her care giving certification revoked, but I don’t know how that ended.
I have one more story about elder financial abuse that I’d like to share, as well as suggestions of what to do if you suspect that you’re witnessing it, but I will save that for the next blog coming soon.
