Saturday, February 28, 2015

I-Team: Broken system?
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The Scott County Public Administrator is responsible for 250 people all over the county.

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I-Team: Broken system?

Court docket on lawyer discipline to be public

Beginning on February 1, the Supreme Court will publicly disclose documents on actions it is considering or taking to discipline lawyers who are members of its bar, a process long shielded in privacy, the Court announced on Tuesday.  Currently, that file is treated as confidential, although final disciplinary actions are made public along with regular orders on pending cases. In the new arrangement, attorneys involved in a case may ask to keep their response confidential, in whole or in part.

Under the new disclosure policy, the Court’s announcement made clear, public availability of that docket will be the general rule.  It will apply to documents filed after February 1.  But if there are reasons to keep an attorney’s response confidential, that will be considered on a case-by-case basis, if sought by the lawyer involved.  Typically, a lawyer is notified that potential disciplinary action is being considered by way of a “show cause” order, to which the lawyer then has a chance to respond and to argue against a disciplinary order.

One of the Court’s most noteworthy disciplinary cases now unfolding involves a “show cause” order issued on December 8, involving a Washington, D.C., attorney, Howard Neil Shipley.  The order told him to respond within forty days on why he should not be sanctioned for his handling of a specific petition for review.  There was no explanation of why that document may have involved a breach of either the Court’s rules or ethical rules.  The petition at issue was rambling and, at several points, nearly incoherent.  There was an indication that a non-lawyer may have had a central role in its drafting.

The forty days Shipley was given to respond have elapsed, but the Court — at his request — has now given him until February 19 to respond.  It is unknown, at this point, whether the new public access policy will apply to the response to be filed in his case.

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Court docket on lawyer discipline to be public

Three-judge panel to hear ethics case against Tulare County judge

Tulare County Superior Court Judge Valeriano Saucedo
A panel of judges appointed by the state Supreme Court will meet April 6 in Fresno to hear evidence against Tulare County Superior Court Judge Valeriano Saucedo, who is accused of violating judicial ethics.

Saucedo, a judge since 2001, allegedly accused his court clerk in an anonymous letter of having an affair and then gave her thousands of dollars worth of gifts.

The three-judge panel will report its findings to the Commission on Judicial Performance. If the commission finds clear and convincing evidence of wrongdoing by Saucedo, it could remove him from office or impose lesser discipline.

The hearing will be held at the Fifth District Court of Appeal and is open to the public.

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Three-judge panel to hear ethics case against Tulare County judge

Friday, February 27, 2015

When Home Caregivers Kill the Elderly With Neglect

The lack of regulation for California's in-home support services program, which pays people to look after seniors or the sick, means many patients are left in dangerous situations.

stavros karabinas/Flickr/The Atlantic
Yolanda Farrell lay mostly paralyzed in a nursing home, unable to feed or dress herself, when her homeless daughter persuaded her to move out.

Linda Maureen Raye, who relatives say had been living in her car with her dog, used her mother’s Social Security to pay for a one-bedroom Riverside, California, apartment and took over as Farrell’s sole caregiver in 2010.

Over the next two years, according to police and court records, Raye took her elderly mother to the doctor once. As her mother’s health declined, Raye stopped cooperating with a nurse sent to advise her on preventing bedsores.

Yet in 2012, Raye was hired officially: She began collecting about $900 a month from taxpayers under the state’s in-home care program for poor people, according to law-enforcement authorities.

By the end of that year, Farrell, an 85-year-old former real-estate underwriter who loved to travel, had died of septic shock resulting from severe bedsore infections. Originally charged with murder, Raye, 60, pleaded guilty to elder abuse in September and was sentenced to 11 years in prison.

“She essentially neglected her to death,” said Riverside Police Detective Christian Vaughan, who investigated the case.

California’s frail elderly and disabled residents increasingly are receiving care in their own homes, an arrangement that saves the government money and offers many people a greater sense of comfort and autonomy than life in an institution. Yet caregivers are largely untrained and unsupervised, even when paid by the state, leaving thousands of residents at risk of possible abuse, neglect and poor treatment.

The move from nursing-home to in-home care is part of a massive shift across the nation, driven by cost-cutting and patient preference. In California, at least four times more elderly and disabled residents receive in-home care than live in nursing facilities—a rate that is only expected to rise as baby boomers age.

Many families either provide care for relatives without compensation or pay out of pocket for caregivers they find through word of mouth, referral agencies, or private companies. But a growing number of elderly and disabled people have incomes low enough to qualify for state-funded care under the In-Home Supportive Services program, or IHSS—the same one that paid Raye to care for her mother.

California’s $7.3 billion IHSS program is the largest publicly funded caregiver program in the nation. The caseload has more than doubled since 2001 and now serves about 490,000 low-income clients throughout the state.

Working behind closed doors for an average of about $10 an hour, these caregivers carry immense responsibility but are subject to little scrutiny, according to law-enforcement officials, elder-abuse investigators, senior-care experts, and court records. Their lapses sometimes lead to preventable injuries and death.

Many clients are too feeble or afraid to complain or ask for assistance. “We don’t know how many times Yolanda cried for help,” Detective Vaughan said. “She didn’t have a voice. She was deprived of that.”

An investigation into the IHSS program found that:
  • Training for caregivers is minimal and mostly optional. California doesn’t require training for everyone—even in CPR, first aid, or preventing injuries. By design, IHSS is not a medical program and caregivers are supposed to confine themselves to tasks such as feeding, dressing, or bathing. But some become ad-hoc nursing aides, helping to dress wounds and manage medications. The state requires caregivers receive training and authorization from physicians in these cases, but only about one in nine caregivers receives it, officials say.
  • Most clients in California, 73 percent, are related to their caregivers, up from 43 percent in 2000. The arrangements assume an inherent trust between client and caretaker—a trust that can go awry when the relationships are dysfunctional, abusive, or financially driven. While many states allow some paid family caregiving, most prohibit spouses from taking the job and some bar relatives entirely. California has no such restrictions.
  • Screening, though improved in recent years, has potentially dangerous gaps. State law requires criminal background checks and bars people from becoming caregivers if they have been convicted of certain crimes, such as elder and child abuse. But the IHSS program leaves the hiring to clients and gives them wide latitude. Felons convicted of robbery, rape, or assault can be paid caregivers if their clients get a waiver from the state. In the past four years, more than 830 people have received such waivers for caregivers convicted of serious offenses. “They can have criminal records, they can have drug addiction,” said Susan Strick, a prosecutor with the Los Angeles City Attorney’s office. “That’s a problem.”
  • Few incidents of abuse and neglect by IHSS workers are documented because authorities aren’t looking for them. County social-services workers are supposed to check on the clients once a year on the state’s behalf but are not primarily focused on the quality of care provided. Their main job is to determine whether clients are receiving the proper number of hours of care and whether their needs have changed. And because social workers are assigned hundreds of clients each, their visits are frequently brief—as short as 30 minutes a year.
Counties are also supposed to report to the state “critical incidents”—potential neglect, abuse, or self-harm requiring immediate action. But reporting practices vary widely, yielding puzzling results. In fiscal year 2012-2013, for instance, not a single critical incident was reported among the 235,000 clients in Los Angeles, Orange, and San Diego counties, the three largest in the state. That same year, smaller Sacramento County reported 1,688 incidents—accounting for most of the problems reported statewide.   (Continue Reading)

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When Home Caregivers Kill the Elderly With Neglect

Ann Freeman: California’s bill has no safeguards against elder abuse or for those who change their minds

On the surface, if you only consider the wishes of a single individual, assisted suicide legislation might seem reasonable, and the media flurry surrounding the case of Brittany Maynard has made it seem that way.

But it is important to look at the significant dangers of legalizing assisted suicide as public policy for all Californians, particularly those who might not have a strong support system; access to health care, palliative care and hospice; or the benefit of a loving, caring family. Assisted suicide legislation has many unintended consequences that can impact the vast majority of us.

As a former hospital social worker for many years, my primary concern is for individuals who might feel pressured into ending their lives. Elder abuse in the United States is rampant, and the vast majority of the perpetrators are family members. I have worked with wonderful, supportive family members, but not all that I have worked with were like this. Some were abusive and stole money from their disabled and elderly relatives.

Nothing in the proposed assisted suicide law protects patients when family pressures, whether financial or emotional, distort the ill person’s choice. And nothing prevents an heir, who stands to benefit from the patient’s death, from helping the patient sign up for the lethal dose.

No assisted suicide “safeguard” can ever protect against coercion. In this era of managed care, will those living with a disability and the seriously ill be more likely offered lethal prescriptions in place of medical treatment? A prescription for 100 Seconal tablets costs far less than most medical treatments, especially considering the cost of long-term care for someone living with a disability.

This scenario has already become a reality in Oregon, where assisted suicide is legal.

The oncologist for cancer patient Barbara Wagner prescribed a specific chemotherapy to extend her life, which was her choice. Her insurance provider, Oregon’s state-run health plan, denied coverage of the treatment but offered, in writing, to pay for her assisted suicide. The same thing happened to Randy Stroup, also of Oregon. When assisted suicide is legal, it becomes just another treatment option.

Would you trust an insurance company to “do the right thing” or the cheapest thing for their bottom line?

In California’s Death with Dignity bill, there is no oversight after the lethal dose of barbiturates is picked up from the pharmacy and no requirement for an outside witness to be present when the deadly drugs are taken. There would be no one there to know whether or not a patient changes her mind or decides that she isn’t ready to die. There would be no one there to know if the individual has taken the pills on her own or if someone else put the lethal dose in a feeding tube.

There are many key opponents to legalizing assisted suicide. These include the American Medical Association, the World Health Organization, the American College of Physicians, the National Hospice and Palliative Care Organization, the American Cancer Society and the League of United Latin American Citizens.

Assisted suicide is bad medicine for California and puts too many people at risk.
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Ann Freeman: California’s bill has no safeguards against elder abuse or for those who change their minds

Thursday, February 26, 2015

PSA: CA Advocates for Nursing Home Reform

Marilyn Young, 88, was recovering from a stroke at a skilled nursing facility in Monterey when she was sexually assaulted and contracted a painful sexually transmitted disease. When Young sued, the facility’s corporate owner tried to force the case into arbitration, a forum that tilts the scales of justice in favor of corporations. What follows is a testimony to persistence of Young’s attorneys to do the right thing for an elderly woman who has suffered a terrible wrong.

Kathryn Stebner, Kirsten M. Fish and Valerie McGinty, 2014 Street Fighter of the Year Finalists

Man Trapped Inside His Own Body For 12 Years Reveals HORRIFYING Abuse

Martin and his wife, Joanne
A man who was in a comatose state, but still fully aware, has come forward with absolutely horrifying revelations about the people who cared for him while he was in the vulnerable state.

At the age of 12, Martin Pistorius came down with an illness that left him in a vegetative state, unable to speak or move on his own. But after several years, he fully regained his consciousness, yet still had his motor skills impaired, and what happened to him is nothing short of sickening, unable to communicate that he was aware of his condition and surroundings.

Labeled as “Ghost Boy,” MailOnline reports that Pistorius didn’t even talk about the unspeakable atrocities in his memoirs due to their nature, but now he’s speaking up for the first time about the years of sexual and physical abuse he endured when his parents left him in the care of others at a home for the disabled. His treatment was so horrible, that Pistoius only rarely visits his native South Africa, where it all happened, because of the flashbacks he gets while there.

“I would dread it whenever my parents told me they were taking me to the care home,” Pistorius told MailOnaline. “Because I knew what would happen, and I had no way of letting them know the agonies I’d suffer.”

Those agonies, he said, included pulling his hair until his eyes watered, smashing a metal spoon into his teeth while they fed him, and screaming at him when his caretakers were angry, but that’s not the worst of it.

“I would be forced to drink scalding tea or fed until I was sick,” the web designer living in Essex said. “Then I’d be slapped, shouted at, made to feel worthless, then would come the sexual attacks from women who were supposed to be looking after me.”

“One woman would come into the room and straddle me and simulate sex with me and touch me inappropriately,” he recalled. “Nothing made me feel more powerless, I longed to run away.”

You may also be able to remember Pistoius from a story that ran a few weeks back, where he said he was forced to watch reruns of the children’s hit cartoon Barney the Dinosaur. Those alone were torture to the man in his state, he said.

Making matters worse, Pistorius was never given justice for what happened to him. When his father tried to take action, the workers at the care facility denied everything, and since nothing was caught on film, the allegations never stuck.

When Pistorius was just 12, he developed a sore throat that soon developed into much more. As time passed, his mind, then body, eventually became nothing but a shell in which his conscious was retained.

Doctors would at some point diagnose it as a degenerative nerve disorder, but there was nothing they could do. At the age of 16, the boy regained his consciousness, and for the next nine years, he would remain fully aware but unable to speak or move.

“You have no idea how frightening it was,” Pistorius said. “The stark reality that I was going to spend the rest of my life like that, totally alone,” he said. “I couldn’t make a sign or a sound to let anyone know I’d become aware again. I was invisible, a ghost boy.”

At the age of 25 he regained full consciousness and the ability to communicate, but that was only after years of horrific abuse.

“Each day I’d count down the minutes until it was over and I was 24 hours closer to going home,” he said.

He did have a happy ending to his story, however. Shortly after he was back to himself, he met his wife Joanne on the Internet. The two married in 2009 and have since bought a home together in Harlow.

His book has also become a best-seller, and he has gotten a degree in the IT field. He also has numerous Hollywood film producers trying to buy the rights to his story. So, needless to say, he’s doing just fine.

It’s sad that people would ever consider abusing someone so helpless in such a manner. What’s worse is that they’ll never be brought to justice over it.

Full Article & Source: 
Man Trapped Inside His Own Body For 12 Years Reveals HORRIFYING Abuse

Former judge to be tried for conflict of interest

Willis Berry Jr.
A trial date has been set for a former city judge who is accused of using his judicial position and public money to help run his personal real-estate business.

Former Court of Common Pleas Judge Willis Berry Jr. goes to trial on April 13. He is charged with conflict of interest and theft of services. Last month Berry decided not to take a plea deal regarding the charges he faces. Berry was expected to formally accept the deal last month but defense attorney, Samuel C. Stretton, said Berry would not accept the plea offer because it might affect his ability to collect a pension. Stretton said he felt the charges against his client are unfair.

“This was all resolved in 2009 with a four-month suspension,” Stretton said. “It should have been brought five years ago. None of this is new so why, after five years, are they doing this? I could see this happening back in 2009 but now it just seems to me to be vindictive. There’s no excuse for that. All of this is because he had a real estate business when he was an attorney and he ran that out of his office. When he became a judge he just continued. He was suspended by the board and retired after that. So I’m just baffled by this.”

The criminal complaint asserts Berry used taxpayer money to pay his judicial secretary for her assistance in managing 16 properties, including rental units Berry owned in Philadelphia. According to Stretton, the plea offer included $50,000 in restitution and two years of probation in exchange for pleading to two counts of second-degree misdemeanor theft.

In June 2009, according to court papers, the Court of Judicial Discipline found Berry brought the judicial system into disrepute and committed the crime of diversion of services. The CJD suspended him for four months without pay.

Stretton said he intends to file motions to strike some of the charges against Berry on the issues related to the separation of powers doctrine. The court will also now need to consider whether the trial should take place in Philadelphia, or if the Philadelphia bench will need to recuse, Stretton said.

An investigation conducted by the state attorney general in July 2013 revealed Berry engaged in the diversion of judicial resources to his business from 1997 to 2007, according to the complaint in the case. Berry diverted roughly $110,880 over the 10-year period to the payment of his secretary, Carolyn Fleming, the state alleged in the complaint.

Berry allegedly directed Fleming to maintain files, correspond with tenants by phone and in-person at the Criminal Justice Center in Philadelphia, prepare and file legal documents including leases and eviction complaints, appear at landlord-tenant proceedings, advertise properties in newspapers, engage in bookkeeping, pay bills and make bank deposits — all on official time, according to the complaint.

The investigation by Attorney General Kathleen Kane’s office was prompted by a 2007 Judicial Conduct Board review of Berry’s use of Philadelphia County employees for non-judicial activities, the complaint said.

During JCB interviews, Fleming confirmed she would spend 10-12 hours a week on work related to Berry’s properties, the complaint said. Additionally, Fleming was required to be present at landlord-tenant court for four to six hours per month, according to the complaint.

The current pending prosecution is not the first time Berry has come under review for misconduct.

Aside from the four-month suspension by the CJD in 2009, the state Supreme Court suspended Berry in April from the practice of law for one year and a day for defrauding a former law client in the settlement of her personal injury claim before becoming a judge.

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Former judge to be tried for conflict of interest

Wednesday, February 25, 2015

For a lucky few, happy endings in living situations

Danielle Jeffries & Ruby Howard

Ruby Howard takes a while to warm up to describing past episodes of her life.

The 58-year-old Virginia Beach woman traveled a path through emergency rooms, psychiatric units and homeless shelters for a year before coming to an apartment complex where she's now seated with a case manager.

"I could see whole episodes go on that weren't really happening," Howard said. "I could come in here and not see this table. Or I could see something that is there and it ain't there. I was schizophrenic. My psychiatrist knew, but I didn't know. I didn't know what was wrong with me. I thought I was all right but I was totally messed up."

She pauses.

"I don't like to talk about it, because I don't like to think about it."

But she does because she feels strongly about the Cloverleaf apartment complex she moved into five years ago. It's run by Virginia Supportive Housing, a nonprofit that opened a complex in Norfolk a decade ago and has since opened 60-unit complexes in Virginia Beach, Portsmouth and Chesapeake.

It's just one example of a model that helps people at risk of being homeless because of finances or disability live in the community with onsite help.

A growing mix of people - the frail and elderly, the mentally ill, people confused by dementia, those without money or family - often fly under the radar.

But the old and frail often wind up together with the young and disabled in longterm-care facilities and adult homes. Some of the sites have staff well trained to blend the populations using therapeutic approaches, and give people space they need.

Others fall short, putting people at risk of injury.

Some housing options are available, but they're in short supply.

The Hope House Foundation, for instance, provides services in apartments and homes for people with disabilities. Community Services Boards support people with mental illness in apartments. PACE centers, or Programs of All-inclusive Care for the Elderly, in Virginia Beach and Portsmouth help disabled people 55 and older continue to live in neighborhood homes.

The problem? There's not enough to go around.

Mira Signer, executive director of the Virginia chapter of the National Alliance on Mental Illness, said: "Generally, it's the same old story - state policy and funding that are not aligned with the needs of the disabled population. It's a very marginalized population, so the needs aren't known."

For instance, there have been bills before the General Assembly for years to expand the auxiliary grant program, which funds care for low-income, disabled people in assisted-living facilities and adult homes. Advocates want to increase the grant amount, which is so low now that many homes won't accept it, and expand it to other types of programs such as supportive independent living.

The legislation is continually tabled: "All they see are dollar signs, and they don't want to pay for it," Signer said.

But for those who support the idea, the dollar signs are in their favor.

Tracey Clark directs support services for the Virginia Supportive Housing complexes in Hampton Roads. She said a homeless person typically costs the public $50,000 a year in hospitals, jails and ER treatment, compared with $15,000 to $20,000 per person in one of their complexes.

"That's not to say everyone becomes the perfect community citizen and never goes to jail or the hospital," she said. "But the likelihood is less."

Howard, for one, has lessened her hospital time.

One day earlier this month she sat in an office at Cloverleaf apartments, where she comes to visit with case managers. On this day, it was Danielle Jeffries.

Another resident in the hallway was loudly complaining about someone who failed to show up. He spoke so angrily that Howard stopped talking and put her hand to her forehead.

"He's not always this way."

Jeffries asked whether she wanted her to bring in a white noise machine, but the tenant settled down and Howard returned to her story.  (Continue Reading)

Full Article & Source:
For a lucky few, happy endings in living situations

High court suspends lawyer Nick Ward for improprieties

Richard G. "Nick" Ward
Attorney Richard "Nick" Ward insisted he did nothing unethical when he used confidential information he learned from a client to later sue him on behalf of another client.

Ward insisted it was proper for him to sue John "Bud" Koons III in a legal fight over Koons' $300 million estate. He insisted it was proper even though Ward and his father, a former president of the Cincinnati Bar Association, previously represented Koons on several issues – including Koons' financial planning and legal work for Koons' large estate.

Meanwhile, a Koons relative hired Nick Ward to sue Bud Koons.

But the Ohio Supreme Court last week decided Ward was wrong, finding it was improper for him to represent opposing sides. Ohio's high court suspended Ward from practicing law for a year.

Ward, who complained to The Enquirer in 2008-2009 about stories it was writing about his involvement in the suits, didn't return calls for this story.

Ward's suspension is the latest chapter in a years-long fight over Koons' $300 million estate. That fight caused the Cincinnati law firm Richard "Nick" Ward's father founded in 1958 to split. The original firm, Drew & Ward, split into the Drew Law Firm and the Ward Law Firm. The Drew firm later closed. The Ward firm appears to be only Richard "Nick" Ward.

"At a minimum the Supreme Court opinion validates your article," attorney Jim Helmer told The Enquirer about Ward's suspension. Helmer represented Koons' interests in the suits.

Helmer was blunt about what he believed was a conflict for Nick Ward in them.

"In my 33 years of doing this, I have never seen anything as unethical and illegal by any lawyer in Cincinnati," Helmer said in a 2008 Enquirer story about Ward and the suits.

Last week, Helmer added, "Even a cursory reading of (last week's) decision confirms what I said."

Ward's father, Richard "Dick" Ward was friends with Koons since at least the time both attended Walnut Hills High together. Koons and his family built a bustling business selling and delivering Burger Beer. Proceeds from that business were placed into two trusts – one for Koons and his descendants, the other for Koons' sister, Betty Lou Cundall, and her descendants. She is the mother of Michael "K.C." Cundall, the nephew who hired Nick Ward to sue Koons.

The Koons family used their part of the trust funds to invest and diversify, buying several Pepsi bottling and distribution companies in Florida and Ohio, and becoming, at one point, the seventh largest such distributor in the U.S. The Cundalls, it was alleged in the suits, spent much of their portion of the trust instead of reinvesting it.

Koons later sold the Pepsi distributorships for $340 million, a transaction Koons relied heavily on Dick Ward and his law firm to make. Nick Ward, a partner in his father's law firm, reviewed documents with his dad regarding Koons' estate.

That wasn't an issue until K.C. Cundall became upset when his family's portion of the trust was revealed to be millions while the Koons portion of the trust was more than $300 million.

Cundall hired Nick Ward to represent him in a suit against Koons and his company, accusing Koons of improperly handing the trusts to the Cundalls' economic detriment. Some of the information Cundall used to sue Koons came from the period when Nick Ward represented Koons. Using that information to later sue Koons was improper, the high court found.

Attorneys representing Koons' estate sued the Drew & Ward law firm (before it was split into two firms) for $10 million.

The suit was settled by the firm's insurance company for $5 million. That is known despite attempts to hide it. The Enquirer fought attempts to make private a settlement made in a public courtroom while on the record – and won.

All three of the Ohio lawsuits regarding that Koons have been resolved, either in Koons' favor or by settlement.

Attorney discipline

Cincinnati attorney Richard "Nick" Ward was suspended last week by the Ohio Supreme Court. He can't practice law for a year.

Ohio attorney discipline like Ward's doesn't become public unless there is a finding of wrongdoing by the high court and disciplinary action is taken;

A complaint is made about an attorney and referred to an arm of the Ohio Supreme Court, which investigates. If there is a finding of wrongdoing, it is referred to the Supreme Court justices, who then make their own ruling;

In 2013, the last year for which statistics are available, the Ohio Supreme Court suspended 51 attorneys for wrongdoing.

Full Article & Source:
High court suspends lawyer Nick Ward for improprieties

Woman indicted for financial exploitation

Carolyn Clemmons Watson
FLORENCE — Authorities said a Lauderdale County woman already sentenced for theft and elder exploitation has been indicted in a separate case for taking several thousands of dollars from the elderly man she befriended while working at a Florence restaurant.

Reports indicate Carolyn Watson, 42, 858 Royal Ave., Florence, is indicted for financial exploitation of the elderly.

Court officials said the indictment was issued during the January grand jury session. She is scheduled to be arraigned by Lauderdale County Circuit Judge Gil Self, Feb. 27.

Police said Watson is accused of taking $16,000 from a elderly man she met while she was working at a local fast-food restaurant.

She was arrested Oct. 23 after the incident was reported to the Police Department.

Florence police Detective Justin Wright said Watson, while working at the restaurant on Florence Boulevard, befriended an 80-year-old man who is a frequent customer.

"(Watson) told the man several stories about her needing money, and he felt sorry for her," Wright said. "She told him she needed money to pay her bills."

Police said the man tried to help Watson and withdrew more than $16,000 from his bank account and gave the money to her.

"All this happened within a three-week period, beginning in the second week of October," Wright said.

Reports indicate after the man made the withdrawals, bank officials contacted his family, who became suspicious and notified police.

Police said the man suffers from dementia-like symptoms.

In a separate case involving Watson, court officials said she was sentenced in December to 15 years each on two counts of second-degree burglary and 10 years on elder exploitation.

Lauderdale County authorities said Watson was arrested in March 2014 in that case, accused of posing as a health care provider to gain access into homes.

Investigators said Watson was accused of going into homes of elderly residents in Greenhill, Killen and Belmeade, in most cases claiming to be a home health nurse or trying to find a certain address.

Investigators said it was a ploy to get inside the residence and steal medication and purses.

Full Article & Source: 
Woman indicted for financial exploitation

Tuesday, February 24, 2015

Senior care facilities mix the frail and the disturbed

Georgie Williams
The nursing home Georgie Williams moved to in her 80s was supposed to be a haven from the deepening confusion of Alzheimer's disease.

The locked unit in the Windsor home did protect her for a while from things like leaving the stove on or wandering away. But on Feb. 16, 2013, danger came looking for her while she lay in bed.

Another resident, a 77-year-old man with a history of dementia and hallucinations, entered her room, sat on her bed and pummeled her face, neck and arms, according to police and medical records.

A nurse responding to Williams' screams caught him with his fist drawn back. It took three nurses to pull him off.

Williams' experience is not commonplace in long-term care, but some experts say the danger is increasing as a widening mix of frail elderly people and those with behavior problems land in nursing homes, assisted-living facilities, group homes and supportive-housing situations.

Elder abuse brings to mind mistreatment by caregivers, but studies suggest resident-to-resident attacks are more common.

A 2014 study by Cornell University found that 1 in 5 nursing home residents were involved in at least one aggressive encounter with fellow residents in the previous four weeks. A 2013 University of Pittsburgh study, funded by the Department of Justice, found that 13 percent of assisted-living residents had been involved in arguments with other residents, 6 percent had experienced an aggressive act, and 4 percent were bullied.

These risks are unfolding on a national stage, where positive trends have led to some negative results:

- People are living longer, putting them at greater risk for dementia, which can lead some to lash out in confusion and anxiety.

- People are surviving serious accidents and war trauma, some with brain injuries that leave them with poor impulse control and aggressive tendencies.

- Those with serious mental illness are being moved out of state-run institutions into communities, putting them in neighborhoods that don't have proper support.

It's a world where assailants and their prey fall into the same category: Victims of disease and disability with fraying family networks who are moving from institutions to places unprepared for them.

"They are invisible populations, but they are there, and they are increasing in numbers," said Dr. Robert Palmer, who directs the Glennan Center for Geriatrics and Gerontology at Eastern Virginia Medical School. "I don't think as a society we have thought enough about how to help them. It's a topic buried deep in the American consciousness."

It's a societal crossroads that Elizabeth Lorenz of Chesapeake never imagined for her grandmother: "I go back to what she must have been thinking lying there: 'Somebody help me.' "

Lorenz and relatives had spent months looking for just the right place for Williams, a longtime Portsmouth resident. They settled on Consulate Health Care of Windsor in Isle of Wight County, and she moved there in 2010.

For a few years, everything went well. As time went on, they noticed some lapses in care. Then one night in February 2013, Windsor police came to Lorenz's door: Her 84-year-old grandmother had been involved in an altercation.

Lorenz drove to Sentara Obici Hospital, thinking her grandmother had gotten into a minor tussle over someone taking something from her room. What she saw stunned her: Dark purple bruises surrounded both eyes. Her grandmother's left cheek was bruised and the skin torn. Her arms were cut and bruised.

Her vision was so blurred from the attack that she couldn't make out visitors. When Lorenz drew close to her, Williams instinctively put her hands up, drawing back in fear.  (Continue Reading)

Full Article & Source:
Senior care facilities mix the frail and the disturbed

In Alzheimer’s Cases, Financial Ruin and Abuse Are Always Lurking

Daniel Reingold, President & CEO-
Hebrew Home in
Riverdale, N.Y.

MIDWAY through the film “Still Alice,” which tracks the growing grip of Alzheimer’s on a 50-something Columbia University professor, that professor, played by Julianne Moore, stands at a lectern to address an Alzheimer’s conference. She is holding a yellow highlighter and a copy of her speech.

She proceeds to talk about her struggles with the disease and how she never knows what will vanish from her memory and when. It’s a lucid, affecting talk, and the viewer would be hard pressed to know anything was wrong with her, if not for the highlighter. She uses it to track her every word so she doesn’t read the same sentence over and over again.

For anyone who has ever watched a family member disappear into Alzheimer’s, Ms. Moore’s performance is gripping, particularly as her tricks to stall her decline inevitably fail and the later stages of the disease consume her.

Yet the movie is also a great vessel to explore many of the financial issues that families need to address when someone is diagnosed with Alzheimer’s or any other disease that causes cognitive impairment.

Ms. Moore’s character has one big advantage over many people who get Alzheimer’s. She and her husband, played by Alec Baldwin, are affluent. They teach at Columbia and have raised three children in what looks like a brownstone near campus. One child is in medical school, another in law school and a third, to the chagrin of her mother, has moved to Los Angeles to become an actress.

When she grows concerned over her own forgetfulness, she has the wherewithal to be seen by a top neurologist. She thinks she has a brain tumor; after a series of tests she finds out it’s Alzheimer’s — a diagnosis she hears about in her husband’s presence.

But stories from financial advisers indicate other families are not so fortunate.

Thomas Mingone, managing partner at Capital Management Group of New York, said he had clients whose mental slide had been apparent to the advisers, accountants and lawyers in the room but not to the client. Since advisers are bound by a fiduciary duty to protect their clients’ privacy, Mr. Mingone said he can’t simply call up their children to let them know.

With a client who seems to be slipping but lives alone and sees family members infrequently, Mr. Mingone said he suggests a family meeting, which allows him to connect with his client’s children. Other times, he said, just asking clients how they are doing brings the problem out.

“Sometimes when you bring this up with clients, it’s a relief to them,” he said.

Once the family is brought in — if there is a family — legal documents can be tended to and the family’s ability to manage Alzheimer’s care can be assessed.

In the film, Ms. Moore’s character gets bad reviews for her teaching and is confronted by her department chairman. She tells him she has Alzheimer’s; a few scenes later, she and her husband are on a beach and she appears to be receiving disability payments.

It’s not always this easy. Not everyone has disability or long-term care insurance; even those who do may not have enough. Advisers encourage people to buy it, but it costs thousands of dollars a year.
Short of having that coverage, an up-to-date estate plan with a durable power of attorney and relevant health care documents is essential. “It’s not that people don’t have an estate plan,” said Richard A. Behrendt, director of estate planning at Annex Wealth Management. “It’s that it’s a will that was done 20 years ago when their kids were 3 and 5. It’s not about who’s going to get your stuff. It’s ‘If I can’t communicate it’s going to be tough to make decisions with my health care providers.’”

And part of that conversation, Mr. Behrendt said, should be pointing out that nursing home care for an Alzheimer’s patient can run around $80,000 a year and last for a decade or more, depending on the person’s age.

“You can have someone with a pretty sizable retirement account that just gets wiped out by an illness like this,” he said. “Less than 10 percent of adult Americans have some long-term care insurance.”
Then there are the family dynamics. Daniel Reingold, president and chief executive of the Hebrew Home in Riverdale, N.Y., said of his three brothers: “Each of us has different parents. They happen to be the same people — unless we describe them.”

That dynamic is on display in “Still Alice”: The daughter in law school is married and has twins after struggling to conceive; the son is in medical school; the daughter acting in Los Angeles keeps her distance from both and seems to get along best with her father.

Of course, that siblings fight and harbor grudges from childhood is news to no one. But those adult children also don’t always respect their parents’ wishes. Consider when a person with Alzheimer’s wants to have a say in when he or she dies.

In "Still Alice," Julianne Moore
Ms. Moore’s character makes a video instructing her future debilitated self on how to take pills hidden in her drawer to commit suicide. The carefully detailed plan is the product of a lucid mind, something she no longer possesses when she later finds the video. Her effort fails when she is interrupted and forgets what she was doing.

William Zabel, a leading trusts and estates lawyer and a founding partner of the law firm Schulte Roth & Zabel, said it was difficult for people in the United States to chose dignified death on their terms. One of his clients wanted him to be with her when she took her own life at the Carlyle Hotel in Manhattan, he said. But doing so would have led to his disbarment.

But after the request, a lawyer at his firm put together a 21-page memo on right-to-die laws around the world. It is a difficult subject, and not just because of the moral issues. There are the logistics beyond the actual act. How, for example, would someone with Alzheimer’s get to a country that allows assisted suicide when he or she has only moments of lucidity, or find a doctor in the United States who might administer a strong dose of morphine?

His firm’s memo includes a “dementia provision,” where people can elect that a list of life-sustaining treatments be withheld and ask that their wishes regarding the end of their lives be upheld. It’s a strongly worded statement, but Mr. Zabel said it might not hold up in court, particularly in states like New York where withholding food and water from a person is illegal.

“In one case, I filmed the decedent about why he wanted to die in a dignified way,” Mr. Zabel said. “Just writing a letter is not the same as seeing it on film, particularly where there are family members who particularly religious and particularly not. You get into this moral quandary of assisted suicide versus dignified death.”

Just as vexing is the abuse of someone with Alzheimer’s by a family member, caregiver or grifter. Hebrew Home established the first shelter for abused elderly people in 2005, and Mr. Reingold said about 60 percent of its clients suffered from some form of dementia.

“There is almost always an underlying financial issue — Mom didn’t give me the money so I pushed her down the stairs,” Mr. Reingold said. “Each case is different, but what’s typical is there is always coercion and control.”

Red flags include an elderly relative suddenly spending time with a new, younger friend — or an adult child or distant relative moving in. Putting good checks in place is not hard but it requires foresight: regular visits by someone who is trusted to monitor someone’s appearance, automated deposits and bill payments, and conversations with bank tellers or doormen who know the elderly person’s patterns.

For people who are alone and have to rely on a durable power of attorney, Mr. Reingold said having two was a good check, one for the person and one for the property.

Here was where the professor in “Still Alice” was fortunate: Her family put aside their differences and together figured out a way to care for her. It’s a good Hollywood ending.

Full Article & Source:
In Alzheimer’s Cases, Financial Ruin and Abuse Are Always Lurking

Chaplain Swindled Elderly Parishioner out of $70,000, Prosecutors Say

Eagles of God Church
COOK COUNTY CRIMINAL COURTHOUSE — A chaplain who once was convicted of murder is now facing charges of swindling nearly $70,000 from an elderly congregant who can't read or write.

Authorities allege Enrique Borges, 50, was working as a chaplain at Eagles of God church, 1132 N. Spaulding Ave., when an 84-year-old man came in looking for help.

The Humboldt Park man — who only speaks Spanish and can't read or write — told a pastor he was afraid his neighbors would steal his money, Assistant State's Attorney Lorraine Scaduto said in court last week.

The pastor then connected the victim with Borges, who wore a chaplain badge every time the pair met, Scaduto said.

In early January, the elderly man gave Borges power of attorney, prosecutors said, and issued him two cashier's checks totaling nearly $100,000.

Borges then brought the victim to a Chase branch and opened a joint account, police said. According to Scaduto, Borges told bank employees he was the man's son-in-law and English interpreter.

The victim had no idea that Borges added himself to the account, police said, and didn't authorize Borges' actions.

On Jan. 29, Borges transferred $12,390 to his own personal bank account, according to a police report. On Feb. 3, he transferred an additional $55,000, the report said.

Police said Borges made $499.34 worth of purchases on the victim's debit card, and withdrew $3,860 of the victim's money.

The victim realized what had happened on Feb. 4 when he visited the bank, Scaduto said. Accounts were frozen on Feb. 6 and Borges was arrested at Chase, 7180 W. Grand Ave., on Tuesday.

Scaduto said Borges was carrying the victim's credit card and personal documents, and he admitted to opening the account and transferring money.

Borges, of the 2800 block of North Mobile Avenue in Belmont Cragin, was charged with identity theft and financial exploitation of the elderly.

Borges was previously convicted in a 1982 gang-related murder and sentenced to 30 years in prison.

On Sunday, Eagles of God Pastor Alberto Arias defended Borges.

He told DNAinfo Chicago that the 84-year-old man came in early January asking for help. According to Arias, the man told the pastor that people "were attempting to kill him and steal his money."

"In my humble opinion, I thought he was a bit paranoid," Arias said.

The man, who briefly lived in the church facility in the 1980s, returned for assistance, and although Arias recommended he look into assisted living facilities due to his declining health, he allowed the man to stay in the church, Arias said.

During that time, Borges, who was the assistant director of chaplains, helped the man move into the church, and took him to doctor's appointments and running errands, Arias said.

Arias said the man asked Borges to add his name to the bank account. Arias cautioned Borges against it.

"I don't like that idea," Arias recalled saying, reminding Borges of the man's constant fear of having his money stolen. "Be careful, be careful, be careful."

Despite his warnings, Borges agreed to have his name added to the account, Arias said.

After hearing about the arrest, Arias was still surprised.

"I warned [Borges], this man is difficult and needed attention and constant care," Arias said. "But [Borges] felt bad and wanted to help."

If any money was spent, it was all spent on the 84-year-old man to buy clothing, food and a bed, Arias added.

"Borges is a good man with good intentions," Arias said. "I feel sorry for him."

Cook County Judge Laura Sullivan on Thursday ordered Borges held in lieu of $100,000 bail.

Full Article & Source:
Chaplain Swindled Elderly Parishioner out of $70,000, Prosecutors Say

Monday, February 23, 2015

Complexities of Choosing an End Game for Dementia

Jerome Medalie
DEDHAM, Mass. — Jerome Medalie keeps his advance directive hanging in a plastic sleeve in his front hall closet, as his retirement community recommends. That’s where the paramedics will look if someone calls 911.

Like many such documents, it declares that if he is terminally ill, he declines cardiopulmonary resuscitation, a ventilator and a feeding tube.

But Mr. Medalie’s directive also specifies something more unusual: If he develops Alzheimer's disease or another form of dementia, he refuses “ordinary means of nutrition and hydration.”

A retired lawyer with a proclivity for precision, he has listed 10 triggering conditions, including “I cannot recognize my loved ones” and “I cannot articulate coherent thoughts and sentences.”

If any three such disabilities persist for several weeks, he wants his health care proxy — his wife, Beth Lowd — to ensure that nobody tries to keep him alive by spoon-feeding or offering him liquids. VSED, short for “voluntarily stopping eating and drinking,” is not unheard-of as an end-of-life strategy, typically used by older adults who hope to hasten their decline from terminal conditions. But now ethicists, lawyers and older adults themselves have begun a quiet debate about whether people who develop dementia can use VSED to end their lives by including such instructions in an advance directive.

Experts know of just a handful of people with directives like Mr. Medalie’s. But dementia rates and numbers have begun a steep ascent, already afflicting an estimated 30 percent of those older than 85. Baby boomers are receiving a firsthand view of the disease’s devastation and burdens as they care for aging parents.

They may well prove receptive to the idea that they shouldn’t be kept alive if they develop dementia themselves, predicted Alan Meisel, the director of the University of Pittsburgh’s Center for Bioethics and Health Law.

“People in their 50s and 60s frequently say: ‘I don’t want to be in that situation. I don’t want to put my family in that situation,' ” he said. “And people will increasingly voice those views to others, sometimes in a formal way through advance directives.”

Mr. Medalie, fierce-eyed at 88, has seen people close to him die lingering deaths from dementia and has already decided. His motto, pithy enough for a T-shirt: “If I’m not me, I don’t want to be.”

Dementia, though a terminal diagnosis, presents unique obstacles for those who want some control over the way they die. It generally kills slowly, over years, and “there is often no plug to pull,” said Dr. Stanley Terman, a psychiatrist in Carlsbad, Calif., who specializes in end-of-life decision-making and estimates that several hundred people have requested copies of his Natural Dying Living Will. “There’s no high-tech, life-sustaining treatment that can be withdrawn or withheld.”

Even in the few states where physicians can legally prescribe lethal medication for the terminally ill, laws require that patients be mentally competent and able to ingest those drugs themselves. Mr. Medalie would prefer that option if he were to become demented, preferably with the barbiturates dissolved in “a little vodka.”

But demented patients don’t qualify for so-called death with dignity. VSED is a lawful way to hasten death for competent adults who find life with a progressive, irreversible disease unendurable. Several medical studies have reported that, with proper oral and palliative care, it can also be a comfortable way to die.

The question for proponents of VSED by advance directive is whether the practice can also provide a humane exit for those who, years later, no longer remember or understand why they wanted to use it.

Proponents of the approach acknowledge that dementia patients and their health care proxies will face great controversy if they try to cut off food and water; so will the professionals who care for them.

Nourishment carries connotations, from infancy, that make stopping it feel different from rejecting medical machinery.

“It’s the rhetoric more than anything,” said Mr. Meisel, the author of the legal treatise “The Right to Die.” “You can apply the word ‘starvation.'”

If those opposed to removing patients from ventilators had thought to call it “suffocation,” he adds, the issue might be similarly contentious.

Moreover, the legal status of VSED by advance directive remains untested. In a recent article in The Hastings Center Report, two advocates argued that food and water should not be withdrawn until severe dementia has eroded the patient’s quality of life and “the self has withered.”

That approach would probably pass legal muster, said Paul Menzel, philosophy professor emeritus at Pacific Lutheran University, and an author of the piece.

Spoon-feeding may constitute basic care, however, more akin to changing sheets or bathing than to medical interventions.
“People get in trouble — nursing homes, even family members — for inadequate nutrition or letting someone dehydrate,” said Thaddeus Pope, the director of the Health Law Institute at Hamline University School of Law. “Neglecting basic human comfort care is a big source of elder abuse complaints and criminal prosecutions.” And if a patient demands that his basic care be withheld in the event of dementia? “Nobody from a legal perspective has really meaningfully grappled with that,” he said.

In several states, including New York, Wisconsin and New Hampshire, statutes have made it difficult to withdraw oral nutrition or hydration, sometimes even if that instruction is included in a directive.
A court case unfolding in British Columbia shows just how tricky these judgments can be.

Margo Bentley, 83, is a retired nurse with advanced Alzheimer’s disease. Her advance directive specified “no nourishment or liquids” if she became incapacitated.

When her husband and daughter attempted to honor her wishes, the care facility where she lived refused, sending the family to court.

Last February, a judge ruled that although a health care provider could legally honor such a directive, Ms. Bentley’s feeding should continue in part because she swallows food placed in her mouth. That constitutes consent, the judge ruled. The family has appealed.

If swallowing is all it takes to legally invalidate an advance directive, Mr. Pope said, then patients will never be able to specify that they want for food and water to be withdrawn should they become demented.

The moral and ethical aspects are even more dizzying. Can one’s current, competent self make decisions on behalf of one’s future demented self — who may find modest pleasure, years later, in a life once deemed intolerable? What if that later self asks for, or points to, applesauce?

“I can imagine people saying, ‘You’re starving this vulnerable person who’s dependent on us for care when this person is willing to eat,' ” said Rebecca Dresser, professor of law and medical ethics at Washington University in St. Louis.

At the other end of the ideological spectrum, Dena Davis, a Lehigh University bioethicist who has published articles on “pre-emptive suicide,” disputes the notion that withholding food should wait until the advance directive writer has reached a severe stage of dementia.

By that point, “you lost your dignity a long time ago; you’ve probably been a burden on your family for six or seven years,” she said. “It’s too little, too late for me.”

Religious organizations, disability groups and uneasy nursing home administrators will also surely weigh in if patients and families try to enforce VSED as detailed in advance directives. Catholic authorities, for example, have generally opposed removing terminally ill patients’ feeding tubes or IV fluids.  

“We should not encourage people to think their life has no meaning or value because they’re in a fragile, vulnerable and terrible situation,” said John Brehany, a former executive director of the Catholic Medical Association. He predicted that Catholic-affiliated hospitals and nursing homes wouldn’t honor such directives.

None of this remotely dissuades Jerome Medalie. For now, “life is exceptionally good.” A veteran of bypass surgery, multiple angioplasties and two knee replacements, he exercises daily, canoes on the nearby Charles River with his grandchildren in summer, and uses a voice-controlled computer to counter the effects of macular degeneration.His wife and children — and nearly everyone he has met in the last 20 years — are fully aware of his desires and instructions, however, and they are committed to carrying them out.

“I want to go out on my own terms,” he said. “I don’t want any church, the government, any doctor or hospital or even any member of my family to contradict what I want for my death.”
But he hasn’t persuaded everyone. Dr. Susan Mitchell, a Harvard Medical School geriatrician and researcher, has met Mr. Medalie and read his advance directive.

If she encountered a future Jerome Medalie, bed-bound and suffering from advanced dementia, she said, “I would not feel comfortable not gently offering him at least a sip of water and a spoonful of ice cream.”

Full Article & Source:
Complexities of Choosing an End Game for Dementia

Would You Be Willing To Report A Family Member For Financial Elder Abuse?

It would take some nerve to report an abusive family member to law enforcement. We also know from the National Center on Elder Abuse that most abusers are family members. And they tell us that only 44 out of 1000 instances of abuse are reported to authorities. Why aren’t more cases reported to the very authorities capable of stopping the abusers?

It seems to me that most family members are simply unwilling to “rat out” another family member even when they know that abuse is going on. When it comes to the elders themselves, there is shame and embarrassment with being taken advantage of by someone close, and someone they really trusted, a grown child perhaps. They hesitate. They are fearful. They want to talk about it but not do anything about it. And the reluctance to report the abuse to Adult Protective Services is not limited to the elders who can’t bear to call the authorities about a son, daughter or other relative.

I received a call from a distressed sister,  convinced that her older brother was stealing from their parents. He had total control over their parents, one of whom had dementia.  He had been appointed by his parents as the agent on both the Durable Power of Attorney and the Advance Healthcare Directive.  This gave him the legal authority to make both financial decisions without being accountable to anyone else and all healthcare decisions as well.  I listened patiently to all the reasons she thought her brother was taking her parents’ money and using it for himself.  I asked her if she had called Adult Protective Services.” No”, she said.  When I asked why not she said “I don’t want to get my brother in trouble”.  Where is the logic in that?

In another case, the elder herself had called. “I gave my grandson a big loan and he hasn’t paid it back” she said.  “And now I need the money to live on”.  She described how her favorite grandson had taken title to her mobile home and gotten a loan, even after she had “loaned” him most of her savings.  I explained that her chances of getting paid back were probably not very good, but the least she could do was to report what had happened to authorities. I advised her that taking a “loan” from an 80 year old and not paying it back would likely be considered elder abuse and it should be reported to APS.  ”Would my grandson go to jail?” she asked.  I told her I didn’t know but it can happen when someone has committed this crime of elder abuse.  She said, “I don’t want my grandson to go to jail”.  And I am sure she did not follow up or do anything more about the problem, even though she was at risk for homelessness.

Elders like the 80 year old woman are typical of why elder abuse does not get reported and therefore prosecuted more often, even when a family member is well aware of it and aware that it is wrong.  They would rather suffer impoverishment than be the one to report abuse. In fact, these same victims may refuse to testify against a relative who has abused them, even when these cases are prosecuted.  Charges may not stick when the victim is unwilling to testify, unless there are independent records to prove the case in court.

It is as much a problem of our emotions and fears as it is of the wrongdoing itself. We somehow justify the actions, we look the other way or we fear what the justice system will do to our abusive relative.  We must stop giving thieves a pass.

I ask, where is the anger at a crime against a person who is easily taken advantage of by the abuser?  Where is the advocacy for the vulnerable elder?  Why are we remaining silent so often  in this growing, $2.9 billion dollar a year problem? At I am only one voice. I do what I can to educate, to encourage reporting, and occasionally to report elder abuse myself.  We need more allies.

I would be willing to guess that there is someone reading this who has a financial abuser in the family or knows of a family where this has taken place.  I urge you to speak up.  To my knowledge, you can remain anonymous in your reporting, just as you can with any crime. Most elder abuse hotlines are staffed 24/7.  Whether or not the criminal justice system can prove the crime is not your problem.  It is your problem to know about the abuse and to do nothing.  One day it could be you who is victimized.  (Continue Reading)

Full Article & Source:
Would You Be Willing To Report A Family Member For Financial Elder Abuse?