The Mental and Physical Cost of Elder Financial Abuse

Changes in cognitive function or appearance – like self-neglect – may leave seniors more 

vulnerable to financial abuse. (Getty Images)

Ideally, David Top would like to move his father, 88-year-old Gabriel Top of Manhattan, into a memory care facility – that is, if the money were available to do so.

After suffering a stroke about a dozen years ago, Gabriel’s short-term memory was greatly diminished, and today Gabriel suffers from severe dementia. Memory care is specialized long-term care offered by some nursing homes for residents with dementia – like that caused by Alzheimer’s disease – and other memory issues. “His dementia is getting worse, and he doesn’t get the amount of care that he needs,” David says of his father. “Part of the goal was to move him to Las Vegas, where they have a top-notch memory care facility.” That’s also where David’s daughter lives and family often gathers for reunions and vacations. “So he would be part of his family’s life, basically, instead of being isolated.”

Though family travel to see Gabriel in Manhattan, they can’t afford to relocate him or put him in memory care, after hundreds of thousands of dollars Gabriel had saved were taken from him by a long-time companion, David says. “He depended on her for everything – for advice and to get to his medical appointments, and really to manage his life,” David says of his father’s companion; at one time, Gabriel and the woman had been a couple. But David notes she started to take utter control of Gabriel’s life, including alienating him from family – even convincing him not to get needed medical care. She also became a joint account holder on bank and investment accounts, eventually removing his name from those accounts. "The amount of money the long-term companion took from Gabriel is estimated at close to $750,000, in addition to an unknown amount of interest and dividends," says Jahna Locke, an Equal Justice Works AmeriCorps Legal Fellow at the non-profit New York Legal Assistance Group, who is working on Gabriel’s case. NYLAG is providing free legal services to try to help recover the money that was taken. “She basically took all his money,” David says.

One of the most common forms of elder abuse, financial exploitation is growing in prevalence (along with other forms of abuse) as the population ages. Most commonly committed by a family member, caregiver or trusted individual, financial abuse typically involves taking money, property or other assets – or withholding those – without a person’s permission. Though in Gabriel’s case, David says he didn’t yet have dementia when the abuse appears to have started in 2012, he and Locke say his companion took advantage of his dementia as time went on.

Even mild cognitive impairment has been shown to inhibit financial-decision-making, studies show, and can make a person more vulnerable to financial exploitation. More than one-third of people 65 and older already have some form of cognitive impairment, notes Dr. Robert Roush, a professor of geriatrics at the Huffington Center on Aging at Baylor College of Medicine in Houston. Roush is the medical project director for the Elder Investment Fraud and Financial Exploitation Prevention Program, or EIFFE, Prevention Program, which was created by the Baylor College of Medicine and funded by a grant from the Investor Protection Trust. Among other things, as part of continuing medical education EIFFE teaches doctors how to screen older patients for cognitive deficits that could put them at higher risk of being financially exploited. “You’ve got a lot of people out there at risk, and a lot of people that we know are being scammed,” Roush says. “For every one of these cases of financial exploitation that we know about, there is so many more.”

Frequently, money that's been stolen is spent by perpetrators and never recovered by victims. In Gabriel's case, efforts to recover the money he lost are greatly complicated by the fact that his alleged abuser recently died, following a stroke last fall. Locke declined to release the individual's name, citing concerns that doing so could compromise future legal action taken on behalf of Gabriel, and in light of an ongoing criminal investigation into the matter. "We're looking into the possibilities of working probate with the [late friend's] estate to see if there's any way that we can capture these funds," Locke says. "The thought is that the funds are still within her name."

“He was saving his whole life for when he needed it,” David says of his father. “He even short-changed himself on some of his quality of life trying to be self-sufficient in his older years.” Though his father isn’t able to articulate his feelings, David says the exploitation by his long-time friend saddened his father and recast the entire relationship. “Mentally it weighs on him,” David says, adding he believes his father has suffered from depression as a result.

Financial abuse not only affects a person’s fiscal health, but overall well-being. Research finds it can raise a person’s risk of depression, leading people to withdraw and increasing hopelessness. Faced with profound loss, some victims even become suicidal, experts say. Additionally, having money and assets stolen in retirement can make it difficult for some people to afford needed medical care.

“When elders lose enough money to have to make choices between paying for out-of-pocket health care costs and routine living expenses, they’re going to go with the latter and forgo the former, which can cause all types of conditions to worsen,” Roush says. That can range from not being able to get needed drugs that aren’t covered by insurance to forgoing treatment due to out-of-pocket costs, or even not going to the dentist or purchasing healthful foods, due to expense.

A study published in the Journal of Elder Abuse and Neglect in January found financial mistreatment, like having money stolen, is associated with a decline in functional health – predicting more difficulties doing activities of daily living, such as dressing or bathing or getting in and out of bed without assistance. The reason for the association is not perfectly clear. But, “a lot of older adults are retired and relying on a fixed income to access care and treatment to sustain their health,” says Jaclyn Wong, a doctoral candidate in sociology at the University of Chicago who led the research. “So perhaps the financial mistreatment is reducing the monetary resources that older adults need in order to maintain their physical well-being.”

For older, frail adults, health can spiral down quickly, particularly if they’re unable to get the care they need, Roush says. “It’s a constellation of things,” he adds of the health effects linked to financial abuse. Many who are abused feel embarrassed or ashamed and withdraw, leaving themselves more vulnerable to re-victimization and myriad other health consequences associated with isolation, from further contributing to depression risk to raising the specter of future heart problems.

While doctors and others on the front lines seek to prevent and report elder financial abuse, Roush says loved ones and seniors should be aware it can happen to anyone. He advises also taking notice if a loved one experiences changes in cognitive function or appearance – like self-neglect – which may leave them more vulnerable to financial abuse.

What’s more, experts say, because of the pernicious nature of financial abuse, it’s important to treat victims with compassion and understanding that reflects the profound impact it can have. Wong reiterates that the problem shouldn’t be viewed purely through an economic lens: “Your economic situation, your social situation, your health situation – those are all linked,” she says.

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The Mental and Physical Cost of Elder Financial Abuse