Separating Belief From Suspicion in Elder Abuse Investigations

by Jeff Ziesman and Andrew Adams

Norton Rose Fulbright’s Jeff Ziesman and Andrew Adams examine financial institutions’ obligations in cases of suspected elder financial exploitation.

The Bottom Line

• Financial institutions have a responsibility to intervene when they suspect their services are being used to facilitate elder financial exploitation.
• Deciding whether to place transaction holds or file suspicious activity reports requires evaluating the facts and using subjective and objective standards.
• The best defense for an institution is to carefully document investigative steps they have taken in cases of suspected elder financial exploitation.

Elder financial exploitation, or EFE, is on the rise, with vulnerable adults losing more than $28 billion annually, according to a recent AARP study. Whether these frauds are perpetrated by family members and acquaintances or professional criminals unknown to the victim, financial institutions may find themselves in trouble if they don’t respond appropriately to being caught in the middle of a fraud scheme.

Financial institutions providing services to, or holding accounts for, a vulnerable adult have a series of steps to consider when suspicious underlying circumstances involving the individual are present: placing a transaction hold on transactions within the account and/or disbursements from their accounts, and/or filing a suspicious activity report with the Financial Crimes Enforcement Network, or FinCEN.

The standard in many states for effecting a transaction hold is synonymous with whether the financial institution “reasonably believes,” after initiating an internal review, that the transaction will result in financial exploitation. If so, the institution may (but isn’t required to) place a hold on the transaction, pending further review and providing appropriate notification to specified state agencies.

A financial institution is required to file a SAR if it has a reasonable suspicion that a transaction (or attempted transaction) through the financial institution is an effort to facilitate criminal activity.

Placing a Hold

A “reasonable belief” is a term that connotes both objective and subjective components. A belief is “a state or habit of mind in which trust or confidence is placed in some person or thing”—or what a person subjectively believes. Reasonable, as a legal requirement, has long been identified as an objective standard.

The North American Securities Administrators Association Inc., created a “NASAA Model Act to Protect Vulnerable Adults From Financial Exploitation,” which has been adopted in various forms in nearly 40 states. The commentary to the Model Act states reasonable belief is “intended to be both a subjective and objective standard – i.e., a qualified individual must have a subjective belief in the existence of financial exploitation, and this belief must be objectively reasonable.”

This blended standard is intended to be flexible and capture instances of actual knowledge of exploitation—as well as instances in which the reviewer has a belief of exploitation, and a reasonable person armed with the same information would reach the same conclusion.

Further adding flexibility to the Model Act standard (and permitting a transaction hold under appropriate circumstances) is the inclusion of the word “may”—that is, “the requested [transaction] may result in financial exploitation of the eligible adult.” With this additional modifier, financial institutions only have to rationally believe that financial exploitation could take place.

A shorthand way to describe this standard is: “Do I believe, after a review has been commenced, that a transaction may be exploitive, and would a hypothetical co-worker agree with me?”

Although not necessarily explicitly embodied in cases or statutes, this operates similarly to a preponderance-of-the-evidence standard that exploitation could take place. Under those circumstances, a financial institution is permitted (but not required) to put a transaction hold in place.

This careful balancing makes sense when it’s understood that a vulnerable adult’s funds are at issue, and potentially being held for weeks. Many vulnerable adults rely on their retirement and investment accounts to meet periodic and other living expenses. However, there is a collective societal interest in putting measured, appropriate safeguards in place to protect the most vulnerable from theft, fraud, or other illegal activity.

One other significant safeguard for financial institutions is the availability of immunity for reporting suspected exploitation to state officials and putting transaction holds in place, as long as the financial institution acted in “good faith.”

In one of the few reported cases on the scope of statutes designed to protect vulnerable adults and financial institution responsibilities, a North Carolina federal district judge gave a broad interpretation to immunity provisions for financial institutions.

Given the overall purposes underlying these statutes and their paternalistic nature, financial institutions have broad space to make judgment calls and, at minimum, buy time to more fully and completely investigate the underlying facts.

In some circumstances, the investigation of the underlying facts and the consequent judgment call will result in no transaction hold (or anything else) taking place. Other instances may result in law enforcement and protective services’ involvement, potentially leading to legal proceedings.

Filing a SAR

In stark contrast, if a financial institution has a reasonable suspicion a transaction (or attempted transaction) is being used to facilitate criminal activity, it is required by law to file a SAR. This includes instances of EFE. As FinCEN has explained in the context of EFE, financial institutions “are uniquely situated to detect possible financial exploitation through their relationships with older customers.”

The reasonable suspicion prong for SAR-filing appears, on its face, to be an objective standard. Analogizing to the well-developed body of criminal law under Terry v. Ohio—which applies a similar standard in the context of brief law enforcement interaction with a suspect—such a legal threshold is lower than probable cause.

Along the same lines, reasonable suspicion requires something more than a mere hunch, but a showing of a reasonable belief isn’t required. Applying a rough percentage range for the reasonable suspicion standard, something like a 33% to 40% likelihood (and certainly well short of 51%) that criminal activity may be occurring seems generally reasonable.

In determining whether a reasonable suspicion is present, all surrounding facts and circumstances must be considered. This will consist of, among other things: the unique characteristics of the customer, the historical and known transaction history in the relevant accounts, other assets and income that the customer may have, and the customer’s risk tolerance and investment objectives.

While there can’t be a precise formula for finding reasonable suspicion because it is inherently fact-based, regulators have identified the following examples of red flags supporting a reasonable suspicion:

• Unusual types of account activity (for the customer, the type of account, or similarly situated customers)
• Customer appears distressed or fearful
• Caregiver shows unusual or excessive interest in the customer’s business or accounts

Enforcement cases against financial institutions for failing to file SARs have been prevalent in recent years. However, because there are a wide range of judgment calls in this space, enforcement cases typically involve instances in which financial institutions have done little in terms of either SAR filings or documenting the underlying investigative steps and reciting why a filing a SAR wasn’t appropriate.

At bottom, a SAR filing is mandatory in instances when the financial institution evaluates a set of facts and merely has a reasonable suspicion it is being used to facilitate criminal activity through the financial institution.

Suggested Steps

As noted above, the same set of facts of suspected EFE will, in many instances, necessitate both a transaction hold and a SAR filing. However, other instances may require one step or the other—or maybe neither step. A non-exhaustive list of suggested practices to consider in these circumstances include:

Immediately contacting the financial professional responsible for the accounts or investments. This should be among the first steps considered, unless the professional is suspected of being involved in the EFE. The financial professional likely will know the vulnerable adult well and be able to shed light on financial, personal, and physical situations.

Attempt to contact the customer. What the customer says (or doesn’t say), and how the customer reacts, may provide clues as to what is occurring in their personal and financial life.

Attempt to contact a trusted contact person or third party reasonably associated with the vulnerable adult. Many financial institutions have been encouraging customers to identify a trusted contact person, or TCP, for the account. Several states also permit contacting a third party reasonably associated with the vulnerable adult (in addition to or instead of the TCP) if there is a reasonable belief exploitation may be occurring. However, neither the TCP nor any other third party associated with the vulnerable adult should be contacted if they are suspected of being involved in the EFE.

Conduct a comprehensive review of the account activity and documents. Review the recent transactions giving rise to the concern against historical transaction data and the account’s investment objectives. An email review using the customer’s known email address may provide additional clues, such as other people who are suddenly being copied on the vulnerable adult’s communications.

Document investigative and evaluative steps considered and taken. A well-documented file will be the best shield against any potential regulatory or civil liability. A broad continuum of gray area exists for transaction holds and SAR filings. Documenting findings, as well as investigative steps taken and steps considered, will be the best support for whichever “reasonable” standard is at issue.

After these steps have been taken, stress-test the facts. The findings and steps should be discussed with at least one other person to assess whether the findings and conclusions are objectively supportable. If the conclusion is debatable, additional investigation may be necessary.

In the case of a transaction hold, once a hold is put in place, continued communication will remain key. Communication with the customer about the status of their funds and any communications with law enforcement or regulators should be frequent and well documented.

Outlook

EFE will keep rising given the continued aging of the US population, coupled with overall investment returns since 2010. The nature and types of EFE also will be dynamic as technology rapidly advances.

Financial institutions will continue to face facts in which EFE may be occurring. Investigation of the underlying facts will often result in concluding that both the “reasonable belief” and “reasonable suspicion” standards were or weren’t met, though in limited instances, one or the other actions may be appropriate. Above all, financial institutions should document their investigative steps and conclusions to make the decisions defensible down the road.

This article does not necessarily reflect the opinion of Bloomberg Industry Group, Inc., the publisher of Bloomberg Law and Bloomberg Tax, or its owners.

Author Information

Jeff Ziesman is partner at Norton Rose Fulbright, assisting financial institutions with regulatory matters brought by the SEC, FinCEN, FINRA, and state securities regulators.

Andrew L. Adams is counsel at Norton Rose Fulbright, focusing his practice on securities litigation and regulatory investigations involving broker-dealers, registered investment advisers, international banks, insurance companies, and other financial services clients.

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Separating Belief From Suspicion in Elder Abuse Investigations

Pennsylvania Department of Aging Elevates Transparency, Speeds Elder Abuse Investigations

by Maryann Pugh

HARRISBURG, PA — The Pennsylvania Department of Aging (PDA) has unveiled significant strides in improving transparency and efficiency across Area Agencies on Aging (AAAs), particularly in investigating suspected elder abuse. Using the recently launched Comprehensive Agency Performance Evaluation (CAPE) strategy, the department is enhancing oversight while giving the public greater insight into local agency performance.

Among the initiatives’ early successes is the progress showcased by Delaware County AAA, which significantly boosted its compliance rate for timely elder abuse determinations. Compliance more than doubled from 40% in 2024 to an impressive 89% in early 2025. This surge reflects PDA’s collaboration with AAAs statewide to expedite investigations and better safeguard vulnerable older adults.

“I commend the Delaware AAA leadership and the entire protective services team for their hard work and dedication to improving their performance,” said Secretary of Aging Jason Kavulich. “Our approach of supportive change is generating measurable results that benefit and protect older Pennsylvanians.”

AAAs handle nearly 40,000 elder abuse reports annually statewide, addressing allegations of neglect, financial exploitation, and other harms. A key metric for evaluating agency responsiveness is the percentage of investigations closed within 20 days. Under PDA’s leadership, Delaware County’s success exemplifies systemic improvements across Pennsylvania, with compliance reporting now publicly available for all 52 AAAs on the department’s website.

PDA’s transparency push also builds on earlier initiatives, such as publishing data on whether initial assessments of elder abuse cases are conducted within designated timeframes. This effort has seen notable gains, with 49 of 52 AAAs achieving at least 85% compliance, up from prior years.

Secretary Kavulich attributes these advancements to CAPE, which works in tandem with tools that help AAA supervisors track performance and allocate resources efficiently. Delaware County AAA leaders emphasized the department’s role in driving progress, with Deputy Director Joanna King stating, “Our supervisors have been able to track performance in every area of our work… to complete investigations in a timely and thorough manner.”

Looking ahead, PDA plans to further engage AAAs on performance enhancements while fostering a transparent environment that prioritizes elder protection. With tools like CAPE and expanded public reporting, the Department of Aging continues to amplify its commitment to Pennsylvania’s aging population.

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Pennsylvania Department of Aging Elevates Transparency, Speeds Elder Abuse Investigations

Deaths during elder abuse investigations rose in Pa.’s largest city as state regulators took no punitive action

By Angela Couloumbis

HARRISBURG — The Pennsylvania Department of Aging oversees 52 county agencies across the commonwealth, assessing them every year to ensure they comply with state regulations for keeping older adults safe from abuse or neglect.

But in 2021, it directed its small cadre of protective services specialists to drop everything and focus on just one agency: the Philadelphia Corporation for Aging.

The extraordinary step was triggered by deep concerns among the department’s top officials over PCA’s staffing shortages and delays in investigating cases.

For the next nine months, state specialists worked around the clock to help PCA handle investigations, including speeding up the timeline for making contact with potential victims and providing them services to minimize their risk of injury — or worse.

“It was an absolute mess,” said Peter Hans, a former protective services specialist at the Department of Aging who was assigned to assist Philadelphia. “It was so distressing.”

Hans said he encountered cases that had remained unresolved for over a year and ones in which an older adult had died during an active investigation — yet PCA was unaware of the death.

Though aging officials say the agency has made improvements since then, PCA continues to have the worst track record in the state for complying with strict regulations meant to keep older adults safe from harm, according to data obtained through public records requests.

Many of its cases, the data show, aren’t investigated within the 20-day state deadline. It has also failed annual compliance assessments by state officials in five of seven recent years examined by Spotlight PA. In the remaining two years, it wasn’t monitored at all.

Records obtained by Spotlight PA through sources show problems ranging from poor paperwork to failures to contact medical professionals to delays in investigating cases.

In the meantime, deaths during open investigations have steeply risen in recent years, and Philadelphia has been particularly affected. In 2019, ’20 and ’21, nearly a third of older adults who died statewide during open investigations lived in the city and were being served by PCA.

Despite the help from state protective services workers, PCA again failed its annual assessment in 2022. That year, the agency handled the case of Luen Ng, an ailing 75-year-old woman who died after her daughter spent months pleading for assistance.

Officials, including those in Gov. Josh Shapiro’s office, have not publicly acknowledged failures in the state’s tattered system for keeping older adults safe. The state Department of Aging can take punitive action against agencies when they fail to meet safety standards, but has never done so.

“That is too bad because this is solvable,” said Mark Zecca, a Philadelphia lawyer who worked for years on federal social services programs, and later for Philadelphia. “It needs leadership.”

Asked if Shapiro was aware of the problems, a spokesperson said in an email: “Will keep you posted on anything to add from our end.”

A PCA spokesperson declined requests for comment for this story, referring all questions to state aging officials. The chair of PCA’s board of directors, Glenn Bryan, also declined to be interviewed.

Karen Gray, spokesperson for the Pennsylvania Department of Aging, said in an email that the agency is overseeing a corrective action plan for PCA. She did not describe the plan — which generally requires a county aging agency to list specific actions it will take to fix problems — but said that protective services staffers at the agency are receiving extended training.

The state, said Gray, has also provided technical assistance that “has allowed PCA to hire more investigators, doubling the number of investigators from as few as 26 to nearly 60, resulting in reduced caseloads.”

PCA, a nonprofit that receives tens of millions of taxpayer dollars every year, has also hired a private contractor to help with its caseload, according to sources with direct knowledge who requested anonymity because they are not authorized to discuss the matter publicly.

The contractor, Service Access & Management Inc., declined to comment about its contract with PCA, saying it does not discuss its work with “stakeholders.”

Because PCA is not a government-run agency, it is not subject to the state’s public records law, and Spotlight PA could not obtain a copy of the contract.

Though the Department of Aging funds PCA, it said it could not provide information about the contract with Service Access & Management Inc. For instance, state officials could not say whether they require PCA to pay for the contract out of its annual state funding; or whether they provide PCA with additional dollars to pay the private company — without reducing PCA’s overall funding by that amount. If the latter, the state would effectively be paying PCA twice for the same service.

Pressed to explain why the department could not comment, Gray would only say: “We do not have information pertaining to AAA subcontractors, nor can we comment on actions taken regarding the reasons for their hiring, or contract termination.”

The state allocated $343 million for the 52 county aging agencies this fiscal year; PCA received $65 million of that total.

In its last federal tax filing, which covers 2022, PCA reported $76.8 million in revenue from grants and contributions, the majority of it from federal, state and local sources. State-specific funding largely comes from Pennsylvania lottery earnings.

During its last annual audit, from June 2023, auditors found “significant deficiencies” in certain internal controls and financial reporting requirements.

Zecca said there is little incentive for PCA or any county aging agency to change if the Department of Aging just hands over money on “a silver platter,” with no accountability. State officials could provide that incentive by allocating a portion of PCA’s funding to another social services entity that could do a better job.

“They have to say, ‘If you are not in compliance, you will lose a part of your funding, and we will give it to another entity who can provide that service,’ ” Zecca said. “You don’t want to lose another part of your funding? Be compliant.”

Hans, the former state protective services specialist, said he made that exact recommendation to his superiors after working with PCA in 2021 and ’22. The agency’s caseload, he said, was alarmingly high, as was the number of open cases of abuse and neglect — PCA was simply unable to deal with it, leaving older adults at risk.

In 2021, when the Department of Aging swooped in to help PCA, nearly 40% of older Philadelphians who died that year had cases open for six months or longer — more than three times the limit imposed by state rules — without a determination by PCA about whether they were being neglected or abused.

“I told them I would divide Philly up by ZIP code, and then I would number those zones, and I would reduce PCA’s block grant by giving those zones to a surrounding county or a private entity,” Hans said.

His plea, he said, was ignored.

Hans retired from his state position last summer. Since then, he has contacted legislators, the Pennsylvania offices of inspector general, attorney general and auditor general, and Shapiro’s office, among others, to sound the alarm.

He said he has been exasperated by the inaction.

“People are dying,” he said. “What else is it going to take?”

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Deaths during elder abuse investigations rose in Pa.’s largest city as state regulators took no punitive action

Advocates: Staffing, medication issues core to Central Minnesota elder abuse investigations

ST. CLOUD — The Minnesota Office of Health Facility Complaints received 2,603 complaints of elder abuse in Central Minnesota last year, according to a new analysis by Elder Voice Family Advocates.

Only a handful of those complaints were investigated by the state Department of Health.

For Central Minnesota, in the last 26 months, officials investigated 89 complaints and half of them were unsubstantiated. 

The Elder Voice report reveals some St. Cloud-area facilities have been investigated several times in the past few years for problems such as sexual abuse, financial exploitation and theft of medication.

Staff issues, such as understaffing and poor training, were at the heart of many complaints against long-term care and assisted living facilities, according to the report "The State of Elder Care in Central Minnesota," which spanned Dec. 1, 2017 to Jan. 31, 2020, before the novel coronavirus reached Minnesota.

These problems are even more salient during the COVID-19 pandemic, said Kris Sundberg, executive director of Elder Voice Family Advocates.

"It was a recipe for disaster before, and COVID is now exposing how poorly staffed these facilities have been," she said. As of Monday, about 80% of the COVID-19 deaths in Minnesota were tied to long-term care facilities. 

The advocacy group reviewed investigations into facilities within about 40 miles of St. Cloud. Not all of the investigations were substantiated, but Elder Voice members want to highlight inconclusive and unsubstantiated investigations, too. 

"Some of these investigations raise more questions than answers," Sundberg said. 

Many senior victims don't feel comfortable reporting abuse in the first place, and the large majority of complaints in Minnesota are not investigated at all, according to the Elder Voice report.

In the 26-month period that Elder Voice reviewed, the state investigated 89 cases at 47 facilities in Central Minnesota. That means 44% of assisted living and nursing homes were investigated in the area.

"There were three incidents of sexual abuse, eleven cases of medication errors, and ten cases of falls as a result of improper transfers or supervision. There was one death directly attributable to the neglect and three other deaths where neglect may have been a contributing factor," according to the report. 

Of the 89 investigated complaints, 27 were substantiated, 17 inconclusive and 45 unsubstantiated.

Four facilities in St. Cloud, Sauk Rapids and Sartell were named "facilities of concern" for repeated state investigations. They all had deficiencies in federal reviews as well. Other "facilities of concern" on the list have closed or are located well outside St. Cloud.

Good Shepherd in Sauk Rapids

In the past two-plus years the state investigated Good Shepherd Lutheran Home six times, twice substantiating complaints of theft. One instance was the theft of medications from three residents, the other a theft of money from a resident. 

Good Shepherd declined to comment for this story. 

Four of the investigations ruled complaints unsubstantiated: one regarding resident violence, another on family member abuse, another on neglect of care and one on the ingestion of a foreign object.

Federal regulators through Medicare cited Good Shepherd for various issues in the past couple years, including four deficiencies reported in August 2019, including issues with staff members' hand hygiene and a failure to "provide separately locked, permanently affixed compartments for storage of controlled medications in 2 of 8 medication room refrigerators."

The entrance to St. Benedict's Senior Community in St. Cloud is pictured in this file photo.  (Photo: Gustin Schumacher, Gustin Schumacher, gschumache@st)

St. Benedict's in St. Cloud

St. Benedict's Senior Community made statewide news last year when a staff member was convicted of sexually abusing a resident.

The Department of Health also investigated the matter, ruled the employee responsible for the maltreatment and "issued a correction order regarding the vulnerable adult's right to be free from maltreatment," according to the Office of Health Facility Complaints July Investigative Public Report.

Jesus Manzanilla Alvarado, 23,
 is charged with sexual abuse
and mistreatment of a
vulnerable adult while working
at St. Benedict's Senior Community.
(Photo: Sherburne County Jail)

That was one of five state investigations into St. Benedict's Senior Community in the past 26 months, according to Elder Voice's report. The state also substantiated a complaint of improper restraint in late 2017. The state ruled another sexual abuse complaint as inconclusive, and two other investigations were unsubstantiated regarding the notification of a physician and a lack of daily activity.

CentraCare provided this statement Wednesday about the investigations: 

"The safety of our patients and residents is always our top priority, so when an incident occurs at one of our facilities, we take immediate action which often includes self-reporting to regulatory agencies. For each case, we conduct an internal review to determine what steps are needed to ensure an incident does not happen again. We are transparent with our families when an event occurs and report these cases publicly per Minnesota Department of Health and Joint Commission guidelines."

In early 2017, the facility was fined nearly $25,000 by federal regulators, and it was cited with multiple deficiencies since then, including five in March 2019. Some deficiencies, including the most severe one, in the recent Medicare report were tied to the sexual abuse incident one year ago.

"Based on interview and document review, the facility failed to thoroughly investigate allegations of abuse, and failed to protect the residents during the investigation," according to the federal report. "This practice had the potential to affect all 143 resident in the facility."

Talahi Nursing in St. Cloud

A coffee spill at Talahi Nursing and Rehab Center resulted in a second-degree burn and a ruling of neglect by the state. It was the only substantiated complaint at that center included in Elder Voice's analysis. 

The facility was investigated five times in the 26-month time frame. One resulted in an inconclusive ruling for alleged poor wound care. There were three unsubstantiated complaints for alleged poor supervision when a resident attempted to kill themself, medication error and poor wound care.

Elder Voice flagged Talahi Nursing for "so many unsubstantiated cases that were serious enough to trigger an onsite investigation."

The facility administrator did not return a Tuesday voicemail seeking comment. 

Talahi Nursing and Rehab Center was cited with eight deficiencies in October and many others in recent years. 

"Based on observation, interview, and record review, the facility failed to ensure proper wheelchair positioning for 2 of 2 residents observed with positioning concerns," according to the federal report. "In addition, the facility failed to provide appropriate care and services for 1 of 1 resident."

Edgewood Sartell

Last summer, the state investigated a report that an employee at Edgewood Sartell gave a resident the wrong medication, causing the client to be admitted to the hospital.

The Department of Health ruled the staff member responsible for neglect. It was one of three investigations into the facility since December 2017. 

Another investigation into an alleged drug theft led to an inconclusive ruling, and another medication error was unsubstantiated, according to Elder Voice's report. 

An employee at Edgewood Sartell would not comment, and no one responded to a request for an interview sent to company's general email box.

Medication errors should not happen, Sundberg said. People suffer when they don't get their medications, and clients can die if they receive the wrong drugs.

"With a really carefully managed and designed system, all of that should never have to occur," she said. 

How to use this information?

Elder Voice members conducted their analysis to identify the root causes of abuse, neglect and exploitation, according to the report. Members then lobby for policy change and support families who use long-term care or assisted living services.

It has long been a challenge to staff assisted living and nursing home facilities, because the work is difficult and the pay is relatively low. There's no "silver bullet fix," Sundberg said. 

"We really empathize with the caregiver," she said. "They're doing God's work, and most of them are doing a good job. But they're getting burned out. And they're getting sick."

Especially during the COVID-19 outbreak, when residents are cut off from visitors, communication is key, Sundberg said. 

She suggests people stay in touch with loved ones who are residents and use a camera to monitor their care and well-being.

Be patient when reaching out to facilities and try to understand the demands they're under, Sundberg said. "Have a really constructive dialogue with the facility management and staff."

And if you do learn of a problem, she said, report it. 

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Advocates: Staffing, medication issues core to Central Minnesota elder abuse investigations

Elder abuse investigations in Connecticut have more than doubled in seven years

Rita Pompano, 76, sitting inside her living room in West Haven. Pompano endured seven months of physical abuse from her husband. (Carl Jordan Castro)

State investigations of elder abuse, ranging from neglect to emotional abuse to physical abuse, more than doubled in Connecticut between 2011 and 2017, from 3,529 to 7,196.

Some of the recent cases investigated by the state Department of Social Service’s Protective Services for the Elderly are chilling. A 74-year-old man who was frail, thin and prone to falling was living alone in a home infested with cockroaches and mice. The in-home care of a woman over 90 was stopped for nonpayment because her niece had spent her aunt’s money on her own household. An 87-year-old man confused about his finances had his utilities shut off after his son had spent his money instead of paying the bills. The 68 social workers at DSS helped all the seniors find in-home care, a new conservator or better housing—whatever they needed to escape the neglect or abuse.

In 2017 alone, the DSS received 11,123 reports of elder abuse and decided that 7,196 warranted an investigation. That year, self-neglect—when adults are unable to provide for their own basic care—was the most common type of elder abuse reported to DSS, at 30 percent, followed by neglect by others, financial exploitation, emotional abuse, physical abuse, sexual abuse and abandonment.

“It’s all trending up,” Dorian Long, DSS director of social work services, said.

Sexual abuse of the elderly is also on the rise, Long said. In the past, DSS would investigate three or four cases a year, working with police, and now it typically handles 40 cases a year. Scams targeting the elderly are also increasing, she said. Seniors can avoid becoming victims by staying involved in their communities. “The more you are isolated, the more vulnerable you are,” Long said.

The Justice Department estimates that 1 in 10 American seniors are abused, and state officials say the problem is likely to grow as the population in Connecticut—already the sixth oldest state -- continues to age.

Complaints about abuse in Connecticut nursing homes, residential care homes and assisted living facilities rose by nearly 15 percent between 2015 and 2017, said Mairead Painter, the state Long Term Care Ombudsman.

Experts say the numbers of elder abuse complaints may be rising due, in part, to greater awareness, but still, many cases are never reported.

“Sometimes individuals are too embarrassed to report it,” Painter said. “Sometimes people are fearful that if they report abuse, they may have to stay longer at a nursing home.”

From physical abuse to scammers

This past January, a Rockville couple in their 70s had several thousand dollars in cash and jewelry stolen when they let in their home men posing as utility workers.

Criminals use other scams as well, such as befriending seniors or showing a romantic interest and then asking for money.

Betty Bajek, 66, of Prospect, volunteered to educate seniors about fraud for AARP after someone stole her credit card number and charged $1,200.

“These con artists prey on lonely people,” Bajek said.

Nationally, financial exploitation and neglect are the most common types of elder abuse. Some states, including Connecticut, count self-neglect as abuse. Julie Schoen, deputy director of the National Center on Elder Abuse, said that is appropriate so those seniors get help.

Sometimes the abuse is physical. When she was 69 and living in Meriden, Rita Pompano said, she endured seven months of physical abuse from her husband, Ralph Pompano.

Each day when he told his wife to grab a pillow, the pain would soon follow.

“I knew that was time for my daily beating,” said Pompano, now 76 and living in West Haven. “He’d have me put my face into the pillow so nobody would hear me screaming.”

She escaped with her son Anthony’s help in 2011, only to have her husband threaten him three months later to find out where she was hiding. Ralph Pompano, 74, pulled a gun and fired a shot at Anthony that day before fleeing to Virginia. Two years later, he died in prison.

Bonnie Brandl, director of the National Clearinghouse on Abuse in Later Life, said she has encountered similar cases.

“The abuser may decide their life is being cut short and will become threatening,” Brandl said. “It’s the ultimate act of power and control.”

Help is available

State Sen. Tony Hwang, R-Fairfield, and four state representatives have proposed legislation to create an elder abuse registry. Similar to the state sex offender registry, it could keep people convicted of such crimes from doing it again, he said.

“We need to be sure our seniors are protected,’’ he said. The bill has been approved by the state legislature’s Committee on Aging and referred to the Senate.

The AARP Connecticut holds workshops across the state to alert seniors about scams, ranging from IRS and sweepstakes scams to fake Nigerian princes, said Erica Michalowski, the organization’s associate state director for community outreach.

Scammers succeed by "keeping the senior off-balance in a heightened emotional state,'' Michalowski said.

Unlike children who are abused, seniors can decline help. Long said DSS social workers do encounter some elderly people living in squalor who refuse their services.

“We put on the charm and try to convince them, but as an adult, you have a right to make choices—even bad choices,” Long said. The caseworkers may go back a few weeks later to try again. If the person says no, they have to close the case.

One of several agencies in Connecticut assisting elders is the CHERISH program in Ansonia, which counseled Rita Pompano after she left her husband. It provides a hotline, court advocacy, safe housing and counseling for victims of domestic violence who are over 60 statewide.

Its coordinator, Mary Jane Liddel, stayed close by as Pompano recounted her story of her husband’s violence. Tearing up briefly, Rita said CHERISH helped her heal. Now, she enjoys freelance writing, cooking for friends and taking road trips with friends.

“I’m just happy that I’m free,” she said.

To report cases of suspected elder abuse, neglect or exploitation in Connecticut, call the toll-free referral line at 1-888-385-4225; after business hours, or weekends, or state holidays, call 211.

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Elder abuse investigations in Connecticut have more than doubled in seven years