E N D
1.
June 16th, 2010
Detroit, Michigan Elder Abuse: A global problem with local solutions….
2. Presented by Paul Greenwood,
Deputy District Attorney,
San Diego County, California
4. Career prosecutors
5.
The views expressed by the presenter are not necessarily those of the San Diego District Attorney’s Office WARNING!
6. By the way we care for our very young, the elderly and the defenseless How are we to measure a community?
7. Sadly, some victims are overlooked, ignored, disbelieved, or simply are abandoned All victims deserve our utmost response
8. “Our debt to the heroic men and valiant women in the service of our country can never be repaid. They have earned our undying gratitude. America will NEVER forget their sacrifices.”
President Harry S. Truman
Inscription at WWII Memorial Why should we care?
9. A Crime
Going unpunished
Predictable
Affecting both urban & rural areas
Where child abuse & DV were 30 years ago
Escalating Elder Abuse is……...
10. Between 1950 & 2000, the total population increased by 87%
Age 65+ - by 188%
85+ - by 635%
By 2030 - 65+ will triple to over 70 million The aging of America
11. 71,000 Americans are 100+
By 2010 there will be 114,000
By 2020, there will be 241,000 Demographics of living longer
12. Fastest growing age group
No known cure for dementia etc.
Victims often do not report
Third fastest growth job is home care
Minimal background checks
High temptation, low risk factors ELDER ABUSE IS EXPLODING
13. Fears of many seniors
Leads to underreporting
Feelings of shame
Concern that exposure will lead to loss of independence
Sometimes accompanied by threats from perpetrator UNDERSTANDING THE DYNAMICS
14. 65+
15. Some of these myths affect all forms of elder abuse
Some affect only financial elder abuse Destroying the myths….My top ten….
16. Elderly people make terrible witnesses Myth #1
17. Forgetful
Senile
Longwinded
Grumpy
Disabled
Fragile AVOID STEREOTYPING OF SENIORS
18. If elderly victim refuses to provide information, there is nothing that can be done Myth # 2
19. We can still build a case by talking to other key witnesses
Start on the outside and work your way to the middle
Let the DA figure out a way to break through victim’s wall of silence
20. Self -determination is not the answer LESSONS LEARNED FROM DOMESTIC VIOLENCE
21. If not punished, the perp WILL abuse again
We CAN convict even without the assistance of the victim
Abuse is a crime against NOT JUST the abused Why self-determination is a problem
22. If elderly victim gives the money voluntarily, it is not a crime Myth # 3
23. There are times when the apparent voluntariness has been diluted by fraud, undue influence or by exploiting the mental limitations of the victim
24. If the financial institution reimburses the elderly victim and then declines to seek prosecution, we have no victim Myth # 4
25. Once a victim, always a victim!
Restitution can NEVER remove the stigma
26. If victim is deceased before we discover the theft, we cannot prosecute Myth #5
27. Wrong!
Treat such a case as if it were a murder
There are some situations in which we do not need the victim for a prosecution
28. Any case where the elderly victim is involved in a home repair & there is a dispute over money – this is ALWAYS a civil matter. Myth # 6
29. Is the “contractor” licensed?
Are there other victims out there?
Did he get the money up front?
What services did he promise?
What did he deliver?
30. Suspects of elder abuse crimes NEVER call 911 Myth # 7
31. Wrong!
Dispatchers need training
As do paramedics
32. There is no point in reporting this incident to local law enforcement; they won’t do anything about it. Myth # 8
33. The impact of a letter!
Persevere
34. Elderly people die from natural causes Myth # 9
35. The importance of an elder death review team
36. 20,000 deaths a year
52% are reportable
Criteria is …not seen by MD in last 20 days/not a “natural” death
Out of 11,000 possible cases 7,000 are waived automatically.
Out of 4,000 cases that come in, only 2,700 autopsies Deaths in San Diego County
37. Dr. Harold Shipman
Charles Cullen Lessons to learn from….
38. Cullen admitted to having killed 5 more patients by injecting them with lethal doses of drugs
Cullen had already admitted to killing 24 patients June 27th, 2005
39. Classic elder abuse murder case
40. There are more important cases out there that are taking up my time Myth # 10
41. APS/Ombudsman program
Law enforcement
Prosecutors
Coroner
Public Health
Seniors
Public Guardian/Probate Court
Elder law attorneys Building blocks to form collaborative approach
42. Every County must have a reporting line
Billboards
Posters
Radio and TV PSA’s
# of calls WILL increase APS/ OmbudsmanCreating/promoting referral line:
43. Recognize red flags of elder abuse
Respond to referral of an elder abuse case
Take initial report and make sure case is assigned to a detective for follow up Law enforcement
44. It cannot be a crime - she gave him the money
It can’t be filed - he does not want us to prosecute
The prosecutor won’t file the case - the victim will make a terrible witness
It is a civil matter - it involves a Power of Attorney Common reactions among law enforcement
45. It’s not just a civil matter
46. People vs. Renee Nieblas
47. These cases are worthy
These cases are provable
We should get more creative in our charging
We should not be obsessed with a win-loss record
We need to talk to APS Prosecutors
48. Train ME Investigators who take calls from police after a death
Establish a protocol for reviewing suspicious deaths of elders
Can instigate an elder death review team Coroner /Medical examiner
49. Remind them of their mandated reporter obligations
Develop training at every hospital, E.R., clinic
Watch for unexplained injuries or inconsistent explanations Public health
50. Reaching them through day centers, senior fairs and other workshops
Provide a positive message!
Top ten tips for safety …
Door prizes & a free lunch
Use them as volunteers - RSVP, DA’s office
TRIAD Involving seniors
51. Act for client for many years
Replaced without warning by new attorney
Obligation to inquire…..
Consult State Bar over attorney/client privilege communications Elder Law attorneys
52. Through public speaking at Rotary, Kiwanis, Lions etc…
Front counter personnel at police/sheriff’s station
911 dispatcher
Banks & credit unions & Western Union
Pharmacies Building the awareness level
53. Train the clergy
Most are unaware of the problem
Encourage an overhaul in visitation ministry Awareness level cont’d
54. Assaults and batteries Physical and Mental Abuse:
55. Delay in reporting
Victim often cannot provide history
Physical findings may be “clouded”
Resident on resident – dementia?
Employee on resident – eye witness?
Victim allegations –how to handle? Problems associated with sexual abuse of elderly /dependent adult
56. Neglect Physical abuse cont’d
57. Deprivation of medical attention
Deprivation of food
Lack of hygiene
Lack of ventilation, heat or light
Over-medicated
Under-medicated Classic neglect cases
58. Malnourished
Semi-comatose
Dehydrated
Coated with fecal matter/ urine stained
Inadequately clothed
Untrimmed toenails, matted hair
Bed sores The classic neglected victim
59. Look for signs of financial exploitation
Documents giving control to suspect
POA
Quitclaim deed
New will
Correspondence, bank statements
Check book, ATM, pawn slips Cross reference with financial abuse
60. Contact Dr. Laura Mosqueda of UC Irvine, Californiamosqueda@uci.edu
61. Manslaughter - neglect causes death
Murder
Intimidation/Mental & Psychological Abuse
False Imprisonment
Torture
Robbery and extortion Physical and mental abuse cont’d
62. Son in his late 30’s to late 40’s
Living at home with Mom
Divorced/ returns or single and unmotivated or just out of jail
Lazy and unemployed
Drugs, alcohol or gambling
Feeds habit off Mom
Sometimes history of mental illness Profile of the physical abuser:
63. Theft
Credit card fraud
Real Property transfers
Home Improvement scams/burglaries
Work by unlicensed contractors/overcharging
Telemarketing,sweepstakes & e-mail scams
Investment fraud Financial Abuse:
64. Canadian & other foreign lotteries
Phishing & identity theft
Investment Frauds
Bogus charities Current top elder financial scams
65. The grandma scam..........
66. Jewelry
Checks
ATM card
Credit card & identity theft
Transfer of title - POA & quitclaim deed
Bogus investment scams Typical theft scenarios
67. Taking property
belonging to another
without consent &
with intent to permanently deprive HOW TO PROVE STEALING?
68. To consent to a transaction a person must:
Act freely & voluntarily & not under the influence of threats, force or duress
Have knowledge of the true nature of the act or transaction involved
Possess the mental capacity to make an intelligent choice whether or not to do something proposed by another person Lack of consent: CALJIC 1:23
69. Consent requires a free will and positive cooperation in act or attitude CALJIC continued
70. Classic case of theft from a competent victim
Theft from an incompetent victim
Theft from a marginally competent victim [by undue influence] Three prosecutable scenarios
71. Victim testifies
Did not give permission
Did not owe monies to suspect
Victim is credible SCENARIO # 1
72. Victim cannot testify
Medical testimony that victim suffers from dementia/ Alzheimer’s/ Parkinson's or some other illness that deprives victim of necessary understanding
Incapacity was present at time of transaction SCENARIO # 2
73. Is it theft, a loan, or a gift?
Victim is marginally competent
Suspect exploited victim’s vulnerability
Victim was unduly influenced or was defrauded SCENARIO # 3
74. Victim ‘was pushed in a direction that he did not want to go.’
The influence by suspect was sufficient to remove the voluntariness of the transaction
No longer free will
Victim has been evaluated by a geriatric psychiatrist/psychologist Undue Influence
75. Length of relationship
Place of first meeting
Prior spending habits
Prior “charitability”
What is left?
Multiple escalating transactions
Statements & conduct by suspect How to prove undue influence?
76. Bank teller
Pastor
Neighbor
Doctor, pharmacist, optometrist of V
Family
Ex- spouse of suspect
Business contacts of suspect Witnesses
77. Bank, credit card statements
Bank surveillance tapes
Prior medical records
Look for the inappropriate purchases
Ask questions, questions, questions!!! Evidence collection
78. Victim was classic example of theft by undue influence
Victim testified
Short term memory problems
Areas of extreme vulnerability People v. Harris
79. Do you have victim’s testimony from a preliminary hearing?
If scenario #2, the death should not affect the proceedings
Avoid Grand Jury proceedings wherever possible What happens if victim dies after investigation begins and before prosecution finishes?
80. Obtaining a consent release form
If V has mental capacity problems, then do NOT get a release
Obtain through search warrant or if after case has been issued, through subpoena Be careful about …...
81. Venue is important
Build a rapport
Look for achievements
Try to identify areas of vulnerability
Preserve the interview on video Interviewing an elderly victim
82. We must bring elderly victims into court AT EARLIEST OPPORTUNITY to allow confrontation to take place
Investigations are time sensitive
Prosecutors should minimize delays in filing Crawford v. Washington
83. Try to avoid any defense request for a continuance
Once the victim has testified in a preliminary hearing, the testimony is preserved Crawford v. Washington cont’d
84. Getting them to court
Bringing the court to them
Waiting at court
Testifying in court
After court - to prevent further victimization Seniors and the court process:
85. Financial
Emotional
Residual Assess the impact of the crime
86. Bringing services to the victim
The one stop shop concept The next step…
87. We respect and honor you!
We commit to seeking justice for you
We prosecute with:
Passion
Purpose
Perseverance A Message to Seniors:
88. Paul Greenwood
619-531-3464
paul.greenwood@sdcda.org Please feel free to contact me: