How Seniors Are Financially Exploited By Care Givers In Five Easy Steps

                       How Seniors Are Financially Exploited

By Care Givers In Five Easy Steps

By Sonja Kobrin, M.P.S. Geriatric Care Manager

www.vipcaremanagement.com

Toll Free 877-588-5158

It is a sad fact that most people who financially exploit the elderly get away with it. They often find it so easy that they do it time and time again. Each time the “Exploiter” becomes more and more bold. They act as though they are entitled to this money and no one else deserves it. Exploiters will do what they do best until they are stopped. This is why they must be prosecuted once they are caught.

Prosecuting these crimes is difficult for the State Attorney because of how it is done. In my career as a professional Geriatric Care Manager in South Florida I have noticed a definite step-by-step process, almost a formula, that Exploiters use to separate elders from their life savings. In many cases the Exploiter actually gets permission from the senior to take their money. Because of this, it can be argued that the senior "allowed" their assets to be taken and therefore, no crime took place. Furthermore, to argue that a senior citizen was easily influenced by the Exploiter is to imply that the senior is incompetent and perhaps should not be in control of any of their finances. Few seniors want to admit that. Instead they justify the theft or even cover it up. Once the senior realizes that they have been victimized, they may feel responsible, guilty or embarrassed. Few will testify against the one who stole from them. Some seniors are afraid of retribution from the Exploiter.

When we think of someone who steals from the elderly, we conjure an image of the stranger lurking around the ATM machine or scam artist selling bogus products. Since Investment Broker, Bernard Madoff "made off' with his client's millions, we have all become familiar with the term "ponzi scheme". But this type of financial exploitation is rare compared to the financial exploitation elder care professionals see every day which is perpetrated by an elderly person's friends, family and caregivers. In cases I have worked, I have seen that THIS type of exploitation achieved slowly, purposefully and in FIVE PREDICTABLE STEPS. The Exploitation is executed so artfully, that the elder and others around them see it happening but cannot believe it is true. They ignore all the small tell tale signs. When the situation finally explodes, the FIVE STEPS are then become obvious. By then it may be too late to do anything about it.

Here are the STEPS. Learn to recognize them and you may prevent this horrible crime from happening to yourself or someone you care about.

STEP ONE: The Exploiter comes to the rescue - they become a caregiver or helpmate when the person suffers a crisis. They may do extra favors for the elder without pay and refuse to take payment even when offered...at first. The Exploiter will later remind the elder of the favors and cause them to feel indebted to them.

STEP TWO: The Exploiter convinces the elder that they are the only one who cares about their welfare. The elder is brainwashed to believe that the true family only wants their money.

STEP THREE: The Exploiter separates the elder emotionally and physically from their family. They bring in their own family to be the "replacement family". Next they tell the elder they are like family to them. The Exploiter may even start to call the elder " Mom" or "Dad". They may deny the true family access to calling or visiting the elder and cause others in the community to regard the true family as exploiters. The elder may never know about all the family's attempts to reach them.

STEP FOUR: The Exploiter gets permission to use the elder's credit card, ATM card or other money for a small purchase. Then they continue to use the elder's assets and transfer assets little by little to their own account or distribute assets among the Exploiter's family members. The Exploiter may shop for the elder but purchase items for themselves as well. They may take the elder out to dinner but also invite their whole family and have the elder pay for it. When the Exploiter's car needs repair or gas, the elder is asked to pay for since that car is used to shop or transport the elder. The elder will feel they have no choice but to agree.

STEP FIVE: Finally, the Exploiter will attempt to take legal control over the person. They may become Power of Attorney, change the Will to disinherit the family and bequeath assets to them self and or their family. A few years ago, I had a case where an attorney changed the Will of a confused dying woman to give her home and assets to an aide whom she had only known for two years. This was especially heinous because that lawyer had previously written the Will for the family and knew that the heirs existed. This family fought the caregiver in court and had to settle for about one tenth of their original estate. I testified against the attorney and he has tried to retaliate against me several times since. In another case, a caregiver in her forties married a ninety- four year old man. She was previously his maid for about two years. She had a notary perform the ceremony in their living room while her children served as witnesses. This act automatically disinherited the elderly man's entire family. The marriage was challenged and annulled. The elderly man was deemed incompetent by a court of law and assigned a guardian of his assets.

The secret weapon these perpetrators use is LOVE, ATTENTION, FAMILY- LIKE CONNECTION, LOYALTY and even SEX...all the things human beings need but may not get once they are aged. In South Florida, many seniors retire to this area only to find themselves thousands of miles from their original family when they need them the most. This isolation creates a dangerous opportunity for Exploiters.

If someone you love has a person in their life, be it friend, family, caregiver, or even a trusted professional and you feel they are taking over that person's finances, lifestyle and even thought processes, get professional help! Contact a professional such as a Geriatric Care Manager or an Elder Law attorney and make sure someone contacts Adult Protective Services. The reality is that the police and State Attorney's office will need you to practically build the case for them in order for them to prosecute. The evidence may need to be gathered secretly in order not to cause the Exploiter to quickly move to STEP FIVE. Most importantly, take action immediately. Know that the elder will feel you are meddling and taking over. They will not thank you for this because they have already been convinced that the Exploiter has somehow earned their loyalty and their money. Act anyway because it is the right thing to do. If you need assistance for an elder in South Florida call me toll free at V.I.P. Care Management, Inc.

1-877-588-5158 www.vipcaremanagement.com

Geriatric Care Managers: The Eyes and Ears For Caring Children Who Live Afar

Sonja W. Kobrin, M.P.S.  Geriatric Care Manager

V.I.P. Care Management, Inc.

www.vipcaremanagement.com

Lantana, Florida 561-588-5151

If your elderly parents live far away, who will be your eyes and ears? Who will educate you about the confusing elder care system? Younger folks have never had to learn about Medicaid, Medicare, Veteran Benefits and Long Term Care Insurance. Most are unaware of the hidden politics of doctors, hospitals, nursing homes, insurance providers and home health care companies which bias them when they offer you options and solutions for your elderly parents.

Every professional seems to have an opinion about what is best, but sometimes these opinions conflict. The doctor wants to send the patient home. The hospital social worker is arranging for nursing home or assisted living facilities to do an assessment for facility placement or rehabilitation. Your parents may be rejecting the idea of hiring a home health aide. Who will be your parents’ unbiased advocate? Even if concerned children rush to their parents’ hospital bedside, how will you know all of the options and most importantly, what these options will cost?  Geriatric Care Managers are professional elder care consultants hired by families to represent their interests and only their interests. A legitimate Geriatric Care Manager takes no referral fees from any company or facility to whom they make a referral. Care Managers are paid by the patient or family to guide the family through the elder care system and to make sure the patient’s needs are met. It is best to hire a care manager who does not own a Home Health Company or Assisted Living so you can easily make changes if you are unhappy with those services.

It is common today for people in the northern states to retire in resort areas like Florida and Arizona, leaving their adult children behind. The problem comes ten to twenty years later. The now aged parents have needs, but their children are living far away. The first time the kids hop a plane to respond to a family emergency, it is no problem. When the problems escalate and that child is now taking significant time away from work and family to assist their parents, the situation becomes critical. As a Care Manager I have met many couples whose marriages and bank accounts are strained by caregiver duties.

Most caregivers are unaware of financial programs which may help offset expensive health care costs. When costly services are needed, families need to know what to expect. Seniors who lived through the Great Depression sometimes distrust their children when it comes to financial and medical decision making. They may feel money is a private matter or have negative opinions about the way their children have spent money in the past. Either way, the concerned children may be dismayed to find that their parents will listen to the advice of a stranger rather than the advice of their own family. Care Managers can be that “concerned outsider” whose expert advice will be heeded. Once the situation is professionally assessed and the solutions put in place, the adult children living afar can work together with the local Care Manager as a partner in their parent’s care.

Does My Mother Have Dementia or Alzheimer’s Disease? - The 7 Stages of Dementia

Does My Mother Have Dementia or Alzheimer’s Disease?

The 7 Stages of Dementia

By: Sonja Kobrin, M.P.S.

Geriatric Care Manager, V.I.P. Care Management

www.vipcaremanagement.com

What is the difference between Dementia and Alzheimer ’s Disease? Dementia is a general term and there are many types of dementias. Alzheimer’s Disease is just one disease that can cause a person to lose memory and thought processes. This loss is called cognitive decline or deterioration. The following is a lay person’s description of the stages of cognitive loss based up the Global Deterioration Scale published by Reisberg, Leon and Crook in the American Journal of Psychiatry in 1982. Regardless of the disease causing a person’s decline in cognitive ability, the stages of cognitive loss are the same:

(NO COGNITIVE DECLINE)

Stage 1 - No Cognitive Decline or memory problems noted.

(FORGETFUL)

Stage 2 – Mild Forgetfulness - Person is aware that they are forgetful and may misplace objects. They may forget names of people they know well but can maintain work and social

relationships. Despite some forgetfulness, cognitive decline will not show up on a test.

(MILD)

Stage 3 – Early Stage Confusion – person may become lost when traveling to a once

familiar location. Co-workers take notice of memory deficits and work performance is affected. They may lose the ability to make quick decisions and have difficulty recalling names of objects. They may forget a word in mid-sentence, have poor reading comprehension, or cannot remember names of new people or places. Treasured objects may have been lost. Memory loss is most evident after a long interview but not apparent at first. The ability to pay bills may be impaired. The person is unable to drive safely as reaction time is slowed. They may begin to write things down to assist with memory.  Clinical testing will reveal a deficit. Person is aware of cognitive decline & feels anxious about it and tries to deny it.

(MODERATE COGNITIVE DECLINE)

Stage 4 – Late Confusion/ Early Dementia – Person may become unaware of current and recent events. There decreased ability to navigate and travel to familiar locations. They may wander and get lost and/or pace the floor. They are unable to learn new tasks or perform complex tasks. The tone of voice may become flat or monotone, they may seem disinterested in the world around them and withdraw from challenging situations. Person uses denial as a defense mechanism. One looses ability to perform serial subtraction exercises and clinical testing reveals marked deficit.

(MODERATELY SEVERE COGNITIVE DECLINE)

Stage 5 – Early Dementia – Person can no longer manage their life without some assistance. Personal information such as address and telephone number cannot be recalled. Person may not remember names of grandchildren, their high school, etc. Person may show disorientation as to date, time or place. They may have difficulty counting back from 40 by fours, even though they once could. Persons at this stage remember major life events. They know their own name and the names of their children. They may need some assistance with choosing clothing but can toilet and eat independently.

(SEVERE COGNITIVE DECLINE)

Stage 6 – Middle Dementia - Person may occasionally forget spouse’s name but generally know people they see every day. They may lose the ability to write. They may hallucinate, see imaginary figures or think their spouse is an imposter. They may not recognize their own reflection in the mirror. Personality and mood may show changes. They may become depressed and/or engage in repetitive behaviors or activities such as cleaning and become obsessed with ideas. They may rummage through belongings. They may eat continuously as they do not ever feel satisfied. Abnormal behaviors are worse in early evening (Sundown Syndrome). Repetitive speech and questions may occur frequently as well as agitation and even violence. They are unaware of recent events although they have some memory of the past. Person may be unable to count to ten backwards or forwards or maintain a thought long enough to act on it. They may need assistance with toileting, bathing, dressing and sleep patterns may be disrupted. The person may confuse day and night.

(VERY SEVERE, ENDSTAGE DEMENTIA)

Stage 7 - Late Dementia - All verbal abilities are lost and may resort to grunting or screaming. Person cannot control bladder or bowel functions and requires total help with toileting and feeding. Person may lose ability to walk and may fall frequently as communication is lost between the brain and the body. The person may experience seizures. They may have difficulty swallowing food and drink and lose appetite to the point of anorexia and serious weight loss.

How Long Should It Take To Get Social Security Disability Benefits?

Social Security has two benefits available to those who are under age 65 and are unable to work due to accident or illness.  SSI is the benefit given to individuals who are not insured in the Social Security system with enough work credits.  SSDI is awarded to those who have worked full time in the past and have accumulated enough work credits.  There are many eligibility criteria beside time worked which can be found on my website www.vipbenefitservicesofamerica.com or the Social Security Association Website : www.ssa.gov.

Those who need to apply for those benefits may do so on their own behalf or have a friend or family member assist them.  They may also chose to use the services of a professional such as a care manager or they may hire an attorney to represent them.

When an individual attempts to apply for Social Security Disability on their own, the application is often denied. Denial may be due to lack of information,  poor wording used on the application and lack of experience and training of the individual completing the form. This can cause delays, hearings, multiple denials and other issues which may cause the applicant to wait a long time, sometimes years for their benefits. Some frustrated applicants give up all together.

When using a paid professional such as a care manager or attorney, the disabled applicant should be aware of several important points which can effect how long the process will take, additional steps such as hearings and lastly, how much the professional will be paid.

The Federal law has unfortunately been structured in such as way that the professional assisting in the Social Security Disability application process may be paid either 25 % of the total retroactive money collected or a maximum of $6,000, which ever is less. The professional can only be paid if the Social Security Disability benefits are approved. No professional can charge for their service in advance of the approval. Obviously this creates a conflict of interest because the longer the case is drawn out, the more retroactive benefits will be due to the applicant and that mean the more money the professional can charge. Cases which are handled most effectively will only take 3 months, making the retroactive benefits just a few hundred dollars. Attorneys are the only professionals allowed to collect from the client even more than 25% of the retroactive benefits as their fee.  If a Social Security Disability hearing is necessary, attorneys are allowed to charge extra for all their time and court costs. There is NO incentive for an attorney to wrap up a case in three months or less or to avoid hearings.

The real travesty with this law is that the applicant is disabled all the while, cannot work and may lose their home, their assets , their car and more while they wait two or three years for a case to finally get approved.

Most Social Security Disability cases should be settled within 3-6 months if the applicant has real documented injuries or illnesses, has sought appropriate medical care and truly cannot work. For a case like this to drag on for years is usually not necessary. Because there are many rules and nuances one must know in order to apply for SSI and SSDI successfully, I do not recommend applying on your own without guidance. If hiring a professional such as a care manager or attorney, ask them for their track record of success and average length of time from application to SSDI or SSI approval. Also ask what percentage of their cases have required a hearing.

It is rare for any case that we process at V.I.P. Care Management or V.I.P. Benefit Services of America to require a hearing in order to be approved. V.I.P. Care Management and V.I.P. Benefit Services of America averages 4 months from application to approval and we a 100% approval rate for our SSI and SSDI applications. Call us at 561-588-5151 to discuss your case. Our 20 minute telephone consultations are FREE at V.I.P. Care Management. To learn more visit our websites at www.vipbenefitservicesofamerica.com and www.vipcaremanagement.com

Concierge Medicine, A Real Value

The old adage is true, "You get what you pay for". Some primary care physicians, motivated by sheer exhaustion have decided to trade quality for quantity. The HMOs have had an effect on all medical practices to the point that many patients have grown used to crowded waiting rooms, lengthy waits in the office and a rushed visit with the doctor.

Concierge Physicians charge an annual fee (around $1,500 per year) to the patient, enabling the doctor to reduce their practice from about 2,000 patients to 500 patients. Now the doctor can be available for their patients who need to be seen right away, can take time to visit patients in the hospital and if needed, be on call 24 hours. Best of all, they can really spend quality time with their patients.

As a care manager, I offer this high level of service and I can do it because I do not have hundreds of clients. I appreciate the opportunity to work with concierge doctors who are available to the patients we have in common, immediately. If I visit a client and find that their new medication is making them sick, I want to have instant access to their doctor. I do not want to hear, " Go to the emergency room", like so many doctors now say to their patients.

In a perfect world, we would all have immediate access to our doctors. But in this world, if you want or need VIP treatment, you can have it, for the cost of one Starbucks coffee a day. If you do not think it is worth it now, wait until Medicare cuts physician billing AGAIN and they have to take on even more patients to make up the difference.

Many people think it should not be necessary to pay for extra service, but we do it all the time. We pay more for the box seats at the concert, we pay more for an upgraded hotel suite. We pay more for first class seats on a plane. If you feel you want upgraded medical care, it is now available and I feel, well worth it, especially if you have chronic medical conditions.

About Health Care Reform

I am normally not the political type, but this Health Care Reform issue has really inspired me to at least launch my perspective into the blogisphere. I cannot believe how many people actually believe that by offering a "Public Option" we will somehow be offering FREE health care coverage to a) illegal aliens b) rich people or c) everyone, including those who can afford to pay for better coverage, thus causing the insurance companies to go out of business. It is unfortunate that fear mongering talk show " entertainers" ( not journalists) are disseminating such misinformation to the public. I want to shed some light on these matters as I see them. I am a professional advocate who is always helping senior clients find a way to cover their health care costs, so this is what I know from actual experience:

1) The only illegal aliens who receive Medicaid are those in the hospital ( coming through the emergency room), those remaining in the hospital due to brain injury or trauma, infants, pregnant mothers and frail elderly who are in nursing homes and have lived in the country documented for over five years. If they are illegal, documentation is often impossible to get, so this happens rarely. Every other illegal person who needs medical attention IS TURNED AWAY.

2) Medicare is a " Public Option" for our aged citizens. They do not have to accept Medicare. They can keep paying for and using another private insurance. Most people choose their public option and then buy a supplemental policy to pay for what the government will not cover, or they pay out of pocket for those "extra" or "luxury" services. Medicare is for every senior regardless of income or assets. Our government, at the risk of seeming like a socialist entity decided to ensure that every elderly person had some basic coverage because they knew most people would not save for their own medical expenses. How much have you saved for your golden years?

3) Social Security is another socialistist government intervention initiated by a wise President who knew that unless the general public were forced to save for retirement, they wouldn't do it or would not put away enough. Have you saved enough for your retirement?

4) A Public Option is an alternative for many hard working Americans who cannot afford health insurance, not even an HMO or who may have a pre-existing condition rendering them ineligible for insurance. Why is it that only the very poor, very young or very old in this country are allowed to partake in a government health care program? And yet it is the poorest and oldest people I know who are ranting against equal health care for all. All Americans deserve the option to have the most basic level of medical care. If we want more than the basics, we can pay for them. That is how Medicare and Medicaid work.

5) Some actually believe that there is not enough money in this country for Medicare, Medicaid and Social Security. To that I say only one word: NASA! We have billions, not millions, billions to invest in blowing up part of the moon to look for water, research on Mars and another planned moon walk. This country has a priority problem, not a money problem. We have a lobbist problem and a lawsuit problem and yes, an insurance problem. Allowing the health insurance lobby to become so powerful, our doctors to feel they are the elite and the lawyers to sue doctors and hospitals ad nausium, is a problem. Please do not worry this country will become socialist or communist. That would mean all citizens are seen as equals and there is no chance of that happening any time soon.

6) You can be a capitalist and still be your brother's keeper. As a for -profit business owner, I charge for the health care consulting I do. That said, I have so many poor, pro bono clients that I formed a non- profit corporation to care for them and raise money for them. If every successfull capitalist started even a modest non- profit company to care for the less fortunate or those who are elderly and have no family support, they would be doing their part. We can all do our part and together help our communities. Visit www.EQOLPalmBeach.com and www.vipcaremanagement.com to learn more about what I am doing. Let's loose the lables: republican, democrat, socialist, capitalist and just be citizens and take responsibility for ourselves and a few others.

When Elders Are Financially Exploited By Friends, Family and Caregivers

It is a sad fact that most people who financially exploit the elderly get away with it. They often find it so easy that they do it time and time again. Each time the Exploiter becomes more and more bold. They act as though they are entitled to this money and no one else deserves it. This is why they must be prosecuted. There will be another victim.

Prosecuting these crimes is difficult for the State Attorney because of how it is done. In my career as a Professional Geriatric Care Manager in South Florida I have noticed a definite step-by-step process, almost a formula, that these Exploiters use to separate elders from their life savings. In many cases the Exploiter actually gets permission from the elder to take their money. Because of this, it can be argued that the elder "allowed" their assets to be taken and therefore, no crime took place. Furthermore, to argue that an elder was easily influenced by the Exploiter is to imply that the elder is incompetent and perhaps should not be in control of any of their finances. Few elders want to admit that. Instead they justify the theft or even cover it up. Once the elder realizes that they have been victimized, they may feel responsible, guilty or embarrassed. Few will testify against the one who stole from them.

When we think of someone who steals from the elderly, we conjure an image of the stranger lurking around the ATM machine or scam artist selling bogus products. Since Investment Broker, Bernard Madoff "made off' with his client's millions, we have all become familiar with the term "ponzi scheme". But this type of financial exploitation is rare compared to the financial exploitation elder care professionals see every day which is perpetrated by an elderly person's friends, family and caregivers. In cases I have worked I have seen that THIS type of exploitation achieved slowly, purposely and in FIVE PREDICTABLE STEPS. It is often done so artfully, that the elder and others around them see it happening but cannot believe it is true. They ignore all the small telltales signs. When the situation finally explodes, the FIVE STEPS are then seen as clear as day. By then it may be too late to do anything about it.

Here are the STEPs. Learn to recognize them and you may prevent this horrible crime from happening to yourself or someone you care about.

STEP ONE: The Exploiter comes to the rescue - they become a caregiver or helpmate when the person suffers a crisis. They may do extra favors for the elder without pay and refuse to take payment even when offered...at first. The Exploiter will later remind the elder of the favors and cause them to feel indebted to them.

STEP TWO: The Exploiter convinces the elder that they are the only one who cares about their welfare. The elder is brainwashed to believe that the true family only wants their money.

STEP THREE: The Exploiter separates the elder emotionally and physically from their family. They bring in their own family to be the "replacement family". Next they tell the elder they are like family to them. The Exploiter may even start to call the elder " Mom" or "Dad". They may deny the true family access to calling or visiting the elder and cause others in the community to regard the true family as exploiters. The elder may never know about all the family's attempts to reach them.

STEP FOUR: The Exploiter gets permission to use the elder's credit card, ATM card or other money for a small purchase. Then they continue to use the elder's assets and transfer assets little by little to their own account or distribute assets among the Exploiter's family members. The Exploiter may shop for the elder but purchase items for themselves as well. They may take the elder out to dinner but also invite their whole family and have the elder pay for it. When the Exploiter's car needs repair or gas, the elder is asked to pay for since that car is used to shop or transport the elder. The elder will feel they have no choice but to agree.

STEP FIVE: Finally, the Exploiter will attempt to take legal control over the person. They may become Power of Attorney, change the Will to disinherit the family and bequeath assets to themself and or their family. A few years ago, I had a case where an attorney changed the Will of a confused dying woman to give her home and assets to an aide whom she had only known for two years. This was especially heinous because that lawyer had previously written the Will for the family and knew that the heirs existed. This family fought the caregiver in court and had to settle for about one tenth of their original estate. I testified against the the attorney and he has tried to retaliate against me several times since. A few weeks ago I testified in a case where a caregiver in her forties married a ninety- four year old man. She was previously his maid for about two years. She had a notary perform the ceremony in their living room while her children served as witnesses. This act automatically disinherited the elderly man's entire family. The marriage was challenged and annulled. The elderly man was deemed incompetent by a court of law and assigned a guardian of his assets.

The secret weapon these perpetrators use is LOVE, ATTENTION, FAMILY- LIKE CONNECTION and even SEX...all the things human beings need but may not get once they are aged. In South Florida, many seniors retire to this area only to find themselves thousands of miles from their original family when they need them the most. This isolation creates a dangerous opportunity for exploiters.

If someone you love has a person in their life, be it friend, family, caregiver, or even a trusted professional and you feel they are taking over that person's finances, lifestyle and even thought processes, get professional help! Contact a professional such as a Geriatric Care Manager or an Elder Law attorney and make sure someone contacts Adult Protective Services. The reality is that the police and State Attorney's office will need you to practically build the case for them in order for them to prosecute. The evidence may need to be gathered secretly in order not to cause the Exploiter to quickly move to STEP FIVE. Most importantly, take action immediately. Know that the elder will feel you are meddling and taking over. They will not thank you for this because they have already been convinced that the Exploiter has somehow earned their loyalty and their money. Act anyway because it is the right thing to do. If you need assistance for an elder in South Florida call me toll free at V.I.P. Care Management, Inc. 1-877-588-5158. http://www.vipcaremanagement.com/