Elder Financial Abuse and Medicaid Denials: Advocates can help older adults regain health and economic security

Elder abuse is broader than violence or neglect.  Victims of elder abuse also suffer from financial exploitation, like a former legal services client, Mrs. Anderson (name changed to protect her identity). Mrs. Anderson is an elderly nursing home resident with dementia in Maryland.  While Mrs. Anderson received nursing home care, her son misused her power of attorney to sell her house without her consent or knowledge. After the reverse mortgage company collected its payment, her the son pocketed the remaining $77,000 and used it to buy drugs. Because of this alleged “gift” to her son, Mrs. Anderson lost her Medicaid eligibility. Without help from civil legal aid, Mrs. Anderson would have been discharged from the nursing home with nowhere else to go.

As defined by the Older Americans Act (OAA)[1], the term ‘exploitation’ means “the fraudulent or otherwise illegal, unauthorized, or improper act … that uses the resources of an older individual for monetary or personal benefit …or that results in depriving an older individual of rightful access to, or use of, benefits, resources, belongings, or assets.”

Some examples of elder financial abuse include: misuse of an older adult’s personal checks, credit cards, or bank accounts; stealing cash, income checks, or household goods; forging an older adult’s signature; identity theft using an older adult’s information; misuse or abuse of a financial power of attorney; and scams that target older adults– such as lottery scams, home repair scams, sweetheart scams, and grandparent scams.

Not only does elder financial abuse take a tremendous toll on individual victims, but it threatens society at large. In 2010, the annual financial loss from elder financial abuse was $2.9 billion. Elder abuse is notoriously difficult to measure, as many victims do not come forward to report it. However, a recent New York study found that 1 in 20 older adults reported experiencing financial exploitation after age 60. More than half the time, a family member was the perpetrator.

Like Mrs. Anderson’s case, older adults with diminished capacity are at greater risk for financial exploitation. Dementia is one of the primary risk factors in elder abuse – studies have shown nearly 50% of persons with dementia experience some form of abuse, whether it is physical, emotional or financial. Older adults with diminished capacity need educated family members and well-trained caregivers, who know how to work with individuals with dementia and can recognize signs of abuse.

Financial exploitation can devastate low-income older adults, who live in poverty and rely on Medicaid for their health and long-term care. When I represented older adults in Maryland, I frequently saw clients who had been victimized twice– they were financially exploited, and then that financial exploitation prevented them from qualifying for Medicaid. Based on those experiences, I was particularly excited to participate a National Legal Resource Center webinar training with our partners at the National Consumer Law Center and Pro Seniors, Inc.  The webinar focused on elder financial exploitation and its impact on low-income older adults who require safety net programs to meet their basic needs. The full webinar recording and slides available here.

As we explained in the webinar, because of Medicaid’s financial eligibility requirements, elder financial abuse can wreak havoc with a person’s ability to receive needed medical care and personal support services. Financially exploited older adults may be denied eligibility for Medicaid because their abuser won’t turn over their bank records. Or the older adult may be found eligible for Medicaid, but receive a penalty period based on alleged “gifts,” though that money was really stolen. Without Medicaid eligibility, seniors may be threatened with eviction or involuntary discharge from a nursing home because of nonpayment.

Legal services are critical to helping seniors receive the medical care and services to which they are entitled. Legal services advocates can help low-income older adults navigate the Medicaid system, and request a hardship waiver to ensure that financial exploitation does not preclude Medicaid eligibility. Legal assistance may also be needed to ensure that other benefits, such as Social Security or SSI payments, are fully available to meet the senior’s needs. Working in partnership with Adult Protective Services, the Long Term Care Ombudsman, and aging network providers, legal services attorneys can help identify potential problems, remedy current abuse, and prevent future exploitation.

[1] Older Americans Act Definition, Section 102(a)(18)(A), 42 U.S.C. §3002(a)(18)(A)

Photo courtesy of Louis Kravitz.

About Jennifer Goldberg

Jennifer Goldberg is Directing Attorney of the Justice in Aging Health Team, and is based in the D.C. office. She develops and implements projects and initiatives that improve access to health care and long term services and supports for low-income older adults across the country.