Jan L. Warner & Jan Collins
Statistics tell us that the longer an elderly person can remain at home in the community, the better he or she will function. Oftentimes, in order to meet these needs, the family must use a full-time caregiver. Still, whether the caregiver is a family member or an outside person, the introduction of a caregiver can become the source of unanticipated and difficult problems.
It is only natural that, over time, a weakened elderly person will come to rely on and trust the person upon whom he or she depends for care. Over time, a caregiver will be in a position to influence and take advantage of an elderly person whose capacity to think for himself or herself may be diminished. After all, the fear of losing a caretaker and being placed in a facility can become more important to the elderly person than long-standing family relationships. Abuse --- financial, physical, or emotional Ė can sometimes result.
What are some of the telltale signs of financial abuse? The elderly person refusing to talk to family members about his/her finances. The caregiver always being present. Large withdrawals from automated teller machines when the elderly person canít walk alone. Frequent and/or sizable gifts to a caregiver. Missing valuables. Unpaid bills even though funds exist with which to pay them. A power of attorney in favor of the caregiver or a new will or a deed being signed when the elderly person seems to be incapacitated. The name of the caregiver being added to a checking or savings account. The elderly person guaranteeing a loan for the caregiver. Withdrawals from accounts that have been in place for years. Sudden sales of stock and removal of funds from long-standing accounts to new accounts. Promises of care for life by the caregiver in return for transfers of property. Signatures on checks that do not resemble the handwriting of the elderly person. Checks and legal documents signed when the elderly person is not able to write.
What are some of the signs of emotional or physical abuse? Withholding medication from or overmedicating the elderly person. Keeping the elderly person in unclean living quarters. Not maintaining the elderly personís physical appearance. Sexual abuse. Preventing the elderly person from having any or meaningful contact with his or her family, neighbors, or the public. Psychological abuse which includes name-calling or a systematic plan to dehumanize the elderly person and make him or her more dependent upon the caregiver. The caregiver prompting the elderly person to answer questions and putting words in the elderly personís mouth.
For these reasons, it is essential that precautions be taken, and the caregiver be monitored regularly from the outset. But itís more difficult that one might think -- even if family members live nearby and visit the elderly person regularly -- to spot the problems because they are gradual.
Taking the NextStep: Before a caregiver is hired, interested family members should meet and choose one person Ė generally a person who has been appointed as attorney in fact by the elderly personís power of attorney Ė who will be in charge. If the elderly person has mental capacity but does not have a power of attorney, he or she should sign a comprehensive durable power of attorney and health care power of attorney.
In order to attempt to avoid the elderly person being influenced to revoke the power of attorney, the document can include a provision that before revocation, the agent will be given notice and an opportunity to approach the appropriate court for relief if necessary. The elderly person should sign letters to all brokers and bankers authorizing the agent to receive copies of all statements and transactions and directing the banker or broker to notify the agent should any suspicious transaction take place.
The elderly person should also authorize all doctors and medical providers to provide records to the agent and to notify the agent about changes in the elderly personís mental or physical status. If the caregiver takes the elderly person to a physician for appointments, the doctor should get history from the elderly person outside the presence of the caregiver in order to avoid prompting. If possible, it is a good idea for family members to take the elderly person to medical appointments and stay involved in the process.
An independent geriatric care manager or registered nurse should monitor the situation at least twice per month with an eye not only toward the elderly personís care and condition, but also abuse-related issues. The care manager should report to the agent.
When hiring the caregiver, in addition to a thorough background check, all of the caregiverís references should be checked out carefully, An employment contract with the caregiver is essential. And finally, the caregiver should never be given access to the elderly personís bank accounts or credit cards.
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