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Experts address elder financial abuse as global problem

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From the Weill Cornell Newsroom:

Clockwise from left: Karl Pillemer, Bridget Penhale, Nelida Redondo, Kendon Conrad, Mark Lachs and Peter Lloyd-Sherlock. Photo: Ira Fox

Clockwise from left: Karl Pillemer, Bridget Penhale, Nelida Redondo, Kendon Conrad, Mark Lachs and Peter Lloyd-Sherlock.
Photo: Ira Fox

Financial exploitation of older people by those who should be protecting them results in devastating health, emotional and psychological consequences. A group of international elder abuse experts met in June at Weill Cornell Medicine to map out a strategy for conducting research on this problem in low and middle income countries.

The meeting, organized by Dr. Mark Lachs, co-chief of the Division of Geriatrics and Palliative Medicine and the Irene F. and I. Roy Psaty Distinguished Professor of Clinical Medicine at Weill Cornell Medicine, and Dr. Karl Pillemer, director of the Bronfenbrenner Center for Translational Research and the Hazel E. Reed Professor in the Department of Human Development at Cornell University, brought together experts from the United States, Canada, the United Kingdom, South Africa, and Argentina.

"Over the last few years, studies have found financial abuse and exploitation of older people to be extremely prevalent and extremely harmful for older people," said Dr. Pillemer, who is also a professor of gerontology in medicine at Weill Cornell Medicine. "These studies have mostly been done in the United States, England, and other high income countries, but very little is known about how this problem plays out in low-income countries. Our goal was to bring together research internationally and comparatively to try to understand this problem."

"This issue is an interesting integration of sociology, medicine, economics and geopolitics," said Dr. Lachs, who is director of Weill Cornell Medicine's Center for Aging Research and Clinical Care and director of geriatrics for the New York-Presbyterian Health System. "There has been growing interest here in the United States on financial vulnerability of older people, but I'm unaware of an international group that is focused on this."

One consequence of older people who are being financially exploited is that they cannot meet their own health needs. There are also psychological and emotional consequences because some older people live in fear of relatives who may be exploiting them and may give away much needed pensions to spouses, adult children, and other extended family members.

According to Dr. Pillemer, based on available evidence, 5 to 10 percent of older people globally may experience some kind of financial exploitation. Exploitation can take different forms. In high-income countries, like the United States, the abuse may encompass theft, misuse of power of attorney or denying access to funds. In low-income regions, financial exploitation results from abuse of local laws and cultural norms. For example, in some South American countries, the law requires that children receive the parents’ dwelling, resulting in children moving parents into nursing homes in order to obtain the house. In parts of sub-Saharan Africa, women may be accused of witchcraft in order to seize their property or gain access to their funds.

Government pensions in low-income countries have become a source of income for older people, which puts them at risk for financial exploitation. However, researchers need to be sensitive to local cultural norms in their conduct of research and analysis of data so governments are not hesitant to provide much needed income to older people, according to Dr. Lachs.

"In some of the countries there's a cultural expectation that if the older person has a pension it will be shared with other family members," Dr. Lachs said. "Whereas in my practice, if a patient tells me that a child is asking for some of their pension, it raises the specter of the potential for financial exploitation."

The group, Dr. Pillemer said, concluded that there's a desperate need for new scientific knowledge about the extent, causes and consequences of this problem, as well as a need to understand how the problem of financial exploitation is the same across countries, and how it differs. The group is now working on a white paper to make the case for comparative research on financial exploitation of older people.

"That's important for a very critical reason: By looking at the dynamics of financial abuse in different countries, we can understand how policies affect both how much abuse occurs and how to deal with it," Dr. Pillemer said.

Top (from left): Chelsie Burchett, Bridget Penhale, Karl Pillemer, Janey Peterson, Kendon Conrad, Mark Lachs, Natal Ayiga, Steve Gresham. Bottom (from left): Peter Lloyd-Sherlock, David Burnes, Nelida Redondo. Photo: Ira Fox

Top (from left): Chelsie Burchett, Bridget Penhale, Karl Pillemer, Janey Peterson, Kendon Conrad, Mark Lachs, Natal Ayiga, Steve Gresham. Bottom (from left): Peter Lloyd-Sherlock, David Burnes, Nelida Redondo.
Photo: Ira Fox

In addition to Dr. Pillemer and Dr. Lachs, attendees of the meeting were:

  • Bridget Penhale, Reader in Mental Health, University of East Anglia, UK;
  • Peter Lloyd-Sherlock, Professor of Social Policy and International Development, University of East Anglia, UK;
  • Steve Gresham, Executive Vice President, Private Client Group, Fidelity Investments, and Adjunct Lecturer in
  • International and Public Affairs, Watson Institute, Brown University;
  • David Burnes, Assistant Professor, Factor-Inwentash Faculty of Social Work, University of Toronto;
  • Nelida Redondo, Senior Researcher, Universidad Isalud, Argentina;
  • Natal Ayiga, North-West University, South Africa;
  • Janey Peterson, Associate Professor of Clinical Epidemiology in Medicine, Integrative Medicine and Cardiothoracic Surgery, Weill Cornell Medicine; and
  • Ken Conrad, Professor Emeritus, University of Illinois at Chicago.

The meeting was supported by the Elbrun & Peter Kimmelman Family Foundation, Inc.

Experts Address Elder Financial Abuse as Global Problem - Weill Cornell Newsroom

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Coordinated team action best addresses elder abuse

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news-pillemer2-inpostThe Cornell Chronicle reports on a recent publication, co-authored by BCTR director Karl Pillemer, outlining the likely traits of victims and perpetrators of elder abuse and the best approach to addressing the problem. The findings from the review of current research suggests that a team approach is most effective:

As many as one out of 10 people age 60 and older will experience some kind of abuse, most often in the form of financial exploitation, says a new Cornell study. Prevalence rates were previously thought to be 4 percent to 6 percent.

“It’s not that the rate of elder abuse has gone up. It’s that with improved research, we now know definitively that this is a very serious public health problem,” said Karl Pillemer, the Hazel E. Reed Professor in the Department of Human Development and a professor of gerontology in medicine at Weill Cornell Medicine.

“Elder Abuse,” appearing Nov. 11 in The New England Journal of Medicine, pulls together research from 46 studies from around the world. Pillemer is co-author with Mark Lachs, professor of medicine and co-chief of the Division of Geriatric and Palliative Medicine at Weill Cornell Medicine.

A profile of those likely to be abused also has emerged, the authors say. At greatest risk are women and elders with physical or cognitive impairments, low incomes or dementia. Those who live with others, such as a spouse or adult children, are also at higher risk; people who live alone are much less likely to be abused because there is simply less opportunity for abuse. On the other side of the coin, perpetrators tend to have mental illness and abuse substances.

“So you can get a picture of an older woman, who is beginning to experience an impairment, lives with a relative (who is likely to be the abuser) and otherwise is socially isolated, and may have some form of dementia. The perpetrator has their own problems. That is what elder abuse looks like,” Pillemer said.

The abuse can take many forms: physical, sexual, psychological or verbal mistreatment, as well as financial exploitation and neglect. The study found that in nursing homes, there are high rates of violence and aggression toward older adults. In particular, residents abusing other residents is more common than staff mistreating residents.

The findings also suggest that doctors play a crucial role in recognizing abuse and intervening, said Lachs. “A physician may be the only person who ever gets the chance to detect elder abuse, because these people can become so socially isolated with just the abuser that often no one else sees them,” he said. And given the prevalence of the problem, a doctor who is seeing 20 patients per day could see several potential victims of elder abuse per week, he added.

Simply removing the victim from their situation rarely works. Some older people, if they have no other choice, would prefer to rely on an abusive caregiver who is also providing care than have to move out of their home or into a nursing home, Pillemer said. “These cases are often unbelievably difficult to resolve. It’s hard for an agency to resist the temptation to move the person into the nursing home. Usually that’s not what the older person wants, and often it’s not the most appropriate place for them.”

Instead, doctors can be most helpful by spearheading a multidisciplinary team of nurses, social workers, hospitals, police, district attorneys and lawyers to help victims get the services they need. One of the paper’s strongest recommendations is for each city to create this type of team. “It’s a simple intervention, but it turns out to really work wonders,” Pillemer said. “The expression ‘It takes a village’ is true for the prevention of elder abuse.”

 

Experts recommend team approach to thwart elder abuse - Cornell Chronicle
Nursing home residents abusing one another and scammers ripping off the elderly, new study finds - Daily News

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(0) Comments.  |   Tags: aging    elder abuse    Karl Pillemer    media mention   
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