Financial Abuse: Underreported but not Uncommon Among Older Women

By Nadia Ibrahim and Bethany Applebaum

Susan sought primary and behavioral health services at the local Health Resources and Services Administration (HRSA)–funded federally qualified health center. During a regularly scheduled visit, her behavioral health provider noticed Susan was particularly concerned and anxious. Her brother Jim had recently moved back to the rural Appalachian community where they grew up. He was living with and caring for their elderly mother, and had convinced her to let him take over her finances.

During a recent visit to her mom’s home, Susan had noticed multiple overdue, unpaid bills in the mail stack. She found it odd, especially because her mom had always been diligent about paying bills on time and living within her means. Susan wondered if Jim, who had a history of drug use, was steal- ing. Jim had previously approached Susan asking for money, but she had refused. When Susan confronted him about her mother’s unpaid bills, he denied any wrongdoing and wouldn’t talk to her. Susan’s mother didn’t believe her son would do such a thing.

The behavioral health provider explained to Susan that what she was describing sounded like financial exploitation, a form of elder abuse. He said that, as a healthcare professional, he had an obligation to report any situations where he feels that someone who cannot take care of themselves is at risk of being harmed. The provider explained that there are resources available in every state, provided through a variety of systems including the healthcare system, Adult Protective Services (APS), the judicial system and social services. These services help to ensure the safety and well-being of adults who are at risk of being abused or neglected.

Functions of these entities differ, but may include investigating reports of adult abuse; providing functional, physical and psychosocial assessments; or the provision or arrangement of medical, social, economic, legal and emergency support services. The provider reassured Susan that her name would not be included in the report, and—with Susan in the room—he called APS. After the call, Susan was relieved, knowing that she had now done something to help her mother.

Training for Providers in Recognizing Exploitation

Older women frequently are the target of financial exploitation, which often may not be recognized as a form of abuse. However, a 2011 joint report from MetLife Mature Market Institute, The National Committee for the Prevention of Elder Abuse and the Center for Gerontology at Virginia Polytechnic and State University suggests the problem is widespread, estimating an annual loss by victims of financial exploitation to be at least $2.9 billion, a 12 percent increase over the $2.6 billion estimated in 2008. The MetLife Study on Elder Financial Abuse, which compared news articles collected in 2008 and 2010, found women were nearly twice as likely as men to be victims of elder financial abuse.

Healthcare providers play an important role in identifying these elder abuse cases. The American College of Obstetricians and Gynecologists supports screening of patients older than age 60 to help identify victims of abuse and provide them appropriate healthcare and supports. It is crucial for providers to be trained to recognize the signs of abuse, as an office or emergency room visit may be the only time a patient can have a confidential conversation away from their abuser. Also, providers need to be equipped with the knowledge of how to connect victims of elder abuse, exploitation and neglect to local or state resources for help and support.

Through grant programs and technical assistance resources, federal agencies within the U.S. Department of Health and Human Services, such as the HRSA and the Administration for Community Living (ACL), as well as the Department of Justice, are working to educate providers and connect older Americans and their caregivers to the necessary information and services.

Resources for Assistance and Reporting

It is also important for healthcare and other providers to be aware of the resources available to assist older adults in cases of abuse, exploitation or neglect. HRSA funds the Geriatrics Workforce Enhancement Program, which supports healthcare workforce training integrating geriatrics and primary care to maximize patient and family engagement and, ultimately, improve outcomes for older adults. Understanding that health involves the whole person—and that social and emotional factors can influence health (and vice versa)—ACL’s Administration on Aging (AoA) has created the Eldercare Locator (; or 1-800-677-1116), a nationwide service to connect older adults and their caregivers to information on state or local senior services.

The National Center on Elder Abuse (NCEA), funded through AoA, serves as a national resource center dedicated to the prevention of elder mistreatment and offers information on training, best practices, research and resources on elder abuse.

The Department of Justice also provides resources for victims of elder abuse and financial exploitation, the providers who serve them, as well as law enforcement agencies and prosecutors through the Elder Justice Initiative. The Elder Justice website explains how to report abuse and financial exploitation in all 50 states and territories, and offers resources for assisting those who have been abused, exploited or neglected, including databases with sample pleadings and relevant statutes for prosecutors.

Fortunately for Susan, the provider she saw knew about the right resources to help her with her mother’s situation—demonstrating the importance of continuing education about abuse and availability of resources for providers, community stakeholders and individuals.

Nadia Ibrahim, M.A., L.G.S.W., is a public health analyst in the Federal Office of Rural Health Policy, U.S. Department of Health and Human Services, HRSA, in Washington, D.C. Bethany Applebaum, M.P.H., M.A., is a public health analyst in the Office of Women’s Health at HRSA. Disclaimer: The views expressed in this article are those of the authors and do not necessarily represent the official position of the U.S. Department of Health and Human Services or the Health Resources and Services Administration.

Editor’s Note: This article appears in the May/ June 2015 issue of Aging Today, ASA’s bi-monthly newspaper covering issues in aging research, practice and policy. ASA members receive Aging Today as a member benefit; non-members may purchase subscriptions at our online store or Join ASA.