Home care fraud: a preventable crisis

By Thomas M. Cassidy

The transition currently under way throughout the United States and Ireland from a predominantly young to an older population requires that we make adjustments that allow the elderly to receive health care at home so that they can age in place, rather than be forced to move into a hospital or nursing home. Although the majority of older people spend their later years in relatively good health, not every older person enjoys an independent and healthy longer life. Regrettably, some seniors develop chronic conditions for which they require the assistance of caregivers. Sometimes this is a short-term need, often it is for the rest of their life. In the United States, older Americans are the fastest growing segment of the population. In Ireland, the over-65 segment is expected to experience the second highest increase in the European Union, rising to 26 percent of the population by the year 2011. Although the Irish have a tradition of family-centered support for their parents and older relatives, in the future this may not be possible, due to a combination of factors, such as an increasing number of older citizens, longer life expectancies, and a dramatic increase in the number of dual income families.

People of all ages, especially elders, face the possibility that at some time in the future they might be in need of assistance in order to remain at home. Although most patients will be fortunate enough to find quality home care, it is important to remember that many tragic mistakes are made by patients and families who make assumptions that their elderly relatives and friends are being cared for by compassionate and honest caregivers, especially if a person suffers from memory loss and is isolated from their family.

Many older people have pensions, their life savings and significant wealth. They are attractive customers for legitimate businesses who see gold in every strand of gray hair. Unfortunately, elders have also caught the attention of a new category of thieves who are focused on stealing from their dependent victims. Many times the money that is stolen from elderly victims is part of an inheritance that either they received from, or intend to leave to, relatives and friends.

A fraud prosecution of a home care worker on Long Island serves as an example of the peril faced by elders everywhere. This fraud was uncovered by the relatives of the patient after the first day that the health aide was hired to provide care. The relatives of the elderly patient found that $1,073 in cash and three rings valued at $2,450 had been stolen. This same home health aide was charged with similar thefts in neighboring counties.

The defrauding and abuse of the elderly is not always reported by its victims, so it is utmost importance that family and friends reach out to elders. Rosalie Wolfe, president of The National Committee for the Prevention of Elder Abuse, provides an explanation as to why some older patients are reluctant to report home care fraud. "They are ashamed that they have allowed themselves to be victimized and so conceal the incidents to avoid being judged incompetent," Wolfe said. "Above all, they fear that they will no longer be able to remain at home." Elder thieves can be stopped by alert consumers who develop a long-term plan which includes some commonsense steps.

All people, especially elders, can extend their good health by creating a safe environment at home. A fall can cause a fracture or other injury, making the patient more dependent and vulnerable. There are many practical ways to increase the safety of a home. Remove hazards such as small step-stools, loose rugs, electrical cords, and other potential dangers. Provide night lights near steps and in bathrooms. Phones should be accessible throughout the home so that emergency calls can easily be made. Bathrooms should be modified to accommodate safety features, such as hand-rails, grab-bars, non-slip floors, or mats in tubs or shower stalls.

After the house is safe, then remove temptation before a home care worker begins employment. All cash, jewelry, financial records, check books, and credit cards should be safeguarded in a protected location such as a safe or safe deposit box. Pension and investment checks should be direct-deposited to prevent theft and forgery. Monitor your mail to make certain that you receive your routine monthly financial statements listing recent transactions. Don’t just throw them in a drawer unread; check for unusual or unauthorized activity. Although there is convenience in electronic banking and credit cards, there is also a fraud danger. For example, in another recent case of elder crime, a man working as a home health care aide for a 68-year-old male client, was accused of using his patient’s credit cards and bank checks to steal $30,000 worth of merchandise and cash. Police said the thefts took place over an eight-month period while the aide worked for the disabled man.

Today, many families have relatives living throughout the country and the world. There comes a time when some elders need the assistance of others to maintain their qualify of life. Unfortunately for some, home care, where workers have frequent unsupervised access to vulnerable patients and their property, offers exceptional opportunities and temptations for fraud. But by planning in advance and taking steps for safe and effective home care, patients and their families can protect themselves from elder fraud and abuse.

(Thomas M. Cassidy is a senior fellow at the Institute for SocioEconomic Studies, a White Plains, N.Y.-based think tank, the author of "Elder Care/What To Look For/What To Look Out For!" New Horizon Press, 1997) and the 1998 Institute monograph, "Long-Term Care Problems and Solutions: A Prescription for Change.")