National Institute of Aging reports each year hundreds of thousands of adults over 60 are abused


Jose: GOOD EVENING, AND WELCOME AT A "HORIZONTE." ELDER ABUSE AND NEGLECT. FIND OUT THE SIGNS AND WARNING OF POTENTIAL PROBLEMS AND ISSUES.

I FEEL VERY HAPPY BECAUSE I AM PART OF THIS COUNTRY.

Jose: PLUS MORE PEOPLE ARE BECOMING U.S. CITIZENS. WE WILL TELL YOU THE REASON FOR INCREASE IN APPLICATIONS. AND IN SOUNDS OF CULTURA "S-O-C" A VALLEY ARTIST DRIVES HIS INSPIRATION FROM LANDMARKS IN THE SOUTHWEST. ALL THIS COMING UP NEXT ON "HORIZONTE."

"HORIZONTE" IS MADE POSSIBLE BY CONTRIBUTIONS FROM THE FRIENDS OF ARIZONA PBS, MEMBERS OF YOUR PBS STATION. THANK YOU.

Jose: THANK YOU FOR JOINING US. ACCORDING TO THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES AND HUMAN SERVICES NATIONAL INSTITUTE OF AGING EACH YEAR HUNDREDS OF THOUSANDS OF ADULTS OVER THE AGE OF 60 ARE ABUSED, NEGLECTED OR FINANCIALLY EXPLOITED. ABUSE CAN HAPPEN IN THE OLDER PERSON'S HOME, ASSISTED LIVING FACILITY, FAMILY MEMBERS HOUSE OR NURSING HOME. JOINING ME TO TALK ABOUT THIS ISSUE IS GABRIEL KORY, PARTNER AT MILLER, CORY, LLP. GABRIEL THANKS FOR JOINING US ON "HORIZONTE." SO, GIVE US A SENSE OF THE SCOPE OF THE PROBLEM. IS IT INCREASING NATIONALLY? WHAT ABOUT ON THE LOCAL SCENE?

Gabriel Kory: I THINK IT IS INCREASING NATIONALLY AND ASWELL AS THE LOCAL SCENE. WE HAVE A BABY BOOMER GENERATION THAT IS GETTING TO THE AGE WHERE THESE TYPE OF SERVICE ARE BEING NEEDED. THAT IS A LARGE GENERATION OF PEOPLE. IT’S SOMETHING WE ARE SEEING ON A BOTH LOCAL AND NATIONAL LEVEL.

Jose: IS IT JUST DEMOGRAPHICS OR ARE THINGS HAPPENING OUT THERE THAT MAKE PEOPLE WANT TO TAKE ADVANTAGE OF THESE FOLKS OR MAKE THEM MORE VULNERABLE?

Gabriel Kory: A COUPLE DIFFERENT THINGS THAT NEED TO BE EXAMINED. NUMBER ONE, WE ARE LIVING LONGER. AS WE LIVE LONGER PEOPLE ARE NEEDING MORE AND MORE CARE AND THAT CARE ISN'T THE TYPE OF CARE FAMILIES CAN PROVIDE AT HOME SO ASSISTED LIVING FACILITIES AND SKILLED NURSING FACILITIES THAT FAMILIES TURN TO WHEN THEY CAN NO LONGER PROVIDE THE CARE FOR FOLKS AT HOME THAT THEY WISH THEY COULD.

Jose: WHERE DOES THE MAJORITY OF ABUSE TAKE PLACE? IN THE FACILITIES? AT HOME?

Gabriel Kory: IT’S A VERY GOOD QUESTION MOST OF THE ABUSE THAT OCCURS ARE BY A FAMILY MEMBER. MOST OF THE ABUSE THAT WE COME ACROSS AT OUR PRACTICE IT’S ABUSE THAT IS OCCURRING EITHER IN AN ASSISTED LIVING FACILITY ENVIRONMENT OR SKILLED NURSING FACILITY GROUP HOME BUT BELIEVE IT NOT THE VAST MAJORITY OF ABUSE IS OCCURING WHEN SOMEONE NEEDS ADDITIONAL CARE AT HOME THAT CARE IS SUPPOSED TO BE PROVIDED BY A FAMILY MEMBER AND THERE IS SOME ISSUES WHERE THE FAMILY MEMBERS ARE ILL EQUIPPED TO PROVIDE THAT LEVEL OF CARE OR IN SOME INSTANCES THEY ARE TAKING FINANCIAL ADVANTAGE OF THEIR LOVED ONE WHILE THEY’RE IN THEIR HOME.

Jose: SO HOW DO YOU DEAL PARTICULARLY WITH THAT KIND OF ABUSE? I WOULD THINK IN THE INSTITUTIONAL SETTING THERE IS OVERSIGHT THERE IS SOME OTHET PEOPLE INVOLVED. BUT WHEN IT IS HAPPENING IN THE HOME HOW DOES IT GET REPORTED OR MUCH LESS DEALT WITH?

Gabriel Kory: THAT IS A DIFFICULT ISSUE. ONE OF THE THINGS THAT WE DO SOME OF THE OUTREACH FROM OUR CASES WE TEACH IN MEDICAL SCHOOL AND WHEN WE TALK TO MEDICAL STUDENTS THAT’S ONE OF THE ISSUES THAT ARISE. SOMETIMES A PHYSICIAN OR CARE PROVIDER IS THE PERSON SOUNDING THE ALARM SO TO SPEAK BECAUSE IN SOME INSTANCES THE FAMILY MEMBER IS LIVING OFF THE RETIREMENT FUNDS OF THAT PARTICULAR LOVED ONES OR THERE IS AN INSTANCE WHERE THERE IS ABUSE IN AN IF I THINKS -- FINANCIAL SENSE. THAT BEING REPORTED IS SOMETHING VERY DIFFICCULT TO DO BECAUSE OFTEN TIMES THE PERSON WHO SHOULD BE DOING THAT ISN'T DOING IT. IN THE ENVIRONMENT AT HOME, VERY DIFFERENT THAN ASSISTED LIVING OR INSTITUTIONAL ENVIRONMENT.

Jose: YOU ARE A PROFESSOR AND PRACTICE AT THE U OF A IN ADDITION TO HAVING YOUR OWN LAW PRACTICE. YOUR’E TRAINING MEDICAL STUDENTS ABOUT SIGNS TO LOOK FOR. AS I UNDERSTAND ARE THEIR LEGAL OBLIGATIONS THEY HAVE TO REPORT ABUSE WHEN THEY SUSPECT IT IS OCCURRING?

Gabriel Kory: THERE ARE. MEDICAL PRACTITIONERS, PHYSICIANS, NURSES, MEDICAL STUDENTS, AND RESIDENTS ARE ALL UNDER AN OBLIGATION TO REPORT SUSPECTED ABUSE AND NEGLECT WHEN THEY COME ACROSS IT.

Jose: WE HAVE OTHER SITUATIONS WHERE PEOPLE ARE SUPPOSED TO REPORT ABUSE SADLY IN THE SEXUAL ABUSE REALM WE HAVE HAD CASES MOST RECENTLY LARRY NASSAR WHERE PEOPLE SAID THEY DIDN'T SEE ENOUGH TO MAKE THEM WANT TO REPORT. I TAKE IT THERE ARE CRIMINAL PENALTIES FOR NOT REPORTING?

Gabriel Kory: THERE IS TWO PARTS OF THE STATUTE THAT APPLY. SOME IS THE CIVIL COMPONENT WHERE YOU OR A FAMILY OR VICTIM CAN SUE SOMEONE WHO IS CHARGED WITH KEEPING SOMEONE SAFE IN AN ASSISTED LIVING FACILITY OR NURSING HOME ENVIRONMENT. THERE IS ALSO A CRIMINAL COMPONENT TO THAT STATUTE AND THAT CRIMINAL COMPONENT AS IT RELATES TO REPORTING IS A MISDEMEANOR. I HAVE NEVER SEEN ONE OF THOSE CASES PROSECUTED.

Jose: DOES IT APPLY TO PHYSICIANS?

Gabriel Kory: IT DOES.

Jose: WHAT TRIGGERS THE OBLIGATION WHETHER IT IS PHYSICIANS OR SOMEBODY ELSE TO REPORT?

Gabriel Kory: IT IS ANY SUSPECTED ABUSE. IF THERE IS A REASONABLE SUSPICION THAT ABUSE IS OCCURRING AND IT COULD BE A SOCIAL WORKER, PHYSICIAN, NURSE IS CONFRONTED WITH THAT THEY ARE UNDER AN OBLIGATION UNDER THE STATUE TO REPORT THAT TO THE AUTHORITIES.

Jose: IN THE SITUATIONS WHERE YOU HAVE FAMILY MEMBERS, SOME OF THEM ARE TAKING CARE OF LETS SAY THE PARENT, BUT ABUSING THEM, DO YOU SEE LITIGATION WHEN FAMILIES SWING TOGETHER?

Gabriel Kory: YOU DO SEE LITIGATION. OFTENTIMES THAT IS RELATED TO FINANCIAL EXPLOITATION WHERE A CHILD, FOR EXAMPLE, HAS POW OF ATTORNEY OR A CHILD HAS ACCOUNTS THAT THEY ARE BEING MANAGED AND ANOTHER CHILD DOESN'T LIKE WHAT IS BEING DONE AND THOSE ISSUES DO COME UP. THEY ARE IN PROBATE CASES IF THERE IS A CONSERVE SHIP IN ORDER. THE VAST MAJORITY OF WHAT WE ARE HANDLING IS PHYSICAL ABUSE, NEGLECT OR EXPLOITATION.

Jose: INVOLVING NURSING HOMES AND OTHER CARE FACILITIES?

Gabriel Kory: CORRECT.

Jose: GIVE US A SENSE FOR THE SCOPE IS THERE A PROBLEM THERE? YOU WOULD THINK THERE IS STATE OVERSIGHT I WOULD ASSUME. IS THAT NOT THE CASE?

Gabriel Kory: THERE IS STATE OVERSIGHT. JUST TO LAY A LITTLE BACKGROUND IN ASSISTED LIVING FACILITIES THERE IS NO FEDERAL REGULATIONS THAT ARE NATIONWIDE PERTAINING TO ASSISTED LIVING FACILITIES. ASSISTED LIVING FACILITIES IN ARIZONA CAN BE AS SMALL AS 4-5 BEDROOMS WITHIN A RESIDENTIAL STYLE HOUSE ALL THE WAY TO AN APARTMENT STYLE ASSISTED LIVING FACILITY THAT IS A LARGE BUILDING. THERE ARE NO FEDERAL REGULATIONS THAT PERTAIN TO THAT LEVEL OF ASSISTENCE. THERE ARE SOME STATE CODE THAT PERTAIN’S TO THOSE AREAS BUT NO FEDERAL OVERSIGHT. NURSING HOMES THAT WE’RE FAMILIAR WITH SKILLED NURSING FACILITIES THOSE ARE GOVERNED BY FEDERAL REGULATIONS THAT DICTATE THE CARE THAT IS TO BE PROVIDED AND THERE IS A GREAT DEAL OF OVERSIGHT.

Jose: WHAT ABOUT THE QUALIFICATIONS OF THE PEOPLE THAT RUN THOSE PLACES? ARE THERE ANY FOR THE PEOPLE WHO RUN AN ASSISTED LIVING HOME?

Gabriel Kory: THERE’S A LICENCE YOU HAVE TO HAVE A LICENSE INORDER TO OPEN AN ASSISTED LIVING FACILITY AND THAT LICENCE CAN BE FOR THAT SMALL ASSISTED LIVING FACILITY WE DISCUSSED OR THE LARGER BUILDING. THERE’S ALSO A LICENSE FOR AN ADMINISTRATOR TO BE A LICENCESED NURSING HOME ADMINISTRATOR IN ORDER TO OPERATE A LARGER INSTITUTION.

Jose: WHAT ABOUT TRAINING? AGAIN, ASSISTED LIVING, WHAT DO YOU HAVE TO DO OR KNOW TO GET THAT KIND OF LICENSE?

Gabriel Kory: THAT IS SOMETHING THAT COMES AS A SURPRISE TO SOME PEOPLE. IN AN ASSISTED LIVING FACILITY ENVIRONMENT, SOME PEOPLE ARE UNDER THE MISCONCEPTION NURSES WILL STILL BE PROVIDING CARE TO MOM AND DAD. THAT IS NOT THE CASE. IN AN ASSISTED LIVING FACILITY ENVIRONMENT THERE ARE CAREGIVERS PROVIDING CARE AND TO BE A CAREGIVER IN ARIZONA YOU NEED 102 HOURS OF TRAINING AND TO GIVE YOU SOME PERSPECTIVE TO BECOME A BARBER IN ARIZONA YOU NEED 1500 HOURS OF TRAINING. THE TRAINING FOR CAREGIVERS IS INCREDIBLY LOW. WHEN YOU COMPARE THE LEVEL OF TRAINING FOR A CAREGIVER VERSUS A NURSE YOU CAN’T REALLY COMPARE THE TWO.

Jose: BETWEEN THE TWO SITUATIONS THE ASSISTED LIVING AND NURSING HOME ENVIRONMENT, WHICH DO YOU SEE THE GREATER POTENTIAL OR ABUSE?

Gabriel Kory: IF YOU ASK THIS QUESTION A FEW YEARS AGO I WOULD SAY THE NURSING HOME SETTING BUT I WILL TELL YOU MOST OF THE CASES -- OR WE HAVE SEEN A LARGE INCREASE IN CASES WE ARE TAKING IN ASSISTED LIVING FACILITY ENVIRONMENTS PRECISELY BECAUSE THE RESIDENT IN THAT ASSISTED LIVING FACILITY ENVIRONMENT NEEDS A HIGHER LEVEL OF CARE THAN CAN BE REASONABLY PROVIDED BY CAREGIVERS IN THAT ENVIRONMENT.

Jose: IN TERMS OF REMEDIES. SOMEONE FINDS OUT THEIR LOVED ONE IS NOT BEING TAKEN CARE OF AND THEY FILE A LAWSUIT. WHAT HAPPENS?

Gabriel Kory: IF SOMEONE BELIEVES THEIR LOVED ONE IS BEING ABUSED OR NEGLECTED IN A NURSING HOME OR ASSISTED LIVING FACILITY AND IT IS IMMINENT I THINK 911 SHOULD BE CALLED THE POLICE SHOULD BE INVOLVED IN THOSE PARTICULAR SITUATIONS. THERE IS ALSO APS ADULT PROTECTIVE SERVICES WHO CAN COME INVESTIGATE AS WELL. THAT SAID, IF A LOVED ONE HAS BEEN HARMED AND YOU BELIEVE THAT THAT CASE SHOULD BE FILED OR YOU BELIEVE SOMEONE SHOULD INVESTIGATE IT YOU SHOULD CONTACT AN ATTORNEY THAT HAS THAT LEVEL OF EXPERIENCE TO INVESTIGATE THAT FOR YOU.

Jose: YOU AND I WERE TALKING OFF CAMERA ABOUT THE EXISTENCE OR LACK THEREFORE OF INSURANCE.

Gabriel Kory: CORRECT. ANOTHER THING MOST FAMILIES DON'T KNOW AND AS AN INQUIRY THAT SHOULD OCCUR WHEN YOU’RE DECIDING WHETHER YOU SHOULD HAVE A LOVED ONE IN AN ASSISTED LIVING FACILITY OR NURSING HOME IS FIND OUT IF YOU ARE INSURED. A NUMBER OF CASES THAT WE’VE LOOKED AT WE HAVE NOT BEEN ABLE TO PURSUE BECAUSE THERE WAS NO INSURANCE. AND THERE IS NO LAW IN ARIZONA THAT REQUIRES ASSISTED LIVING FACILITIES OR SKILLED NURSING HOMES TO BE INSURED.

Jose: SOMETHING TO CHECK ON BEFORE YOU PUT YOUR LOVED ONE THERE?

Gabriel Kory: ABSOLUTELY, I THINK THAT IS JUST AS IMPORTANT.

Jose: ONE LAST AREA I WANT TO EXPLORE QUICKLY. THERE IS LITERATURE OUT THERE SUGGESTING AMONG HISPANIC THERE IS LESS USE AND LESS CONFIDENCE IN ASSISTED LIVING OR PUTTING YOUR LOVED ONES IN INSTITUTION SETTINGS AS OPPOSED TO TAKING CARE OF THEM AT HOME. HAS THAT CHANGED OVER TIME?

Gabriel Kory: I THINK IT HAS IN THE COURSE OF MY PRACTICE. I’LL GIVE YOU A PERSONAL EXAMPLE, MY MOTHER TOOK CARE OF BOTH MY GRANDPARENTS IN HER HOME UNTIL THEY PASSED AWAY. OVER TIME, MY MOTHER IS HISPANIC, WE GREW UP IN NOGALES THIS IS WHERE IT TOOK PLACE. I’VE SEEN MORE AND MORE HISPANIC CLIENTS WHO NEEDED ASSISTED LIVING FACILITIES AND SKILLED NURSING FACILITIES. I THINK THE REASON FOR THAT IS PEOPLE ARE LIVING LONGER, PEOPLE HAVE MORE COMPLEX DISEASE PROCESSES AND THEY NEED MORE HELP AND HELP THAT CAN'T BE PROVIDED IN HOME. AS A RESULT FOLKS ARE TURNING INTO THIS PARTICULAR FACILITIES. I DON'T THINK IT HAS TO DO WITH SOCIOECONOMIC BACKGROUNDS, ETHNIC OR CULTURAL ISSUES BECAUSE I SEE HISPANICS AS WELL AS MANY OTHER ETHNIC BACKGROUNDS WHO USUALLY TAKE CARE OF FOLKS IN THEIR HOMES NEEDING TO RELY ON THESE BECAUSE OF THE ISSUES RELATED.

Jose: MORE OF A MATTER OF NOT HAVING ANY CHOICE NOT ANY ALTERNATIVE BECAUSE WHAT THEY CAN DO FOR THEIR LOVED ONES IS NOT ENOUGH.

Gabriel Kory: THAT’S TRUE.

Jose: THANK YOU SO MUCH FOR JOINING US ON "HORIZONTE" TO TALK ABOUT IT. IT’S A TOUGH ISSUE TO DEAL WITH IT AND AS YOU SAID IT IS GETTING WORSE.

Gabriel Kory: I BELIEVE IT IS. THERE ARE MORE AND MORE CASES COMING IN. I WOULD LIKE TO SAY THAT THERE IS LESS BUSINESS FOR US BUT UNFORTUNATELY THAT IS NOT TRUE. WE KEEP SEEING THESE CALLS. SOMETHING NEEDS TO BE DONE ABOUT IT.

Jose: THANK YOU SO MUCH FOR JOINING US ON "HORIZONTE" TO TALK ABOUT IT. THERE ARE MORE PEOPLE BECOMING U.S. CITIZENS AND WE WILL TELL YOU WHY COMING UP NEXT.

According the Department of Health Services’s National Institute of Aging, there are hundreds of thousands of senior citizens every year who are abused, neglected and financially exploited.

The crime may take place in the person’s home, an assisted living facility, nursing home or family member’s house. Gabriel Kory, a partner with Miller Weber Kory LLP, says most abuse will be inflicted by a family member. However, his law firm deals mostly with neglect found in assisted living facilities.

Kory mentions a few reasons why more senior citizens are having to be placed in homes. The average person is living longer, and with that comes the need for more care than many families are able to provide. The senior citizen age group is also becoming larger as the baby boomers get older, so this is being seen on both the national and local levels.

“The vast majority of abuse is occurring when someone needs additional care at home,” Kory says. “That care is supposed to be provided by a family member, but then the family member is either ill equipped to provide that level of care, or in some instances taking financial advantage of their loved one while they’re in their home.”

One of the services offered by his firm is teaching medical students what to do if they are suspicious of abuse. Kory says that it will often be the physician or care provider who sounds the first alarm. It’s not easy to know when a senior citizen is being taken advantage of when they’re living with a family member, but it’s not impossible. He says that medical professionals are under an obligation to report suspected neglect and abuse when they come across it.

It is a problem that needs to be addressed more frequently as more people are having to be admitted to assisted living. Kory says that those seeking help aren’t limited to one ethnicity or group. He says in his personal experience, he has seen more Hispanic families putting their loved ones into homes because they don’t have the means to care for them.

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Gabriel Kory: Miller Weber Kory LLP

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