Aging & Loneliness

Preventing Illinois nursing home neglect is one thing–ensuring nursing home residents actually thrive as human beings is another. The Chicago nursing home lawyers are not naive enough to assume that all senior at long-term care facilities are living their best life so long as they are not neglected. Instead, preventing the abuse and mistreatment is merely a baseline. On top of that, facilities must help these individual live well. Helpfully, a range of new research efforts have emerged which seek to better explain the lifestyle challenges faced by local seniors in all situations. The information from that research should be used, where possible, to craft better living situations for all local elderly citizens.

One big theme hit upon time and again in these studies involves loneliness. A fascinating new study from research at Cornell, and published in Psychology and Aging, found that loneliness plays an important role in the aging process. More succinctly: Lonelier people age faster. Considered in that way, increasing meaningful social interaction is not only a way to improve the quality of one’s life but it also may prolong it. The full study can be found here.

Senior Housing News discussed the research effort earlier this summer. The study paints a unique picture, because it counsels, in some ways, toward increased use by seniors (and their families) of alternative living arrangements that increase the opportunity for social interaction At times that might mean leaving one’s home. It is often assumed that allowing a senior to stay in their own home is always preferable to alternative living arrangements. Yet, this research suggests that, in some cases, it might be better to consider senior centers or retirements commitments–so long as it means the difference between loneliness at home and interaction in the community.

Each Chicago nursing home lawyer at our firm appreciates that this is just one of many considerations. Obviously, there are other factors in a potential move that must also be considered. Aging in place at home may still be preferable. But, this new research should at least be considered as part of a comprehensive analysis of your family’s unique situation.

In any event, it is helpful to look at the full study. Researchers noted that loneliness produced bodily changes which actually mimic the aging process. This results in increased risks of heart disease. Interestingly the negative effects were seen both in seniors and young adults. However, the negative effects were more pronounced in the seniors. In addition, seniors were more likely to be lonely in general.

The researchers were quick to note that temporary pangs of loneliness needed to be distinguished from the chronic problem. Everyone experiences the temporary emotions from time to time in various settings. That is likely an unavoidable part of the human condition. But the chronic problem is the real concern. This refers to prolonged periods of loneliness which may manifest in real, harmful bodily changes. The lead author summarized that “one of the most important and life-affirming messages of this research is the reminder that we all desire and need meaningful social connections.”

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New Program from CMS to Improve Dementia Care & Antipsychotic Drug Use

Seniors with cognitive conditions like Alzheimer’s and other dementias are most at risk of suffering Illinois nursing home neglect and abuse. The Chicago nursing home attorneys at our firm work with many families whose seniors were severely injured or even killed after a facility failed to take their unique mental vulnerabilities into account. The neglect takes many forms, from failing to protect residents from one another to allowing wandering and elopement. It goes without saying that failing to account for these vulnerabilities is unacceptable.

Improper restraint of these residents is another problem. Many seniors with dementia are given drugs unnecessary–not to deal with a medical condition but to make them easier to “control.” By drugging a senior into a stupor, some nursing home caregivers are able to avoid the more challenging tasks of providing full care to the resident. These unnecessary medications not only have serious effects on the seniors quality of life, but they are downright dangerous. Many studies have been conducted connecting serious adverse (even fatal) effects of drug use–usually antipsychotic medications–for residents with dementia.

We have a long way to go before all long-term care facilities properly account for the unique challenges faced by residents with dementia.

Seeking to improve the situation, the Centers for Medicare & Medicaid Services (CMS) recently announced a new initiative to address the use of antipsychotic medication in nursing homes. In announcing the new partnership, CMS officials admitted that recent data found that over 17 percent of all nursing homes had residents who received higher than recommended dosing levels.

This percentage is likely on the low end, as many other studies have found even more widespread problems with these prescriptions. For example, one report found that 40 percent of dementia residents were prescribed an antipsychotic without any diagnosis of actual psychosis. In short: too many patients are receiving these drugs. That is where the new CMS initiative comes in. The acting administrator for CMS said that “As part of this effort, our partnership has set an ambitious goal of reducing use of antipsychotics in nursing homes by 15 percent by the end of this year.”

The CMS program is multi-faceted. For example a new training program is being launched which focuses on “patient-centered” care. This care takes quality of life issues into account, instead of simply focusing on control. In addition, there will be new behavioral training for state and federal surveyors, hoping to better identify this form of nursing home neglect and abuse. On top of that, the “Nursing Home Compare” website will soon include data on antipsychotic drug use all facilities, so that families can consider the statistic when making nursing home choices.

This new CMS initiative should be applauded–hopefully it has the intended effect of curbing this widespread problem. Yet, the Chicago nursing home neglect lawyers urge all local families to remain vigilant about the care received by their loved ones at these homes. That includes an understanding of the medications prescribed to your loved ones. It is important to ask questions about the benefit and risks of all drug. Also, be sure to raise concerns if you suspect that a resident is showing mental or functional issues after taking a new medication.

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Medication and the Elderly

Minimizing the Use of Restraints in Nursing Homes

Challenges Facing Young Residents in Nursing Homes

Nursing homes are sometimes still referred to as “Old Folks Homes” or other colloquial phrases indicating them as a space filled only with the elderly. While senior citizens are obviously the most in need of these skilled nursing facilities, the Chicago nursing home abuse attorneys at our firm know that there are actually a good amount of young individuals at these homes. At the end of the day, these nursing homes are places for all individuals who do not need to stay in a hospital but who need care that cannot be provided at home.

However, the fact remains that younger residents often face social challenges that are often not met at these facilities. Their plight is a hidden one, as few consider the lifestyle consequences for younger people living in long-term care homes. A recent Medical Express article went so far as to explain how these individuals were denied basic human rights.

The story shared information on new research published by the Summer Foundation. The study (found here) evaluated the quality of life for young people living in nursing homes. Expectedly, the underlying theme was that there are serious ramifications for those individuals such that everything possible should be done to move these younger individuals out of these facilities and into alternative living arrangements

Our Illinois nursing home neglect lawyers appreciate that this was a comprehensive research effort, evaluating individuals over a five year period. Entitled, “Younger People in Residential Aged Care,” the research sought to examine the effect on program participants who took advantage of alternative living options. In particular, about 500 people under age fifty were involved. Half of the group avoided nursing homes altogether while the other half left a nursing home where they previously lived.

What did the researchers find?

Those not in nursing homes scored far better on a range of quality of life indicators. The main benefit, claim the researchers, is the opportunity to make everyday choices. One of the key problems with nursing home life for younger individuals is the highly structures lifestyle that often leaves little room for creativity or individual choice. In some ways this structure is important to prevent nursing home neglect that leads to accidents for the most vulnerable residents. But, that does not mean there is no room for flexibility.

For example, the study found that the lack of materials and too much structure often means that basic human rights is denied to these residents. For example, many nursing homes have rigid locked doors schedules, denying residents access to the outside. This means that many residents are literally locked into the home without the chance to interact with others as they might like

Some of these challenges are natural outgrowths of an institution that is aiding individuals with various needs. The care needed by a 85 year old man with dementia is far different than a 38 year old woman. But that does not mean that these facilities can do nothing to make the experience better for the younger residents. Our Chicago nursing home lawyers know that many different quality of life initiatives can be undertaken to maximize the freedom and potential thrive for all residents–regardless of their age. Those quality of life programs should be fully explored.

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Continuing Challenges Faced By LGBT Seniors in Nursing Homes

My Elder Advocate touched on a very unique issue in a recent post discussing quality of life concerns in nursing homes. As Chicago nursing home abuse attorneys, it is sometimes easy for us to focus entirely on the individual instances of misconduct that cause serious harm (or even death) to residents. Obviously no senior should be hurt at one of these facilities as a result of unreasonable care.

But it is insufficient to focus only on stopping the most egregious harm. We should also pay attention to actual quality of life issues inside these homes Nursing home have the reputation of being a place where one simply exists, without a chance to thrive, grow, and meaningfully contribute to their community. It doesn’t need to be that way.

As the article from My Elder Advocate explained some groups of seniors face even more challenging quality of life issues at these communities than others, including lesbian, gay, bisexual, and transgendered seniors.

The story notes that the federal Nursing Home Reform Act protects many groups of residents from discrimination, including discrimination based on sexual orientation. Yet legal protection from overt discrimination is not the same as creating an environment where all residents are free to be open and honest about themselves. Unfortunately we still have a long way to go in that regard.

A recent survey found that three out of every four LGBT seniors admitted that they would likely not be open about their sexuality in a nursing home. Nearly 90% of respondents felt that the staff members might discriminate against them if they knew. Another 80% thought that other residents would discriminate. These LGBT seniors were concerned about being isolated in the long-term care facility if they were open about their seuality. Nursing home lawyers know that it is little wonder why. Sexual orientation concerns are hot-button political issues which have clear generational differences. Many seniors in nursing homes grew up in an entirely different world in relation to these issues than the world in which the current generation is living. Thus, it is not surprising that entering a nursing home may feel like going back to less tolerant time for LGBT seniors.

The story shares the story of one female couple that was together for 58 years. One of the woman suffered from Alzheimer’s and was forced to move into a nursing home when her health deteriorated. However, as a result of various pressures, the woman’s partner had to pretend that she was a “sister.” The resident ultimately passed away. A few years later her surviving partner had to move into an assisted living facility as well. However, she stressed endlessly about displaying her pictures with the love of her life, over fear of the reception from others in the community.

Our Chicago nursing home abuse lawyers believe that all nursing home residents should be able to live safely as themselves in local long-term care facilities. Staff members should do everything in their power not only to keep residents healthy but allow them to thrive as unique human beings.

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Infected Tube Leads to Nursing Home Neglect Lawsuit

The term “nursing home” is often used colloquially to refer to all living spaces where seniors normally stay. But our Chicago nursing home abuse attorneys realize that this is misleading–there is actually a range of long-term care facilities. Some homes provide more aid than others and each provides various levels of freedom for the senior residents. In most cases, when talking about a nursing home, one is referring to “skilled nursing facilities” (SNFs). These are spaces that provide the most “in-depth” medical care, above and beyond simply helping with chores, grooming, and similar tasks.

SNFs are filled with nurses, certified nursing assistants and others who are trained to provide skilled care when necessary to ensure the well-being of residents. Expectedly, some cases of nursing home neglect in these locations involve problems with the medical care provided. Sometimes the appropriate medical care is simply not provided and at any times it is done incorrectly. This is distinct from other forms an negligence which are related to basic safety lapses–like wandering and elopement.

For example, ABQJournal North reported this week on a new nursing home neglect lawsuit stemming from inadequate medical care provided to a resident at one of these skilled nursing facilities. In particular, the lawsuit alleges that a resident suffered a serious infection as a result of a mistake made with a feeding tube. The tube was allegedly placed incorrectly, caused liquid formula to fill the resident’s abdominal cavity. It goes without saying that even small problems can cause serious injury or harm to residents at SNFs, because they are already have health problems. They wouldn’t be in the facility otherwise.

The suit in this case was filed by the resident’s adult daughter. In the suit, the daughter notes that her now-58 year old mother was admitted to the defendant-facility in May of 2010. At the time she was in the advanced stages of multiple sclerosis. She went to the nursing home directly from the hospital where she had received treatment for a brain injury.

The resident was not in her right state of mind when first admitted to the SNF. The complaint in the case notes that, while she was confused and hallucinating, the woman accidentally pulled out a gastric feeding tube that inserted into her abdomen directly. Staff members at the facility tried to reinsert the tube–but they did so incorrectly. Instead of putting it back into the woman’s stomach, it was short. This led to the nutritional formula seeping throughout the abdominal cavity.

Perhaps as a sign of the cut corners at this establishment, nothing about the incident was noted in the resident’s chart as required. Our Chicago nursing home abuse attorneys know from experience that nursing home resident charts are often poorly kept. Charting is done haphazardly and sometimes even intentionally wrong.

In this case, the woman was obvious suffering the following day. Her temperature rose and her abdomen was firm. She was transported to a local hospital where she needed a surgical procedure performed and treatment for infection. The resident was forced to spend five day in the hospital to recover from the injury.

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Nursing Home Lawsuit Filed After Resident Injury From “Flesh Eating Bacteria”

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Ensure Proper Treatment of Seniors By “At Home” Care Workers

California lawmakers are locked in an interesting situation with elderly people who require in-home support and the individuals charged with providing the in-home care. The “In-Home Supportive Services Program,” is the government program designed to provide at-home care for low-income elderly, blind and disabled people so they may remain in their homes as an alternative to institutional care. Yet, the program is under scrutiny as additional evidence of lax employment requirements by the Program and abuse or fraud by employees continues to surface despite legislation intended to curb such actions. Our San Diego elder abuse attorneys understand the concern, as the senior community remain the number one target of abuse and neglect—it is critical that their caregivers be willing and capable to ensure proper treatment at all times.

A story from California Watch recently discussed the issue. In 2009, legislation enacted by then Governor Schwarzenegger sought to exclude anyone who had committed a felony in the last decade from the program–expanding the previous scope of the ban that barred only those convicted of child abuse, elder abuse or defrauding a government health care assistance program. A Superior Court Judge later did not agree with this expansion and so the legislature responded with a milder version in 2011 that expanded the scope of convictions to include more types of felonies but did not go as far as originally intended.

The current requirements eliminate individuals with particular criminal convictions, but still allow individuals to work in positions of trust with the elderly or disabled who would not be employed in similar positions in other fields that require such trust. In other words, there are convicted felons who would be otherwise unemployable to a certain extent working to provide in-home care to elderly or disabled people getting compensated an average of $1.50 over minimum wage.

The obvious concern is that the situation is ripe with opportunities for theft, fraud or abuse and that the program does not adequately screen applicants to prevent such crimes. Screening is a difficult part of the program especially since it took over one year to complete the initial background checks in 2009 on the over 390,000 caregivers in the program. Over 800 individuals were disqualified from continuing their jobs; a number that can be interpreted as good or bad. The predicament gets even more complicated because the patients can sign waivers allowing individuals who would otherwise be disqualified from the program due to previous convictions to continue to provide in-home care. This highlights the often overlooked issue of the lack of quality, reliable caregivers available for the program. This issue has not been addressed because of the heavy focus on screening applicants and eliminating abuse within the program.

Despite legitimate fears of fraud and abuse within the program based in part on actual incidents, the number of reported crimes does not suggest that incidents of such crimes are widespread. Yet, as San Diego elder abuse lawyers, we know that only a fraction of mistreatment is ever reported—most seniors suffer in silence and accountability is few and far between.

In any case, proponents of heightened restrictions regarding past convictions point to the numbers and say that they could be lower and there is more they can do to reduce that number. A “statewide task force” comprised of “district attorneys, fraud investigators and other government officials” is working to monitor the In-Home Supportive Services program and develop policies designed to combat fraud within the program. As a result, certain “protocols” may be put in place this Fall that will hopefully reduce incidents of fraud.

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Direct Care Workers Crucial to Preventing Nursing Home Neglect

Our Chicago nursing home abuse attorneys know that one of the crucial components of proper support at long-term care facilities involves front-line, direct care workers–the individuals who actually help residents with their day-to-day tasks. When nursing home neglect occurs it is frequently rooted in mistakes related to care provided by these workers. This is not necessarily because the workers are intentionally abusive or even careless. Instead, the problem is often simply a lack of total direct care workers. Short staffing problems are all-too-common, meaning that residents wallow without basic or timely aid. In these situations basic problems can go unnoticed and allowed to grow into complications.

Interestingly, in many ways residents and these care workers sometimes fight the same battles against owners and operators of these facilities. Most staff members are committed to helping residents to the best of their ability. Yet they are thwarted in their mission, because there are too many residents and not enough staff members. Many staff members are also not given sufficient training or access to the tools they need to provide reasonable care. All of these limitations are spurred by the company’s goal of maximizing their own profit, regardless of who is hurt as a result. This, of course, is on top of the fact that direct-line care workers are usually the worst compensated members of the entire staff.

Nursing Home Employee Strike
The confrontational relationship between important care workers and facility management was on display in a new article from the New York Times on a strike by employees of a nursing home chain. Over 600 workers at five different nursing homes walked off in early July. The spur for the strike were changes by the company which eliminated at least six sick days and a week of vacation for these workers. The company also froze pensions and required many employees to pay more than $6,000 a year more for health coverage.

Sadly, the story notes that the strikes have “thrown the facilities into disarray, creating much worse service for the residents.” This is not a surprise considering that stability in care workers has long-been associated with better outcomes for residents.

Of course, economic realities are always a factor in management of these facilities, but the bottom line has to be reasonableness. Owners and operators cannot be allowed to stand behind claims of economic changes to justify any and all cuts to direct workers, particularly since those changes are likely to affect the quality of care to residents.

This particular strike has already spilled into the courts. Last week the labor board issued a complaint against the nursing home company for bargaining in bad faith and illegally imposing benefit cuts of the workers.

Chicago nursing home abuse attorneys stand arm-in-arm with all those committed to ensuring reasonable care for seniors at long-term care facilities. Many factors are involved in that care, but time and again distortions caused by the profit-motive are at the root of the mistreatment. This cannot be tolerated. Fortunately, the civil law provides an avenue for accountability and redress, often spurring widespread changes at these facilities.

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Federal Officials Join Hospice “Whistleblower” Lawsuit

Mistreatment by those charged with caring for seniors, disabled, and terminally ill residents takes many forms. Every Chicago nursing home lawyer knows that the most common problems are those involving the intertwining of profit-motive and negligent care. These care locations are often businesses seeking to make a profit, but, at the same time they are fulfilling a vital role for those whose life and death literally hang in the balance. For that reason, when they act inappropriately and cause harm, the civil law allows those hurt to seek accountability.

Unscrupulous conduct by these institutions affect not only those directly harmed but all of us. That is because most funds used for this care comes from taxpayers, in the form of Medicare and Medicaid payments. This fraudulent use of public money cannot be tolerated–particularly when it causes severe physical and emotional pain to residents who depend on proper conduct. Illinois nursing home abuse lawyers know, however, that many facility owners continue to act inappropriately to maximize their own bottom line, regardless of the effect on others.

Whistleblower Lawsuit
For example, the Orlando Sentinel reported recently on a new whistleblower lawsuit filed against a hospice center. According to the lawsuit the defendant-company engaged in routine over-billing of Medicare. This was done by admitting patients for services that did not qualify as terminally ill and keeping some of them there for as long as five years. This particular home was actually a non-profit facility.

The story notes that the latest action by a federal judge allows federal officials to intervene in the suit–a sign that they likely found enough evidence in their own investigations into the matter. A second review by federal officials found a 77% “error rate.” This means that over 3 out of every 4 patients admitted to the hospice care were eventually deemed not to have needed the care. The care is generally limited to those who are certified to likely have less than 6 months to live.

The attorney representing the former employee who first brought the problem to light noted that the hospice facility may ultimately be on the hook for up to $33 million in penalties. This figure was arrived at because the government may seek “triple damages” in these cases–three times the amount of the alleged overbilling.

The nursing home lawsuit was first filed a year ago by the former administrator who moved up to become the facility’s VP for Finance. However, the man claims that he was eventually fired after he urged the non-profit board to reimburse Medicare for overbilling. He claims that that the CEO was incentivized to keep the money for financial reasons. The non-profit CEO took in a $120,000 base salary in addition to about $200,000 in annual bonuses as a result of the facility’s census count.

It remains imperative to stamp out misconduct at all of these care establishments, whether it be based in finances or outright physical/emotional neglect. Nursing home neglect lawyers appreciate that the two are often related. In all cases, however, taxpayers deserve proper use of their funds, for reasonable care that provides a necessary service to those in need.

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Elder Financial Exploitation: Theft By Family Members

Nursing home neglect and abuse is one of the most common forms of exploitation of elderly community members. Yet, according to a new study commissioned by the U.S. Department of Justice, the actual form of abuse that occurs with more frequency than anything else is unauthorized use of senior funds by family members. Considering the amount of assets taken by relatives, it is important for local residents to understand the problem and the ways to prevent this abuse. Our Chicago elder abuse attorneys appreciate, however, that tackling this problem is easier said than done. That is because relatives are usually the ones who actually protect seniors. It is difficult to address the issue without that oversight.

The Problem
Senior financial exploitation caused by family members can vary in scope–from small sums taken to entire life savings stripped away. For example, one former law enforcement officer who now trains others to tackle this abuse notes that over the years he has “seen as much as three-quarters of a million dollars that disappeared over 18 months. The money, or control of a house, its all just stripped away.”

Federal, state, and local officials have been devoting more and more resources to this problem. For example, the Department of Health and Human Services announced that $5.5 million will be distributed for elder abuse prevention efforts. Similarly, the Elder Justice Coordinating Council also launched an effort to prevent this abuse–include work on financial matters with the Consumer Financial Protection Bureau.

Two main themes are common in the cases: (1) A family member with their own problems, and (2) Seniors with cognitive health issues. More often than not the family members who engage in theft have mental health issues, substance abuse problems, or both. Individuals who seem financially dependent on their elder relatives are more likely to engage in theft. In addition, seniors who have cognitive challenges–like dementia or Alzheimer’s–are most at risk.

Prevention Tips
A recent story from the Fiscal Times discussed this problem and listed a few red flags to help identify the problem. Our Chicago elder abuse lawyers urge all seniors (and their loved ones) to take note of these basic tips to prevent financial exploitation before it expands. In many ways the key is to identify possible theft early on, before the wrongdoer gains a foothold and takes more and more. Some of those identification signs include…

***Sudden isolation: For both well-being and safety reasons, it is never a good idea for a senior to be isolated from others. That is particularly true when they interact with only one or two individuals.

***Change in Financial Control: Obviously, a sudden or unexpected change in financial control might indicate exploitation. All those with control over a senior’s finances should be scrutinized reasonably.

***Secrets: Secrecy is at the heart of this problem. Scammers usually try to keep things secret and seniors often fail to mention possible problems, either because of confusion, shame, or both. All suspicions about a senior keeping issues quiet should be investigated to ensure they do not relate to some form of abuse or exploitation.

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New Financial Scams Targeting Seniors

Elder Abuse Prevention Laws Strengthened

New Financial Scams Targeting Seniors

The Orlando Sentinel reported last week on a new scam that federal authorities believe is being used to target seniors. All local seniors are being warned about the effort, the latest in a seemingly endless string of fraudulent activities targeting the elderly community. Our Chicago elder abuse attorneys appreciate that the vulnerability of many seniors–often those who live alone–make them prime targets for unscrupulous individuals seeking to make a quick buck.

According to the story, this latest scam involves claims about “sweepstakes” winnings. The scam works by fraudsters making anonymous calls to seniors claiming that they have won the well-known Publisher’s Clearing House Sweepstakes. The scammers claim that the senior will receive various prizes, but with smaller sums needed to be paid first to collect. In fact, the caller claims that the senior would even be driven to the bank by a member of the FBI and sweepstakes officials to withdraw the necessary funds.

Unfortunately, many have fallen for this senior financial exploitation in recent weeks and months The details of the scam are altered somewhat but each usually involve claims of winning and the need to make a payment first to collect those winnings. For example, the story explains how one woman ended up forking over $5,000 to scammers to pay what she thought was back-taxes and storage on two vehicles she owned.

The Sweepstakes Scam
Authorities have gotten a wave of reports of this sort of scam. They explain that the seniors are usually targeted because they previously filled out forms or signed up for offers online. Scammers take that information submitted online and then call the senior. The caller says that the senior won the sweepstakes for which they signed up online. Often the caller claims that the prize will be given as soon as the senior buys something called a “Green Dot MoneyPak card.” The card allows individuals to buy things without a checking account or credit card. The victims usually load the card, with the information and funds stolen.

Our Chicago elder abuse attorneys know that it is crucial not to take these scams too lightly. It is easy to identify as suspicious when reading about the deal, but the situation is much different when dealing with it while talking to a real person on the phone. It is easy to believe the claims made over the phone, especially when one is naturally trusting.

For that reason it is crucial to keep an eye on the finances of local seniors who may be at risk of being exploited. In addition, it is helpful for seniors to be educated about these common scams and basic safety tips to avoid being victimized. Some of the most common tips to protect seniors include:

-Never give identifying information (social security number, credit card details) to those over the phone unless you initiate the contact. Anyone calling randomly and asking for this information is suspect.

-Be very cautious about filling out forms where personal information is needed.

-Online forms are a key “fishing” spot for these scammers. For that reason, when filling out one of these forms always uncheck the box that allows the site to give out the information to other companies.

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Elder Abuse Prevention Laws Strengthened

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