California Elder Law Attorney Blog

A 78-year-old woman died because a nursing home failed to properly monitor her medication and failed to check her into an emergency room fast enough when her brain started bleeding, according to state regulators.

The California Health and Human Services Agency fined New Hope Care Center $100,000 after an investigation into a report that the nursing home at 2586 Buthmann Ave. ignored the worsening condition of a patient admitted a year ago with a hip fracture, heart problems osteoporosis, hypertension and osteoarthritis.

State investigators concluded that New Hope caregivers "failed to ensure that the resident's medications were monitored and failed to fully assess the resident or promptly notify the physician when there was a change in the resident's condition, which resulted in the resident's death," according to Al Lundeen, a spokesman for the state agency.

The fine levied on the nursing home is the maximum penalty the agency can impose for a "AA" citation, the harshest assessment for hospitals and nursing homes in California.

Employees of the 5-year-old for-profit nursing home declined to comment on the state's findings. New Hope's corporate owner Evergreen Healthcare Companies, LLC, did not return phone calls seeking comment.

According to the state, caregivers failed to keep a close eye on the condition of the patient -- whose identity was withheld in the report -- after a doctor ordered an increase in medication to prevent blood clots. A possible side effect of the medication is excessive bleeding, according to the regulatory agency.

Because the nursing home staff didn't monitor a change in the woman's condition after the doctor upped her anticoagulant prescription, the state said they missed warning signs that could have saved the woman's life.

On Sept. 14 last year, days after the doctor-ordered increase in her blood-thinning medication, the woman started slurring her words and complaining of a headache, according to relatives who visited her that morning.

"Things did not seem right with her," the woman's daughter told the state agency, according to the report accompanying the citation. The woman's husband said the patient couldn't talk "because she had a bad headache ... and was repeating, 'my head, my head.'"

Even though the woman woke up just a couple hours earlier, she started nodding off, waking up only to vomit. Her husband complained that the nursing home employees didn't treat the situation as an emergency. He "felt like the staff was not taking her condition as seriously as he knew they needed to," according to the citation.

The woman died that day in the emergency room of a Tracy hospital. The patient's death certificate cites "....inappropriate bleeding or clotting secondary to medication" with hypertension and bleeding in her brain as her cause of death.

New Hope has a spotty public history.

Nursing Home Compare, a government Web site run by Medicare, gave the facility one star out of a five-star ranking -- that's "much below average" -- for an assessment that looks at health of patients, safety, staffing, quality of care and other criteria.

The health and human services agency issued a citation and a $1,000 fine in February last year after determining that the nursing staff failed to properly monitor the facility's infection-control policy. A complaint from July last year says that several patients accused New Hope nurses of walking right past them when they ring the call button.

Sources within the agency have confirmed that there's an ongoing investigation into New Hope that may end in a second "AA" citation stemming from complaints filed by Tracy resident Paula Baca about medical negligence toward her mother.

"We do have other complaint investigations (connected to New Hope) that are ongoing, but at this time it is too preliminary to disclose information, so that's all we can say about that," said Ralph Montano, spokesman for the state's health agency. "It's also far too early to speculate as to the outcome of those investigations."

Baca's mom stayed at the nursing home between 2006 and 2007. She didn't die at New Hope, but her health certainly worsened because of her stay there, according to Baca.

"They totally ignored my mom," Baca said of her 74-year-old mother, whom she transferred to another nursing home months before her death last year after filing complaints against New Hope for allegedly failing to treat her mom's serious skin infection. "When doctors finally inspected her, they found she had bone marrow cancer, E. coli and a blood infection, among other things."

The state issues about 20 AA citations a year to California's 1,300 registered nursing homes. That's about 1.5 percent of nursing homes in the state.

Several complaints along with the citation history of the nursing home -- which averages a citation and several complaints a year -- is available on the health and human services Web site at hfcis.cdph.ca.gov.
Contact Steven Peck's Premier Legal toll free at 1-866-999-9085 to talk to an experienced nursing home abuse and neglect attorney and visit us at www.premierlegal.org.

Many laws have been passed to address caregiver fraud and manipulation. In 2007, for example, financial institutions became mandatory reporters of suspected financial elder abuse.

Experts advise seniors to:

Check the background of any caregiver and make sure he or she is properly licensed.

Be wary of someone who suddenly takes an interest in your financial affairs

Become an expert on the legal concept of power of attorney

Learn to say no to your children - sometimes, they are the ones going after your money.

Family members and friends should:

Pay attention to any sudden changes in behavior on the part of their loved ones, such as growing isolation.

Keep in touch with your loved one and pay attention to any "red flags," such as a new person in their life.

Be watchful. Employers and agencies that provide senior services have an obligation to make sure that their agents aren't committing fraud or receiving "gifts." Do not blindly trust your caregiver.

To report elder or dependent adult abuse or neglect, call Steven Peck's Premier Legal to talk to an experienced elder abuse attorney toll free at 1-866-999-9085 or visit us at www.premierlegal.org

She was hired to clean a house. She also cleaned out most of her client's bank accounts, or so a lawsuit alleges.

A criminal investigation into a Garden Grove housekeeper accused of taking more than $1.4 million from a retired octogenarian couple with serious medical ailments highlights the growing problem of financial elder abuse in Orange County.

The bad economy is only making things worse, say law enforcement officials and those trying to prevent seniors from getting scammed - often by loved ones.

Experts have seen children in their 50s and 60s who have lost their jobs moving back in with their parents - only to rip them off.

They've also seen caregivers who earn a position of trust with those who cling to them during their final years, police and other officials say.

The elderly are particularly susceptible to financial scams because they often feel isolated and are quick to trust new friends, experts say. Also, many have ailments that cloud their judgment and thinking, and thus can become vulnerable to financial predators.

"I have heard financial elder abuse referred to as the 'crime of indignity,' and it's definitely on the rise," said Julie Schoen, director of the Financial Abuse Specialist Team for the Council on Aging of Orange County, which serves older and dependent adults and their families.

Reported cases of financial elder abuse in Orange County totaled 1,141 in 2008, with similar caseloads this year, said Carol Mitchell, program manager of Adult Protective Service of Orange County, which responds to allegations of elder abuse and neglect.

The actual numbers are believed to be much higher - and growing - because the crimes are notoriously underreported and there could be a lag in reported cases since the economy soured, Mitchell said.

"Not all of these cases involve large sums of money," she said. "Some involve a person simply diverting monthly Social Security payments into their own bank account."

HIRED HELP

What two lawsuits claim was the scheme carried out by Garden Grove housekeeper Marlina Heinz falls on the other end of the spectrum, with fancy cruises, a brand-new Corvette, and a quickie wedding in Vegas - to a frail, stooped-over widower more than three decades her senior.

No criminal charges have been filed against Heinz, although police in Orange are investigating her for possible fraud-related crimes, Sgt. Dan Adams said.

Lawsuits filed against Heinz say she looted more than half of the assets of Charles and Lois Woodbridge of Orange.

Heinz could not be reached for comment. Her attorney, Michelle West, also could not be reached.

The lawsuits were filed by Rancho Santa Margarita attorney Noelle M. Tomp, who has been practicing elder, probate and trust law for 16 years.

Tomp sued Heinz on behalf of John Woodbridge, the only child of the Woodbridges. Charles and Lois lived for decades on a quiet street in Orange and ran a profitable family business, Woodbridge Advertising, where John also worked.

In 2002, Lois was diagnosed with Alzheimer's and dementia. In early 2003, her husband - who went by "Woody" - was diagnosed with Parkinson's.

John and his wife, Melissa, insisted that a housekeeper be hired to help the couple a few times a week.

Heinz started working for the Woodbridges in July 2005. She was assigned to them through Dana's Housekeeping in Garden Grove.

VEGAS WEDDING

Heinz's duties increased as the conditions of Woody and Lois worsened. Another caretaker eventually was hired to help out.

Five days before Lois' death, at age 81, in October 2006, while Lois was lying in a coma, the lawsuits allege, Heinz took Woody to an attorney to have his and Lois' longstanding estate plan amended so she would receive $200,000 in cash and be named trustee of their estate.

About a month after Lois died, Heinz was added to the couple's bank accounts and started burning through cash, including purchasing a Corvette for about $60,000 in March 2007, the lawsuits allege.

Other allegations include that Heinz drove Woody to the Little White Wedding Chapel in Las Vegas and married him on July 3, 2007 - despite her already having been married, since October 1993.

After the wedding, Heinz amended the family trust to give her most of the assets - taking them away from John, according to the lawsuits.

Heinz isolated Woody from his neighbors and his son and daughter-in-law - even accusing John and Melissa of trying to steal from him, the lawsuits say.

"The greatest loss to me is not the theft of my family's assets, but the fact that my father, who suffered from severe dementia, was deceived into believing that I did not love him anymore and was trying do him harm," John Woodbridge told the Register.

"There is no judge or court ruling that can ever erase the pain of this."

When Woody died on June 24, 2008, Heinz controlled the majority of his remaining assets and didn't tell any of his friends or neighbors or have a memorial service, according to the lawsuit.

"She refused to release Woody's ashes to John (but) 'generously' gave him two tablespoons of his remains," the lawsuit says.

CALL FOR VIGILANCE

The civil lawsuits against Heinz were settled last week, Tomp said.

Lawsuits remain against Dana's Housekeeping and two attorneys Heinz used to alter the Woodbridges' trust. Tomp is alleging legal malpractice.

Under terms of the settlement, Heinz agreed to pay John Woodbridge $50,000 in cash and give him a home she bought in Garden Grove, according to Tomp.

John Woodbridge, who said he also lost a lifetime of photos, said the settlement only goes so far.

"The hard lesson I learned was, if you have elderly parents and need to get them assistance, you must pay close attention to the hired helper and don't trust anyone - especially if they start becoming too familiar with your family's affairs," he said.

"If they do, replace them immediately."
Contact Steven Peck's Premier Legal toll free at 1-866-999-9085 to talk to an experienced california elder abuse attorney or visit us at www.premierlegal.org

Many elderly people rely entirely on family or other trusted individuals to help them. Whether it is for physical needs or emotional needs, as people grow older they tend to need more and more help from others. This dependence on caregivers or family members makes an older person more vulnerable for abuse.

For example, an older person relying on her children to provide meals and transportation and help her with financial decisions finds it difficult to complain when one of her children takes advantage of her. If, for instance, the child takes her money, hits her or neglects her care, the parent may be threatened with loss of support from the child if the parent complains. The child may also use threats of violence to keep the parent in line.

It is estimated that 5% to 10% of elderly Americans are suffering abuse. According to the National Committee for the Prevention of Elder Abuse,

"Spiraling rates of elder mistreatment are reported by both practitioners and researchers. In a recent national study of Adult Protective Services (APS), typically the agency of first report concerning elder abuse, there were 253,421 reports of abuse of adults age 60+ or 832.6 reports for every 100,000 people over the age of 60. The National Elder Abuse Incidence Study found that more than 500,000 persons aged 60+ were victims of domestic abuse and that an estimated 84% of incidents are not reported to authorities, denying victims the protection and support they need."

Much attention has been focused on abuse in nursing homes but most of the elder abuse in this country is at the hands of family members or other caregivers in the home.

The majority of the victims were females between the ages of 60-89 and 60% of the perpetrators were family members/relatives, while 24% were non-related paid caregivers.

The protective needs identified were as follows:

self-neglect 31%
physical abuse 16%
exploitation 19%
caretaker neglect 12%
emotional abuse 19%
sexual abuse 3%
In conducting the investigations, it was not uncommon to find that adults who were self-neglecting were also being exploited or abused. Thus, if only one in ten cases are ever reported, it is possible that 9 out of 10 is close to the actual ratio of unreported versus reported cases.

The lack of reporting elder is the same in all States, and each are experiencing close to the same ratios of underreporting as the others.

There are a number of reasons why incidents of abuse, neglect, or exploitation are not reported to Adult Protective Services or other authorities. One of the most common reasons is the victim's fear of losing support. Many of the perpetrators are family members and the victim fears that reporting the crime will result in removal of the caregiver, as the perpetrator may face incarceration or may discontinue relations with the victim once accused, charged, or convicted. Many of these victims fear that by reporting abuse they will be left alone and expected to care for themselves or they will be forced to live in a nursing home.

Many states have implemented mandatory reporting laws to assist in the prevention of abuse, neglect or exploitation of vulnerable adults. Most states have laws that state that "any person who has reason to believe that a vulnerable adult has been the subject of abuse, neglect, or exploitation shall immediately notify Adult Protective Services or the nearest law enforcement agency. Anyone who makes the report in good faith is immune from civil liability in connection with the report; however, any person who willfully fails to report is / might be guilty of a misdemeanor."

It is important to note that the anonymity of the person or persons making the initial report and any other persons involved in the subsequent investigation shall be preserved and may only be released in accordance with the rules of the division In addition, all investigation information is confidential.

The following is a list of indicators of abuse, neglect or exploitation. It is important to note that the following lists are merely indicators and may not always be violations.

Signs of Abuse:

Unexplained bruises, welts, fractures, abrasions or lacerations
Multiple bruises in various stages of healing
Multiple/repeat injuries
Low self-esteem or loss of self determination
Withdrawn, passive
Fearful
Depressed, hopeless
Soiled linen or clothing
Social Isolation
Signs of Neglect/Self-Neglect:

Dehydration
Malnourishment
Inappropriate or soiled clothing
Odorous
Over/under medicated
Deserted, abandoned or unattended
Lack of medical necessities or assistive devices
Unclean environment
Social Isolation
Signs of Exploitation:

Missing/"disappearing" property
Inadequate living environment
Frequent/recent property title changes or will changes
Excessive home repair bills
Forced to sign over control of finances
No/limited money for food, clothes and other amenities
Prevention can only occur if there is awareness, the statutes are adhered to, and any suspicions of abuse, neglect or exploitation of vulnerable adults are immediately reported to Adult Protective Services and/or law enforcement.

All states have agencies that receive complaints of abuse. In some states failure to report abuse of the elderly is a crime.
Contact Steven Peck's Premier Legal toll free at 1-866-999-9085 to talk to an experienced elder abuse attorney or visit us online at www.premierlegal.org.

Every year as many as 10% of older adults are reportedly abused by a family member. It should be stressed that the statistic is based on reported incidents of abuse, so the prevalence of elder abuse is likely greater than the numbers indicate. The elderly are a particularly vulnerable population for a number of reasons. They are faced with mounting health problems, dwindling financial resources, shrinking social networks and a diminishing capacity to meet their daily needs. As a result, they must rely on professional caretakers or family members to help them through their daily routines.

Elder abuse is a complicated term that has yet to be adequately defined in the eyes of the law. Along with physical and emotional abuse, the elderly are susceptible to some types of abuse that could lead to life or death circumstances.

Financial exploitation

Most elderly individuals rely on a limited income, usually a retirement fund or social security payments. As a result, they may be forced to live with their children or other family members to make ends meet. Family members may take it upon themselves to "take care" of the finances by taking over bank accounts and household budgets, thereby allowing them to spend freely without consequences. Family members could also petition for power of attorney, which give them further power to take control of properties and other assets of the elderly individual. When these resources are tapped dry, they are left with nothing and family members who may turn to other forms of abuse to rid themselves of the burden of caretaker.

Neglect

The elderly have to face diminishing physical health and cognitive impairments, which makes their dependence on family members for meeting their daily needs more complete. Their caretakers may fail to administered necessary medication on schedule, causing further deterioration of health. They may intentionally forget to bathe or feed their charges, something vital for those who can no longer perform those activities on their own. Sometimes abusers will utilize especially cruel methods of humiliation, such as waiting until their charge has already soiled themselves to help them to the toilet. This creates an additional layer of helplessness and shame over the inability to control basic body functions. In their weakened states, the elderly would not be able advocate for themselves and sometimes are not even aware enough to understand they are being neglected.

Isolation

The elderly also have a constantly shrinking social network, thereby increasing their isolation from social supports that may help mitigate effects of abuse at home. Health issues also complicate matters by making it more difficult for them to be able to go out without assistance. Even when they are able to speak to friends, the elderly are often ashamed to share abuse that may be occurring because they don't want to admit they can no longer take care of their basic personal needs. They may also feel that they deserve the abuse because their abusers ridicule them for their weaknesses.

What you can do to help, contact Steven Peck's Premier Legal toll free at 1-866-999-9085 to talk to an experienced elder abuse and neglect attorney.

For all the attention paid to the very serious problems of abuse of children, spouses and animals, another group, the elderly, are increasingly being mistreated and abused,
Not only are there more Americans over 60 now than ever before, but it appears that elder abuse cases are rising at a faster rate for that age group. It is a looming problem all over the United States.

The National Center on Elder Abuse, a congressionally funded clearinghouse, says adult protective service agencies nationwide tallied 253,421 reports of elder abuse of adults 60 and older in 2006. That amounts to 832 cases per 100,000 in that age group. That may seem like a small number to some, but research has shown that as much as 84 percent of elderly abuse and neglect goes unreported to authorities. That research has led the Senate Special Committee on Aging to estimate that as many as 5 million older Americans in fact may be victimized every year.

The most recent numbers in California alone are cause for concern. The state Department of Social Services and Ombudsman received more than 30,000 reports of adult abuse or neglect in 2008, according to California elder law and abuse attorney Steven Peck who may be contacted toll free at 1-866-999-9085.Furthermore, the number of people requesting help in has risen almost 40 percent in six years.

What constitutes elder abuse against older people? It can run the gamut, from denying ailing elderly people food, medicine or help with hygiene to ignoring people with Alzheimer's or dementia who may get disoriented and wander from their home. It even extends to physical abuse or murder. Sadly, the perpetrators are most often their own children or, ironically, their caregivers.

The motivations for such mistreatment are often similar to those in child and spouse abuse -- the family member or caregiver takes out their personal problems on the most vulnerable around them, with whom they share a complex love-hate relationship. But with elderly victims, there often is an additional alarming factor: financial exploitation. Americans who have built up life savings only to become unable to handle their own affairs may be at the mercy of greedy relatives or caregivers.

When you consider the stresses that the recession has placed on people of all ages and income levels, there is reason to worry that elder abuse cases will jump in 2009, 2010 and 2011 and into the future.

Congress has added funding to adult protective services agencies in recent years to help combat the problem, but it may not be enough -- and it will help only if elder abuse is reported.

It also is vital that the authorities who receive reports are trained to address the problem. State and local caseworkers can identify a clear case of elder abuse, but a sheriff's deputy or police officer may not. It is here that adult protective services and elderly advocates could better partner with law enforcement, often the first responder in cases of severe abuse.

For its part, California has formed partnerships with advocacy groups to educate the public -- none too soon. The adage "strength in numbers'' does not apply when it comes to the elderly, many of whom must rely upon younger people in their later years.

Contact attorney Steven Peck to talk to an experienced elder law lawyer toll free at 1.866.999.9085 or on the web at www.premierlegal.org

IMAGINE YOURSELF leaving a rehab or long-term care facility to recuperate at home. Once there, the driver helps you inside, and that afternoon there's a knock on the door.

A friendly person says he has been sent by the facility to help at home. You invite him in. How convenient! You need assistance, and here it is.

Payment is discussed. Maybe you write a check. And one of the newest variations of elder fraud is under way.

"It's my biggest peeve," said Melissa McKowan, deputy district attorney for San Mateo County, referring to the relatively recent practice of scammers tracking people coming out of long-term care facilities.

"These people wait outside the hospital and follow the transportation vehicle to the home," said McKowan, a member of her department's Elder Fraud Unit. "Then they ring the bell and claim to be sent by the hospital or facility to provide in-home care. They quote an inflated price ... and get into the house. And they go on from there."

What happens next varies, but the client rarely benefits.

"People knock on the door and in time weave themselves into the lives of the senior," she said. "They may steal a checkbook or take cash from a forgetful client who can't remember if (she) has paid them or not. They may eventually get into the will. Once in the house, they are like termites -- they can clean you out from the inside."

This latest twist reflects increasingly brazen patterns of local elder abuse. Meanwhile, at the international level, McKowan noted increasingly complex telephone pyramid schemes and solicitations from all over the world using sophisticated methods to block identification.

McKowan advises the elderly at home to keep visitors outside unless they know or expect them.

"Keep them at the door and tell them you will get back to them and check," she said. "If you're leaving a hospital and the hospital says it will send a caregiver, you should still check. Normally, the patient calls the caregiver."

Wariness should extend to protecting personal information, including Social Security number, address and phone numbers. She advises shredding all financial information, including statements and bills: "Just tearing things up is not enough."

Detective Glenn Teixeira, of the San Mateo Police Department's Fraud Division, delivered a similar message at a recent presentation on elder fraud at Borel Bank.

Among his tips: Never leave mail in an unsecured mailbox -- send mail through the post office or an official mailbox. Don't leave personal information, including driver's license, Medicare insurance card, AARP card or credit cards, in your car.

Don't provide personal information to unsolicited requests by e-mail or over the telephone. If a nonprofit contacts you for a donation, ask them to send you a request by mail. Only verify personal information when you initiate the call.

Seniors are targeted for specific reasons, McKowan said: "They often live alone, they may have a nest egg, and, having grown up in different times, they are polite."

And as the population ages and the economy remains in the doldrums, McKowan said elder abuse will continue to increase. To protect themselves, seniors need to apply words used in a different context but appropriate here: "Just say no."

Sometimes, McKowan said, "Politeness can get you."

Contact Steven Peck's Premier Legal toll free at 1-866-999-9085 to talk to an experienced elder abuse and neglect lawyer or visit us at www.premierlegal.org

Georgia Fitsos died in October 2007 of acute sepsis and other complications from what her family's lawyer calls "a bedsore the size of a turkey platter," a Stage 4 pressure wound that had eaten deeply into her flesh.

It was discovered almost by chance two months earlier, when Fitsos' son found her suffering unrelated shortness of breath. Paramedics rushed the 82-year-old woman to the hospital from a Folsom board-and-care home, the Broadstone Residential Facility.

Now Broadstone's owner and administrator, Adriana Catuna, and her husband, Viorel, are the focus of pending legal action on three fronts.

A felony elder abuse trial continues in mid-September, and the Fitsos family's civil suit, claiming negligence and wrongful death, goes to court a month later. The Department of Social Services' Community Care Licensing division began license revocation proceedings in late July.

Douglas Broomell, who represents Adriana Catuna in the civil litigation, declined to comment.

Lisa Franco, Adriana Catuna's criminal defense attorney, said: "I've had nothing but good reports from the other patients and families of patients who've stayed at the Broadstone. Mrs. Catuna is not guilty of the injuries that were caused.

"I hope things work out well for Mrs. Catuna," Franco added. "Her patients love her. She has a good case."

The Sacramento County Public Defenders Office, which represents Viorel Catuna in the criminal action, didn't return phone calls.

With a huge demographic wave of baby boomers sweeping into old age in the next two decades, the Broadstone litigation raises a number of issues.

Long-term care for the elderly isn't cheap: John and Peter Fitsos paid a monthly fee of $3,500, which rose to $4,500 in May 2007 after their mother suffered what the family said was a minor stroke.

State regulators monitor the industry, but patient advocates said enforcement can sometimes lag. Barring complaints, about one-third of California's 7,800 residential care facilities for the elderly are randomly inspected each year, said DSS Deputy Director Jeff Hiratsuka.

When families visit care homes, they see facilities that look clean and neat, and they assume this means elderly loved ones are well-tended, said Lesley Clement, an elder abuse attorney representing the Fitsos family in the civil matter.

"If you went into a day care center and found a child dehydrated with diaper rash penetrating to the bone and physically restrained because they're crying, you'd have the district attorney and attorney general's office lining up to take those cases," she said.

Too often, she said, care providers tell families their loved one would have died anyway - and families, who don't know where to turn for help, believe them.

Deputy Attorney General Steven Muni, who is prosecuting the criminal case, agrees.

"Working with law enforcement on elder abuse cases, we're where domestic violence was 20 years ago," he said. "We're still in the process of educating the public and the courts. The elderly are some of our most vulnerable people."

Georgia Fitsos emigrated from Greece to Sacramento in 1952 when she married a fellow native of the Peloponnese who was 30 years her senior. He died in the early 1960s, and she raised their two sons alone in east Sacramento.

She was diagnosed with Alzheimer's disease and dementia in 2006, and it quickly became clear to her sons that she couldn't continue living alone. That fall, she moved into a private room in the Broadstone, where, according to the facility's brochure, residents "can enjoy a lifestyle of Elegance!"

"I've been blaming myself for killing my mother for the past couple of years, because it was my decision for her to go to this facility," said retired attorney John Fitsos, 55, her older son.

He went by the Broadstone regularly to visit his mother, take her out to lunch and bring her to his house, he said.

In July 2007, he took pictures of her with a huge black eye. She told him someone hit her, he said, while Broadstone staff told him that she fell asleep sitting in her wheelchair at the dining table and hit her face on the table.

A month later, he found his mother suffering shortness of breath at the Broadstone and called 911 because, he said, the on-site attendant - who has since returned to her native Romania - didn't speak enough English to make the call.

Besides the bedsores, Mercy Hospital of Folsom personnel found that Georgia Fitsos, a diabetic, had high blood-sugar levels and extremely low blood pressure, according to medical reports. She died that October at the Bruceville Terrace skilled nursing center.

The initial investigation of Fitsos' complaints to Community Care Licensing resulted in Broadstone receiving a $600 fine in late 2007.

"I filed suit when I saw the system fall apart," said Fitsos, who wants to establish a nonprofit group to advocate for reform of the residential care industry.

"I'm not interested in blood money," he said. "I'm not interested in an adversarial situation. I'm interested in seeing legislation passed that really protects the public."

Please contact Steven Peck's Premier Legal to talk to an experienced elder abuse and neglect attorney toll free at 1-866-999-9085.

It is incredible what we find just right here in Los Angeles County "The volume of referrals has increased tremendously in the past few years. And it's not limited to certain socioeconomic or racial categories. It's happening all over the county and the State of California." says Elder Law Attorney Steven C. Peck.

Peck says " hundreds of thousands of statewide reports of adult abuse,neglect or exploitation were made last year to the California state's Adult Protective Services unit. Usually a concerned friend or family member makes the call about adults who are unable to protect themselves due to a physical or mental limitation. But the calls also come from social agencies, health care providers, police officers or any number of sources, according to Peck.

"Abuse and neglect of our elderly and vulnerable citizens happens every day," says Peck. "We need to do all we can to make the public aware that this is a crime which, by law, must be reported."

The number of individuals receiving help through the Adult Protective Services unit has increased nearly 40 percent over the last five years and is growing.

"We've seen a tremendous increase, at least double the number of referrals, in the last three or four months, to our California offices" Peck explains.

More than 80 percent of the time the abuser is related to the victim.

"The No. 1 issue I'm seeing right now is these relatives who are living off their older, frail relatives," says Peck an attorney with Premier Legal located in Van Nuys, California and serving all of the State of California.
" We're seeing a lot of people who are unwilling to place a loved one in a care situation because they can't let go of that money. They are living off their grandparent's or their elderly parent's Social Security check or pension. Medicaid would take that money if they put them in a nursing home."
"We've seen cases where the relative takes the client out of the nursing home, sticks them in a room in the house and leaves them there, just so the relative can live off the client's Social Security check."

Investigations by Adult Protective Services are not limited to residences. The unit also checks reports regarding individuals at nursing homes, assisted living facilities, boarding homes, group homes, mental retardation facilities, hospitals and other settings, Walley said.

"There are a number of laws that specifically apply to crimes against the elderly,"Peck says. "Occasionally we have to take legal action."

A recent MetLife study said that elder financial abuse costs senior citizens more than $2.6 billion per year and is most often perpetrated by family members and caregivers.
"We see a lot of elder fraud and financial abuse," attorney Peck says.

"The saying goes, 'Why do you rob banks? Because that's where all the money is.' Well, that's why they go after older people, because they have savings."

And if responsible family members aren't checking on the spending habits of a parent in declining health, there is more potential for fraud and financial abuse.

"It is not uncommon for us to find that the person handling the money was actually in early stages of dementia and nobody knew it or realized it," Wright said. "So they were not getting the bills paid, or they were making poor judgments, such as getting fixated on lotteries or the Nigerian scams. We see that."

Scam artists prey on older persons because the first thing to go is often a senior's judgment and executive decision making, Wright said.

"It's easy for the families not to realize that something is wrong," she said. "They won't pick up on it until the dementia has progressed a little further. Then they start finding it in the checkbook and say, 'Oh, my goodness, what has happened here?' ... A lot of times that comes to the surface when someone goes to the hospital with a medical crisis."

It is important that family members maintain close contact with their parents, their siblings and the caregivers, especially if the parents live a great distance away from their children. There is more opportunity for financial abuse in those situations.

"For example, a sitter may have access to a lot of financial information and checkbooks, this kind of thing," says Peck, . "They might get that elderly person to sign checks, write checks, and they will cash them.

"Or the family members may be working or out of town and are depending on that caregiver for their parent's transportation to and from the doctors and banks. There is a lot of opportunity for that caregiver, particularly if that elderly person is very dependent on them, to get their name added to bank accounts or cash out CDs."

Attorney Steven Peck says "a good way to keep track on financial matters for out-of-state parents is for the adult child to have a power of attorney, which will enable the child to receive copies of bank statements so they can see what transpires each month."

"The most important thing is to keep close contact with your parents and their needs," he says.

You may contact Elder Law attorney Steven Peck toll free at 1-866-999-9085 or visit him at www.premierlegal.org for your free consultation. Act Now!!!

Whether you're a paid caregiver or someone just helping out the family of an elder in need, you are responsible to report elder abuse issues or elder abuse neglect. The very young and very old among us are often targets of abuse and/or neglect; it is our duty to report such issues.

Here's a few signs to looks for regarding elder abuse or neglect:

1. Unexplained bruises, cuts or soreness - bumps do happen but if you are seeing a pattern to bruises, cuts or soreness (for example, are they occurring after weekend visits from family?), you must report these incidents.

2. Guarded behavior such as reluctance or avoidance of conversation.

3. Observed changes in the elderly persons behavior around others - does he or she become quiet or cower when others are present? Does the atmosphere in the room change when one particular person appears?

4. Is the elderly person clean and comfortable? Cleanliness becomes more difficult as we age but, at the very least, clothing should be fresh and unsoiled.

5. Is the elderly person always asking you for food or water? This could be a sign that they're not getting enough when you're not there.

If you or anyone else see signs of any kind of elder abuse (remember, emotional abuse is every bit as damaging as physical abuse), please contact Steven Peck's Premier Legal at 1-866-999-9085 to talk to an experienced elder abuse and negelct attorney.

Written patient care policies and procedures shall be established and implemented to ensure that patient related goals and facility objectives are achieved as is established by California Administrative Code Title 22 Section 72523.
(b) All policies and procedures required of these regulations shall be in writing, made available upon request to physicians and other involved health professionals, patients or their representatives, employees and the public shall be carried out as written. Policies and procedures shall be reviewed at least annually, revised as needed and approved in writing by the patient care policy committee.
(c) Each facility shall establish and implement policies and procedures, including but not limited to:
(1) Physician services policies and procedures which include:
(A) Orientation of new physicians to the facility and changes in physician services and/or policies.
(B) Patient evaluation visits by the attending physician and documentation of alternate schedules for such visits.
(2) Nursing services policies and procedures which include:
A) A current nursing procedure manual.
(B) Provision for the inventory and identification of patients' personal possessions, equipment and valuables.
(C) Screening of all patients for tuberculosis upon admission. These procedures shall be determined by the patient care policy committee. A tuberculosis screening procedure may not be required if there is satisfactory written evidence available that a tuberculosis screening procedure has been completed within 90 days of the date of admission to the facility. Subsequent tuberculosis screening procedures shall be determined by the attending physician.
(D) Notification of physician regarding sudden or marked adverse change in a patient's condition.
(E) Conditions under which restraints are used, the application of restraints, and the mechanism used for monitoring and controlling their use.
(3) Infection control policies and procedures.
(4) Dietary services policies and procedures which include:
(A) Provision for safe, nutritious food preparation and service.
(B) A provision for maintaining a current dietetic service procedure manual.
(5) Pharmaceutical services policies and procedures.
(6) Activity program policies and procedures.
(7) Housekeeping services policies and procedures which include provision for maintenance of a safe, clean environment for patients, employees and the public.
Contact Steven Peck's Premier Legal toll free at 1-866-999-9085 or visit us at www.premierlegal.org to talk to an experienced California Nursing Home and Abuse lawyer.

If you or someone you love is injured or dies in a medical malpractice case, there are limits to how much money you can recover in court.

A recent challenge to the California state law that caps some damages was struck down in a state appeals court. But the issue may be headed to the state's high court next.

Holly Stinnett's husband, Stanley, died after a series of medical mistakes in a hospital.

"Never in my entire life did I ever see myself at 39 being a widow, never," Stinnett said.

She sued the doctor and the hospital, and the hospital settled just before trial.

A jury found the doctor negligent and awarded Stinnett $1.4 million in medical costs and lost wages and, $6 million for pain and suffering.

However, Stinnett will likely collect much less because of a state law that limits damages for pain and suffering in medical malpractice suits at $250,000.

The California State Legislature passed the Medical Injury Compensation Reform Act -- or MICRA -- back in 1975.

The state legislature was supposed to keep doctors' insurance rates reasonable so they wouldn't leave California to practice somewhere else.

Dr. Paul Phinney, who works for the California Medical Association, said MICRA has held doctor insurance premiums down.

"MICRA stabilized that situation and provided a mechanism of compensating patients fairly, while still preserving access for patients to quality, affordable medical care," Phinney said.

Under MICRA, medical costs and lost wages -- called economic damages -- are unlimited.

"The more money that's pulled out of health care into the pockets of personal injury lawyers, the less money that's available to health care," Phinney said.

Pain and suffering -- or non-economic damages -- are limited to $250,000 dollars.

Chris Dolan with Consumer Attorneys of California says that's not justice.

"If you lose your husband, your wife, your child, your leg, that value is $250,000," Dolan said.

What's worse, Dolan says, economic damages don't apply to the elderly and children.

Those patients or their families can only collect up to $250,000.

"It was just a terrible thing to do to people who've been harmed and a great thing to do to the insurance companies' bottom line," Dolan said.

"You can't replace what I've lost, but for future people, for the people out there that do need that, to get started again, they need to change the law," Stinnett said.
Contact Steven Peck's Premier Legal toll free at 1-866-999-9085 to talk to an experienced elder law and nursing home abuse and neglect lawyer or on the world wide web at www.premierlegal.org

The shame of elder abuse does not diminish; it simply escalates so that an estimated 2 million elder Americans suffer abuse: physical, mental, financial. It can occur at home or in a facility. The abuser can be a family member or a hired caregiver.

The situation threatens to worsen; the Census Bureau estimates that by 2030, 1 in 5 citizens will be 65 or older, and by 2050, the 85-plus group will have tripled.

We live in communities where friendships are important and privacy is respected: It is not our business to question what goes on behind closed doors. On the other hand, we should recognize these signs of abuse and make it our business to check them out.

Some clues to look for:

-- Unexplained injuries: bruises, scratches, fractures.

-- Serious and persistent bed sores, signs of improper nursing care.

-- Persistent or chronic infections ---- more signs of improper care.

-- Sudden or chronic weight loss; is food being withheld?

-- Unsanitary living conditions, linens not changed, clutter ignored.

-- Increasing dehydration; is water being withheld?

-- Sexual abuse: unusual bleeding, suspicious injuries, STDs.

-- Repeated wandering; patients who have dementia or Alzheimer's disease may not be monitored correctly.

-- Excessive costs, financial fraud, overcharging on medical bills, etc.

Financial scams and fraud are insidious forms of elder abuse that require alertness and special precautions. Steven Peck an elder law attorney in Los Angeles, California says

"Beware of "fake charities." Call the Better Business Bureau or Attorney General's office if you are suspicious. Ask door-to-door solicitors for a business permit or registration, or just say firmly, "No, thank you."

Be wary of get-rich-quick schemes. Never invest before you investigate. Don't hesitate to call the Department of Corporations at 866-275-2677.

Besides financial scams, elder lawyer Steven Peck lists these categories of abuse: abandonment, false imprisonment, isolation, neglect, physical abuse that includes restraints, and finally, psychological abuse.

Examples are chilling:

A caregiver or new friend pressures you or a family member to hand over power of attorney so he can "help straighten out" finances. It is possible to lie sick, malnourished and suffering with bedsores while a relative is emptying the bank account or an aide is ignoring responsibilities.

A home repairman can be persuasive ---- pay cash on the spot for the great job of home improvement he will do. It happened to us once ---- only once!

The epitome of abuse is when you forget to take your meds and the nurse on duty slaps you across the face. It happened!

If you suspect mistreatment in a nursing or care home, call Steven Peck's Premier legal to talk to an experienced elder abuse and neglect attorney toll free at 1-866-999-9085 or visit us on the web at www.premierlegal.org.

According to a National Study, 84 percent of elder abuse cases go unreported. Why? In some cases, the abuser may be the only caregiver. Other instances are more subtle: for example, adult children who never visit a mother. They are abusing her by leaving her feeling isolated and unloved. Or the nursing home patient who is ignored, treated roughly is often afraid to complain.

We must be sensitive, observant and unafraid to register a complaint. Speak up! You might save the quality of life ---- or even the life ---- of a friend or relative.

Standing to seek Restraining Orders in California is granted to any "interested person" under California Welfare & Institutions Code Section 15600 (j) which reads "It is the further intent of the Legislature in adding Article 8.5 (commencing with Section 15657) to this chapter to enable interested persons to engage attorneys to take up the cause of abused elderly persons and dependent adults."

ARTICLE 8.5 includes Section 15657.03 which provides for Restraining Orders and distinguishes the "elder" from the "Applicant" seeking the restraining orders.

Attorney Fees and Costs are Available when you represent an Applicant seeking Restraining Orders.
Contact Steven Peck's Premier Legal toll free at 1-866-999-9085 to talk to an experienced elder law attorney about restraining orders or at www.premierlegal.org

There are far too many sad, but true crime stories of seniors and the elderly being abused, whether physically, emotionally, mentally or financially.

What can you do to protect yourself or your elderly loved ones?

Stay educated about identity theft, recent identity theft scams, identity theft laws, your rights, remedies and so on. Here's a great list of resources to check out and save.
Trusted Sources for Helpful Information on Protecting Yourself from Identity Theft:

AARP, the American Association of Retired Persons offers tips through their magazine and their website.
IDtheft.gov is the federal government's website resource.
The non-profit organization, Identity Theft Resource Center, has information on their website, , as well as a toll free number, 1 (888) 400-5530.
The US Department of Justice
Visit this website to learn more about the Older Americans Act,
If you're not internet savvy, your local library can assist you with internet research.
Many seniors have carried their social security card and number around for decades and it is a hard habit to break but seniors need to understand that today the practice simply isn't smart or safe. Medicare card numbers put seniors at risk too. Instead seniors can leave their cards secured at home and instead carry a copy of their Medicare card with them, with the SSN blacked out. This will help you get the medical treatment you need in case of emergency and but still keep your information safe in case of a theft. Hospitals will not deny treatment based on carrying a copy of your Medicare card. The real card can be presented later.

Do not give out information over the phone, especially bank account or credit card information. If someone calls and claims to be from a bank or credit card company, hang up and call the institution back at a number you already have on a statement. Real institutions will not ask you for sensitive information over the phone and will already have the answers to the questions scammers are fishing for.

There are so many worthy charities out there and unfortunately so many charity scams that want to prey on the generosity of the elderly. CharityNavigator.org is a trustworthy site for researching charities before giving.

Invest in a shredder and a lock safe box. Keep and lock up tax returns for seven years but you have 15 year old tax returns, it is time to shred them.
Wayne Stenehem, the North Dakota Attorney General, spoke at the West Central Vulnerable Adults Coalition event and shared, "Certainly things you need to keep indefinitely like your marriage, divorce, other family, military records. Those kinds of things you keep forever, but your bank accounts and your telephone accounts, those kinds of things can be destroyed."

Shred all pre-approved credit card offers. They put you at risk for identity theft.

Never sign the back of your credit cards. Instead write photo i.d. required. This makes a stolen credit card less useful in retail stores or banks, although it could still be used for on-line or phone shopping.

Signing up for the Do Not Call Registry can help protect your phone number from scammers.
-Opt out of receiving offers based on your credit report by calling 1-888-567-8688, the Federal Trade Commissions "opt out" line.

Review your financial records including banking, credit card, Social Security benefits, insurance statements and Medicare statements as they arrive for inaccuracies.

Use passwords but choose carefully. It's tempting to chose an easy to remember number like the last four digits of your social or your birthday but these are too easy for identity thieves. Also, don't write down and keep your passwords on your desks, in your purse or address book. Lock these away in your lock box too.

Don't carry credit cards with you that you don't need. Be sure to make copies of cards and have all phone numbers on file in case your card is stolen or accessed.

Protect your mail from identity thieves. Use a locking mailbox and cancel mail delivery through your post office when you will be away.

Don't put your trash out way ahead of time for curbside pick up and make sure any trash bins you store outside aren't easily accessible without being seen. Dumpster diving is just one small way identity thieves go treasure hunting but it still happens..

Lastly, be very careful when issuing a power of attorney. Don't make a quick, rash or emotional decision and be very suspicious of new acquaintances or newly interested relatives that offer to be your power of attorney. Power of attorney really does offer a lot of power.
Contact Steven Peck's Premier Legal to talk to an experienced elder law attorney toll free at 1-866-999-9085 or visit us at www.premierlegal.org

Governor Schwarzenegger has signed Assembly Bill 392 (Feuer), urgency legislation that will immediately restore $1.6 million for local Long-Term Care Ombudsman programs over the next year. The bill will help ensure protection from abuse and neglect for California´s vulnerable and elderly residents of nursing care and assisted living facilities.

"This legislation could make the difference between life and death for nursing home patients facing abuse or neglect. Now patients and their families who depend on the Ombudsman to monitor facilities and investigate key complaints can rest a little easier," said Assembly member Mike Feuer (D-Los Angeles).

The funds for the local programs will come from existing penalties paid by long-term care facilities that have failed to comply with federal laws for the protection of residents, meaning that AB 392 has no General Fund costs.

Last year, Governor Schwarzenegger vetoed $3.8 million in funding for local Ombudsman programs, representing about half their funding. As a result of the cuts, the programs have been forced to lay off staff and drastically reduce services, compromising their abilities to investigate complaints and monitor facilities.

Since these cuts have taken effect, residents have suffered the dire consequences of unchecked poor treatment. In late June 2009, a Northern California facility owner and one care giver were arrested on suspicion of criminal abuse and neglect of a resident whose untreated pressure sores were so severe that they resulted in fatal sepsis. After the arrest, the two suspects posted bail and continued to collect payment to provide care for the six other facility residents. With the funding restored for the next year, local Ombudsman programs will be able to respond to cases where similar reports of abuse are made.

"California´s senior citizens not only bear a disproportionate share of reductions in health and home care services, but they are particularly vulnerable to abuse," said Assemblymember Dave Jones (D-Sacramento), a joint author of the bill. "This is prevents the rollback of the oversight and protections provided by the Long-Term Care Senior Ombudsman program. I am pleased to join Assembly member Feuer in authoring AB 392 and speaking out to protect funding for this invaluable program."

Local Ombudsman programs conduct frequent unannounced monitor visits to facilities, and they provide timely response to reports of suspected abuse and neglect. They investigate thousands of abuse cases each year. Without the scrutiny of the Ombudsman programs, the facilities are reviewed just once a year (or less) by government agency inspectors. No other program duplicates this critical advocacy service.

California´s population of adults over 60 is projected to grow to 6.5 million by 2010 and up to 9 million by 2020. As Californians grow older, it will be especially necessary to make sure that the long term care facilities that serve this population are properly monitored and complaints investigated.

Steven Peck's Premier Legal is devoted to the representation of elders. Contact us toll free at 1-866-999-9085 to talk to an experienced elder law attorney.

In the United States, two-thirds of nursing homes are investor-owned, for-profit businesses. But are they better than not-for-profit homes? The results of an analysis published today suggest that not-for-profit homes, overall, may provide higher quality care.

The paper, published online in the British Medical Journal, examined 82 studies carried out in the United States and Canada between 1965 to 2003. Forty studies showed significantly better quality in not-for-profit homes and three showed the quality was better in for-profit homes. The remaining studies, however, had mixed results, which suggests wide variability among institutions.

Nursing homes, whether for-profit or not-for-profit, vary substantially in their management styles, motivations and organizational behavior, the authors note. Thus, they wrote, the report is not a blanket judgment of all institutions. "Some for-profit institutions may provide excellent quality care, whereas some not-for-profit institutions may provide inferior quality care."

However, in the big picture, the analysis found that nursing home residents in the United States would receive 500,000 more hours of nursing care per day if all not-for-profit institutions provided all nursing home care.

Given the costs of nursing home care and the fears families have about the well-being of their loved ones, more research describing the qualities of superior nursing homes might be in order.

Contact Steven Peck's Premier Legal toll free at 1-866-999-9085 to talk to an experienced nursing home abuse and neglect attorney.

Elder abuse, also referred to as elder mistreatment, is any abuse or neglect of a person aged 60 or older by a caregiver or another person in a relationship involving an expectation of trust that threatens his or her health or safety. It is difficult to determine the prevalence of elder abuse because many times cases are not reported. A 2003 National Research Council report estimated that there are between 1 million and 2 million cases of elder abuse and neglect in the United States every year. Family members, adult children, or spouses are implicated in 90% of the cases of elder abuse. Those affected are usually elderly people who are cognitively or physically frail, depressed, lonely, or lacking social support. The August 5, 2009, issue of JAMA is a theme issue on violence and human rights that includes an article reporting that both elder abuse and self-neglect in a community-dwelling population are associated with an increased risk of death.

TYPES OF ELDER ABUSE

Physical abuse such as the infliction of pain or injury,including physical or drug-induced restraint

Sexual abuse, including any nonconsensual sexual contact

Emotional abuse, including infliction of any mental anguish

Caregiver neglect--refusal or failure to fulfill caregiver obligations to meet basic needs, including food, clothing, housing, and medical care

Financial exploitation, including any unauthorized orimproper use of the funds or resources of an elderly person

RISK FACTORS FOR ELDER ABUSE

Elders with memory problems (such as dementia) or who are physically dependent on others

Elders with depression, loneliness, or lack of social support

Caregiver stress when the caregiver feels overwhelmed with the care of the elder

Caregiver has history of substance abuse or history of abusing others

Caregiver has high emotional or financial dependence on the elder

PREVENTION OF ELDER ABUSE

Intervene if you suspect elder abuse--in California contact Steven Peck's Premier Legal elder care help line at 1-866-999-9085 to talk to an experienced elder abuse and neglect attorney or go to www.premierlegal.org

Listen to elders and their caregivers.

Get help from family, friends, or local support groups.

Seek counseling or other support if you are feeling stressed or depressed.

Get help if you have substance abuse problems.

Older adults who are subjected to abuse or self-neglect face a greater risk of premature death than other seniors, according to a study published in the August 5 issue of JAMA.

Moreover, contrary to widely held views that elders who are physically or cognitively impaired are more likely to suffer adverse consequences from abuse or self-neglect, the researchers found that even more capable seniors also faced a higher risk of dying.

Elder abuse and self-neglect are serious, common and under-recognized public health issues, according to Dr. XinQi Dong, a researcher and geriatrician at Rush University Medical Center and the study's lead author. There are an estimated 2 million cases of elder abuse and self-neglect in the United States each year.

"Our findings demonstrate the dire health consequences for these vulnerable older adults," Dong said. "Health care professionals and others who serve the elderly need to identify and report suspected cases of abuse or self-neglect early and act quickly to ameliorate the problems."

The researchers examined records for 9,318 individuals 65 years of age and older who were enrolled between 1993 and 2005 in the Chicago Health and Aging Project, a longitudinal epidemiological study of a community-dwelling population. In-person interviews were conducted to assess the participants' health history, physical function, cognitive function, health behaviors and psychosocial factors.

Of the 9,318 participants, 1,657 came to the attention of social agencies because of reports of abuse or self-neglect. Abuse refers to psychological/emotional abuse, physical abuse, sexual abuse, caregiver neglect or financial exploitation. Self-neglect refers to behaviors that threaten the person's own health and safety.

The study found that elder abuse was associated with a more than two-fold increased risk of premature death from all causes and an almost 4-fold increased risk of premature death from heart disease specifically. Self-neglect was associated with an even greater risk of premature death, particularly during the first year after self-neglecting behavior was identified. During that year, the risk of premature death from all causes was five times as likely as for elders who did not neglect themselves, and the risk of premature death from heart disease specifically was eight times more likely.

The researchers considered alternative explanations for the increased risk of dying prematurely -- including differences in sociodemographic characteristics, medical conditions, health habits, cognitive function, physical function, depression and social networks -- but none of these factors significantly altered the findings.

The study also found that increased mortality was significant for older adults subjected to abuse or self-neglect no matter what their level of physical or cognitive function, except for one group: abused elders with the highest level of functioning. The researchers speculated that these individuals perhaps had more insights into the dangers of the abusive behaviors, were more likely to seek help, or had the ability to modify the relationship with the perpetrator, and so were able to escape the threats to their safety and well-being.

According to Dong, the field of elder abuse is estimated to have lagged more than 20 years behind that of child abuse or intimate partner violence.

"With the rapidly growing aged population in this country, problems of elder abuse will likely become even more pervasive, affecting our family, friends and loved ones," Dong said. "We hope our study will stimulate more discussion about these problems and help advocate for additional research and resources, as well as national policy initiatives, to improve the health and well-being of this vulnerable population."
Contact Steven Peck's Premier Legal to talk to an experienced elder abuse lawyer toll free at 1-866-999-9085.

With several key senior programs facing drastic cuts, those who work with this population say the new California state budget gives a new spin to the term "elder abuse."

Programs that provide food for seniors, and also help keep them in their own homes are slated to be gutted by Oct. 1, according to Steven Peck, an elder law attorney located in Van Nuys, California.

In signing the 2009-10 budget, Gov. Arnold Schwarzenegger eliminated nearly $10 million for senior programs statewide, thereby crippling services for millions of seniors, says Peck. "I would call it a crisis," says Peck,

The new California state budget sends a message that seniors are not valued and also gives a new definition to the term "elder abuse,"

All California counties were bracing for the big budget reductions, and are now totally unprepared to deal with loss of all the funding for the elder abuse programs.

"These are very significant cuts" and come at a time when the elder community is seeing a greater demand for services as a result of epidemic elder abuse.

Also targeted are Alzheimer's Day Care Resource Centers (ADCRC), which provide day care for those with Alzheimer's disease, and other forms of dementia who can't be served by other programs.

Last year these centers provided tens of thousands of days of care for thousands of elders abused in California.

Efforts are under way to have local food banks pick up those services so that elders continue to get food regularly.

For more details concerning elder law, elder abuse, and neglect contact Steven Peck toll free at (866) 999-9085, or go to www.premierlegal.org

Kathy Greenlee views the aging of America as a national benefit, even as she acknowledges caring for senior boomers eventually will cost the government millions of dollars.

The question is: How to make the cost of that care economical and beneficial? Better put: How to give the best value to the aging senior and the taxpayer?

We will see a "great wave of social capital," she says, as younger, active seniors take a greater role in volunteering, philanthropy and maintaining their positions in the workforce.

"These seniors will change the definition of everything," says the new U.S. assistant secretary for aging at the Department of Health and Human Services.

Greenlee, confirmed at the end of June, revealed her aspirations for aging Americans last week at the Minneapolis-based conference of the National Association of Area Agencies on Aging.

It is time, she told me by phone after her speech, "to rewrite the concept" of age and retirement as the oldest of 76 million boomers reaches age 63.

The goal is to keep seniors - they are people 60-plus, she tells me - active and productive. That means taking care of themselves and not expecting government aid.

But even as she spoke, California's legislature battled budget constraints that forced cutbacks in senior services, particularly home health care, used primarily by frail seniors - usually defined as folks older than 80.

Without state-supported home health care, a larger percentage of these frail seniors end up in nursing homes, where their care is paid by Medicaid, a combination of state and federal dollars. Nursing home care on average costs three times the amount of home-based care, according to AARP.

"As secretary of aging in Kansas, I did a study on Medicaid support,"

Greenlee said. "Most seniors have some form of financial support but need to find help in extending it longer. For example, 20 percent of all seniors in Kansas nursing homes spent down $40,000 to $70,000 of their money to pay for the nursing home and then went on Medicaid, which pays the entire bill. If their money could have been supplemented with government-sponsored home care, they could have stayed home longer and actually used fewer government dollars overall.

"There has to be a way to create policy to allow people to stay at home and age in a place that's more manageable," Greenlee said shortly after her appointment. "The services people want are often the least expensive to deliver if we can figure out how to do it - how to shape that program so it works and sustains the increasing number of seniors who ask for those services."

She describes the necessary core services - meals on wheels, home health aide, exercises, transportation.

"We need to find balance and connection," she said. "We need a blurring of the lines between what we consider nursing home care and health care."

Keeping seniors at home also requires attention to socialization, she says. "We have to help them with isolation, boredom, depression. We need a new kind of intergenerational program, one with a new lingo."

Greenlee would connect more seniors to the middle-aged population, people in their 40s and 50s. Seniors, she emphasizes, "need to know they have a reason to live."

"I think the greatest pressure will be to throw the spotlight on the local senior networks, to bring to conversation at the federal level what these organizations are and how we can create partnerships," she said. "People are doing terrific work for seniors, and we need to celebrate what we do collectively."

Bringing senior service groups to the federal table to share collectively would be a positive solution, agrees Marilyn Ditty, head of the Orange County (Calif.) South County Senior Services. "We all share the same goals of keeping people in their homes - healthy, secure and part of our communities."

Everyone agrees on goals, but the support dollars are most often lost in translation.

"What we have now is specific," Greenlee said. "We need to come to the table and network, share information and get systems in line."
Contact Steven Peck's Premier Legal toll free at 1-866-999-9085 to talk to an experienced elder law attorney