Finances as a health issue for seniors

Doctors are being encouraged to make sure elderly patients aren't victims of fraud

April 10, 2011|By Eileen Ambrose, The Baltimore Sun

We have a special relationship with our doctors. We trust them and tell them intimate details about our lives. And doctors who see us regularly are likely to notice changes from visit to visit that might signal that all is not well.

That's why some regulators and advocates for the elderly are reaching out to primary-care physicians, hoping they will use their unique position to help spot when older patients — particularly those with mild cognitive impairment — are victims of financial fraud.

About half the states so far have signed on to the Elder Investment Fraud and Financial Exploitation program that aims to train doctors on the red flags of financial exploitation and gives them the information they need to refer patients for help.

The program is run by the nonprofit Investor Protection Institute and the Baylor College of Medicine. Maryland regulators say they will be watching how the program develops before deciding whether to join in.

Diagnosing financial fraud may seem an unlikely role for busy doctors. But finances are a health issue, say regulators and geriatric specialists. Elderly patients bilked out of their savings can be under heavy stress that causes their health to deteriorate or leaves them unable to afford medicine and regular visits to the doctor.

"Financial health directly relates to physical health," says Tina Kotsalos, investor education coordinator with the Pennsylvania Securities Commission, which has joined the program. "Those people who have been scammed often fall into severe depression. And there are studies that show that fraud victims die sooner."

Besides, doctors are expected to keep an eye out for patients' financial well-being. Most states, including Maryland, require physicians to report financial exploitation of elderly patients to adult protective services.

Certainly, older Americans could use an extra layer of protection.

The Investor Protection Trust reported last year that one out of five Americans ages 65 and up said they were victims of a swindle. And a 2009 MetLife study estimated that the elderly are bilked out of $2.6 billion annually. Those numbers are only likely to grow with millions of baby boomers heading into retirement.

The Elder Investment Fraud program grew out of a 2009 pilot project at Baylor College of Medicine in Texas.

Robert Roush, director of Baylor's Texas Consortium Geriatric Education Center, helped launch it. He says he became interested in the issue after learning that the elderly parents of Christopher Cox, the former chairman of the Securities and Exchange Commission, had been swindled.

If that could happen to the parents of an SEC chairman, Roush says, what did that mean for the rest of us?

He and colleagues at Baylor started researching why some seniors were more vulnerable to fraud.

Roush says the brain naturally shrinks and loses fluid as we get older, which can contribute to a weakening of mental skills. Patients who develop this so-called mild cognitive impairment can carry on with their usual daily activities, but they become less risk-averse with their money and are four times more likely to make financial mistakes than their healthy counterparts, Roush says.

And the number of Americans in this stage of health is significant. A Duke University Medical Center study found that 35 percent of those ages 71 and older suffered from cognitive impairment.

The Baylor team held focus groups with primary care physicians, asking them if they would consider screening for financial fraud and how best to approach patients about money matters without offending them, Roush says.

From that, Baylor developed a continuing medical education program that trained Texas doctors how to quickly spot financial abuse of those with mild cognitive impairment.

It also developed a pocket guide with a list of red flags to look out for and questions to ask patients. The guide gives doctors who detect financial fraud a list of resources to refer patients to, including the United Way, securities regulators, elder law attorneys and adult protective services.

Roush is working with the Investor Protection Institute, National Adult Protective Services Association, the North American Securities Administrators Association and others to take the program nationwide.

Pennsylvania, for instance, will start training doctors later this spring.

"We definitely don't want to burden doctors," says Kotsalos of the Pennsylvania Securities Commission. "We just want them to have a place to go if they see or suspect some form of this abuse."

Maryland already trains bankers to spot when older customers might be victims of fraud. Some Maryland geriatricians see a role for doctors, too.

Dr. Colleen Christmas, a geriatrician at the Johns Hopkins University, says she used to be uncomfortable about asking patients about money, but no more.

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