Chapter 10: Crimes Against the Elderly
Myrtle was in her 90s and homebound when discovered by Adult Protective Services. Her only child made a visit from out of state and found her mother in poor condition. Jim, a distant relative in his 40s, was residing in Myrtle’s home. Jim claimed to be caring for Myrtle, but the home was cluttered and dirty and the food on hand sparse. Myrtle stated that she wanted to be left alone and that her daughter was a troublemaker who was after her money. On follow-up visits, Myrtle was observed to be sitting in the same filthy robe and slippers, her hair greasy and her bed linens soiled. A guardian was appointed and attempted to arrange home care, but due to Jim’s interference and Myrtle’s unwillingness to cooperate, services could not be provided. On the final attempt, a visiting nurse found Jim passed out on the lawn. Further investigation revealed that Jim was obtaining narcotics in Myrtle’s name and that her investments had been cashed out and her bank accounts emptied. Myrtle was moved to an assisted living facility and for the first few weeks was tearful and disoriented, crying frequently and requesting to be taken home. Eventually, Myrtle’s distress abated and she began to ask about her daughter. Three months after her placement, Myrtle had no recollection of Jim and was thriving. She had become an active participant in social activities and was enjoying all that the facility had to offer. Her daughter continued to visit from out of state, enjoying access that Jim had discouraged. Myrtle spent the next several years in good health and could not recall ever having been skeptical of her daughter’s intentions. Jim was never heard from again. The significant monies that disappeared while Jim was living with Myrtle were not able to be recovered, and Myrtle was left with tax liabilities, interest, and penalties to pay.
1: Did Jim exploit Myrtle? How? What were the consequences? |
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| 2: Did Jim neglect Myrtle? How? |
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Gertrude was 83 years old when a pattern of being brought to the hospital by her daughters with dehydration and low blood sugar prompted a report to Adult Protective Services. APS found Gertrude’s home to be in deplorable condition. Her daughters, in their 50s, appeared to have a hoarding disorder. After APS arranged for some clearing of clutter and the daughters agreed to enroll Gertrude in adult day care, the case was closed, only to be reported again the following year. When APS revisited, the home was in worse condition than before. Many rooms were impassable, and a leaking refrigerator was causing rot and slippery floors. Again, APS arranged to clear clutter. Gertrude’s daughters stated that they were caring for Gertrude as best they could, cooking breakfast every morning, sending her to day care when she was willing to go, and fixing dinner every night. A guardian was appointed for Gertrude, and home care sought, but services could not be provided due to the condition of the home. Gertrude’s daughters resisted any further cleaning or clearing of clutter, insisting that Gertrude wanted to hold onto every item. Gertrude herself said very little, but knew that she did not want to go to a nursing home. After several more trips to the hospital, however, Gertrude was placed in a nursing facility. Later, it was discovered that most of the kitchen appliances and the bathtub were not operational-though the daughters had reported cooking and bathing-and Gertrude’s bed was infested with insects burrowed into the underside of her mattress. Gertrude had been complaining about being bitten, but her daughters thought that she had been imagining it. Gertrude’s condition improved in the nursing facility. A month after placement, when asked about going home, she responded that it might be better if she stayed in the nursing home. Her daughters insisted that she desperately wanted to return home, but Gertrude never conveyed that desire to anyone else involved in her case.
3: Why was a guardian appointed for Gertrude? Who generally initiates guardianship proceedings? |
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| 4: How can forensic nurses become advocates for elders facing abuse? |
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After a brief hospitalization, Dot, in her 80s, was referred to a visiting nurse association for follow-up care. Dot was weak and confined to bed, and her sister, Helen, in whose home she lived, was caring for her. The visiting nurse observed Helen to be inappropriate during caregiving. Helen would yank Dot by the hair in order to lift her head or change her position, and would yell at her and leave her unattended for lengthy periods of time. Dot was nonverbal due to dementia. Helen denied being inappropriate with Dot and stated that she loved her sister more than anything in the world. A guardian was appointed for Dot for the limited purpose of finding her a nursing home placement. When a nursing home was located, Helen became extremely agitated, began to yell and scream, and attempted to block ambulance drivers from transporting Dot to the facility. Helen called for emergency assistance from police. The responding officers convinced Helen to permit Dot to be transported to the nursing home, informing her that she would be arrested if she tried to interfere. In the months after Dot’s placement, Helen was extremely stressed, crying each day and begging for Dot to be returned home. Helen expressed her inability to carry on without Dot, saying that she missed her sister and had no reason to live with Dot gone. Helen was encouraged to visit the nursing home frequently, and a bus pass was obtained for her to make transportation easier. Two years after Dot’s placement, Dot was in good physical health but remained nonverbal. Helen, however, had experienced a significant decline in her physical and mental health, and continued to talk about how upset she was that Dot had been removed from her home.
5: Was Helen aware of her abusive behavior? |
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| 6: How would you describe Helen's mental health state? How did this affect her ability to care for Dot? |
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