Nursing Homes Abuse Blog - By Jonathan Rosenfeld

Perhaps one of the most de-humanizing aspects of nursing home life is the reliance on others for toileting needs. Especially in the case of bed-bound residents, notifying a staff member every-time one needs to use the toilet, means being reliant on others for basic bodily functions.

When the staff fails to timely assist with toileting needs, the results can be not only embarrassing but downright dangerous.  If left in their own waste, residents are at an increased risk of pressure ulcers (also referred to as bed sores, decubitus ulcers or pressure sores) and infection.

This failure to timely tend to the toileting needs of residents resulted in Glendale Home's $20,800 federal fine and their staff's mandatory enrollment in 'dignity training'.  The sanctions come after six residents complained to New York Department of Health officials that the staff at the facility humiliated them when they failed to answer their calls for assistance in using the toilet.

In the case of an obese nursing home resident, who required two-person assistance and a mechanical lift for transfers with transfers out of bed, a nursing home inspector noted:

"She state that sometimes staff would become angry with her for calling out when they were so bust and tell her she would have to wait.  She also stated that when she was waiting for help she would be in pain from the urgency of needing to void.  The resident said that on several occasions she had wet herself while waiting for the staff and that she was mortified and embarrassed when she wet her bed."

In another case, nursing home inspectors observed a man sitting naked on a bed pan who was yelling for staff to close the door as attempted to gain some privacy.

When officials questioned the nursing home staff about the delay in bringing residents to the toilet and obvious disrespect of privacy, many said the some days the facility seemed short staffed in order to cope with the needs of the residents. In addition to delays in toileting, the under-staffing was also manifested by the fact that some residents were not turned in their beds or bathed regularly.

Despite the staff's own contention that the facility was under-staffed, the facility administrator chose to 'redeploy' the current staff to cope with spikes in call-bell use as opposed to hiring more staff.

Read more about the disrespect of nursing home residents in New York here.

Related Nursing Homes Abuse Blog Entries

Nursing Home Owner Leave Resident On Bedpan for 24-Hours, Now Faces Jail Time

Call Lights. How Should Staff Respond?

Incontinence Amongst The Nursing Home Population

Too we look to environmental causes of falls....cluttered hallways...improperly footwear...yet in many fall-related situations the real 'cause' of the fall lies within the person herself...

Hypotension (low blood pressure) is a problem for many nursing home residents, causing dizziness and fainting. Blood pressure readings measure the pressure in arteries - systolic pressure (the top number in a reading) measures the pressure the heart generates when pumping blood out to the rest of the body and diastolic pressure (the bottom number in a reading) measures the amount of pressure between heartbeats. A systolic blood pressure of 90 millimeters of mercury or less or a diastolic blood pressure of 60 millimeters of mercury or less is considered low.

Orthostatic hypotension, also known as postural hypotension, occurs when a person’s blood pressure drops after changing position from lying down or sitting to standing as blood pools in the legs leaving less blood to circulate back to the heart. In the elderly, orthostatic hypotension can be caused by changes in blood pressure regulation due to aging, dehydration, and certain medications.

Common causes of orthostatic hypotension include dehydration, medications, heart problems, diabetes, and nervous system disorders; all of which are common in the elderly. Dehydration can occur easily in nursing homes because of sickness or inadequate care. Also, many drugs commonly prescribed to the elderly including diuretics, high blood pressure medication, heart medication, and drugs to treat Parkinson’s disease can all cause orthostatic hypotension.

Orthostatic hypotension is more common in older adults, with over 15% of persons 65 and older suffering from it. In addition, about 50% of elderly nursing home residents suffer from orthostatic hypotension. Elderly patients, especially those who are heavily medicated or have prolonged bed rest, are especially at risk. Nursing home patients are also at risk for dehydration if they do not receive adequate care.

Orthostatic hypotension can cause dizziness, light-headedness, blurry vision, nausea, and fainting, which can cause dangerous falls. Elderly persons are particularly vulnerable to falls because of weak bones and complications from other health problems. Orthostatic hypotension can also cause strokes due to the changes in blood pressure and mental impairment because of brain damage.

Elderly nursing home patients should be properly diagnosed by a physician because not all dizziness is caused by orthostatic hypotension. If properly diagnosed, extra care can be taken with patients to prevent dangerous falls. Nursing home staff should take added precautions in the morning, when residents are first getting out of bed because that is when they are most at risk for a drop in blood pressure. The staff should also ensure that elderly residents are adequately hydrated, avoid hot weather, stand slowly, increase salt intake, and even apply compression stockings to help reduce symptoms. These simple steps can make the difference between a healthy and safe nursing home resident and one injured by a severe fall.

If your loved one suffered a nursing-home-related-fall and are looking for an explanation, one of the fist areas that should be analyzed is to see what medications the individual was taking.  Nursing home staff has a duty to do an assessment of all residents-- including a medication review--- to determine their 'risk' of falling.  A failure to do such an assessment-- or if it was improperly conducted opens the facility to potential fall-related liability.

Sources:
MayoClinic.com – Hypotension
MayoClinic.com – Orthostatic hypotension
Merck – Orthostatic Hypotension

Thanks to Heather Keil, J.D. for her assistance with this article.

Cook County Judge James Linn sentenced Morris Lee Brinkley, a home-care nurse, to two years probation and 60 days of community service following her role in the death of a Chicago boy who she responsible for caring for.   Earlier, Brinkley pleaded guilty to criminal neglect of a disabled person.

Brinkley provided home-care nursing to the 13-year-old boy with cerebral palsy.  Despite the fact that she only saw the boy on weekends, she admitted that she was aware that the boy was mistreated by his mother-- yet she failed to alert authorities.

When questioned, Brinkley knew the boy's mother:

• Left the boy alone for extended periods
• Allowed the boy to sit in his own excrement
• Become malnourished
• Develop serious bedsores
• Canceled regularly scheduled doctors appointments

In March, 2008 the boy was taken to La Rabida Children's Hospital because he was having trouble breathing.  Unfortunately, by the time the boy was taken to the hospital, there was little medical officials could do.  On March 15th the boy died from infection known as sepsis that originated in the advanced bed sores.

"These are acts of omission rather than commission," according to Judge Linn. "Something got out of control here," he added.

The boy's mother and another home-care nurse were also charged criminally for their role in the boys death.  Their cases are pending.

Thank goodness this judge decided to punish (albeit seemingly lightly) a health care professional who violated her duty to protect a disabled person she was responsible for caring for.  Hopefully this will 'encourage' other nurses to do their job and report abuse and neglect when they witness it.

Read more about this Chicago home-care nurse here.

Related Nursing Homes Abuse Blog Posts

Home Care Nurse Has License Suspended In Connection To Death Of Disabled Boy

Cook County Nursing Home Pleads Guilty To Gross Neglect Charges

Government Report Confirms Pressure Ulcers Harm All Nursing Home Residents; Regardless Of Race, Sex or Age

Today, the Village of North Aurora, IL will consider mandatory fingerprinting for criminal background checks for all residents of the North Aurora Care Center as well as other changes at the facility.  Originally constructed in 1971 for the 'care of old age", today the facility provides both daily living assistance and medical care for 103 patients.  In 2006, almost half of the facilities residents had a primary diagnosis of mental illness and 60% of the residents were younger than 60.

In addition to conducting criminal background searches of residents, the proposal under consideration would also have the facility install alarmed doors to alert staff if a resident is leaving without permission, mandatory sign-out for all residents, mandatory staff chaperoning of residents and a fenced-in yard for the facility.

The proposals came primarily in response to community complaints regarding the residents behavior and that it is located next to an elementary school.  Officials at the school claimed that residents solicited money from people in the neighborhood, swore at students and staff while they were on the playground, urinating on school property and wandered on school grounds.

Although the facility may exclude people who have been convicted of violent crimes, the Federal Fair Housing Act prohibits panning people with mental illness from living in the facility.  Medicare statistics estimate the number of mentally ill people living in nursing homes has risen 50% since 2002.  On a national level, residents with mental illness account for 9% of the nursing home population.

I predict we will be seeing more of these types of safety parameters installed at nursing homes throughout the country.  And why not?  Removing a group of known offenders from an extremely vulnerable group just makes common sense.

Source:

N. Aurora nursing home patients under scrutiny, Daily Herald, June18, 2009

Nursing Homes Abuse Blog Related Entries:

In Wake Of Sexual Assault Of Elderly Woman, Chicago Nursing Home & Administrator Named In Civil Lawsuit

Man Charged With The Rape Of Fellow Resident In Illinois Nursing Home

Young, Mentally Ill Residents Pose Significant Threat To Nursing Home Residents
 

As we reported in a recent blog entry,  thirty-two nursing homes made it onto the first-quarter 2009 “violator list” published by Illinois Department of Public Health (“IDPH”) in March.  Today we shine a spotlight on one of those facilities: Clearbrook East.

Clearbrook East is a 92-bed, non-profit nursing home facility, located at 3802 South Old Wilke Road in Rolling Meadows, Illinois, that serves adults with developmental disabilities.  Its website proclaims that it is committed to “creating innovative opportunities, services and support for persons with disabilities.”   Regrettably, the IDPH report suggests that Clearbrook East fails to do all that it should to protect its clients from neglect.

On January 8, 2009, the IDPH issued Clearbrook East a violation notice and fined it $15,000.  It found that the facility did not ensure that there were adequate protections in place for resident safety.  Most significantly, Clearbrook East staff failed to develop and implement the facility’s policy to prevent neglect. 

IDPH found, for example, that the staff’s failed to properly follow residents 'care plans'.  During the course of its survey, IDPH investigators determined that the staff's failure to follow its policy resulted in a resident suffering a seizure and another resident suffering multiple multiple falls with serious injuries on another. 

With respect the the fall incident, investigators determined that Clearbrook East staff held a meeting specifically to discuss this particular client’s extensive history of injuries from falls and how to prevent such falls in the future.  However, just four months later, the client fell again, this time sustaining two fractured ribs.  The staff’s failure to follow-through on the preventative measures constituted a violation of the policy barring neglect.

The IDPH regulates nursing home facilities and establishes basic guidelines to ensure that residents of nursing homes are protected.  A facility’s failure to follow IDPH regulations can result in needless neglect and abuse of residents.  In the Clearbrook East, clear policies on neglect could have prevented a resident prone to seizures from a painful injury caused by a fall. 

Our firm is committed to protecting the rights of residents-- especially those with disabilities-- to live free from injury and neglect and we appreciate the work of the IDPH in monitoring these facilities for compliance with basic standards.  If you would like to discuss an incident involving neglect at Clearbrook East, or any other facility, we would be honored to discuss you situation.  (888) 424-5757

As an injury lawyer who frequently handles nursing home negligence matters, I find myself regularly thinking 'what happened to plain old common sense'?  I mean, you can train the nurses, physicians, maintenance workers and administrators til' you're blue in the face-- yet most of the commonly encountered nursing home problems could easily be avoided with plain old common sense.  

Want an example?  How does checking on the temperature of food before feeding a disabled person? Is that too much to ask? 

Along those lines, homicide charges were filed against Alador Thompson, an employee of Cambridge-Brightfield Assisted Living Facility in Hatfield, PA.  The charges are related to an October 8th incident in which Thompson poured scalding oatmeal into the mouth of an Alzheimer's patient she was responsible for feeding.  The oatmeal caused the resident to suffer burns to his lips, tongue, and the inside of his mouth.

The resident was taken to a local hospital for burn treatment.  After three days of hospitalization, the resident was returned to Cambridge where he apparently stopped eating and died.

On August 5th Thompson will be arraigned on charges related to involuntary manslaughter and neglect of a care dependent person. 

Hey district attorney, can I make a suggestion?  How about filing similar charges against the administrator of the facility for accepting this poor man back at the facility and allowing him to starve to death following the obviously severe burns he suffered on hands of your employee? 

Read more about this case of severe neglect at a Pennsylvania assisted living facility here.

Related Nursing Homes Abuse Blog Posts

Ohio Nurse Sentenced To 12 and 1/2 Years For Sexually Abusing 100 Nursing Home Residents

Guilty Plea From Nurse Accused Of Abusing Tennessee Nursing Home Resident

Nursing Home Resident Chokes To Death On Dinner

The family of a Chicago nursing home resident has filed a wrongful death lawsuit against Sacred Heart Nursing Home in connection to a fall at the facility.  The lawsuit asserts that Sacred Heart failed to supervise the nursing home patient with bipolar disorder, schizophrenia and a propensity to fall.

The woman left her room without the knowledge of the nursing home staff and fell down a stairwell at the facility resulting in fractures to her back, closed head injuries and paralysis.  Eight months after sustaining the injuries, the woman died. 

The lawsuit is pending in Cook County, Illinois.  Read more about this nursing home lawsuit here.

Falls In Nursing Homes

Nursing homes have a non-delegable duty to conduct an assessment of a nursing home residents regarding their fall risk when the individual is admitted to the facility and re-assessment during their stay.  Although the nursing homes can not be held responsible for all falls in their facilities, nursing homes should be mindful of the following conditions that increase the likelihood of falls:

• Vision problems, individuals inability to perceive light, glare levels and depth perception may result in their inability to identify fall risks
• Cognitive impairment
• Memory problems
• Weakness in lower and upper extremities
• Bladder dysfunction
• Gait and imbalance problems

Irrespective of an individuals fall-risk assessment, nursing home staff should properly monitor residents to insure their well being and monitor dangerous areas such as: stairwells, bathrooms, kitchens and medical areas. 

Related Posts

Nursing Home Sued After Resident Fractures Both Hips In Separate Falls

How Many Falls Is Enough To Impose Responsibility On Nursing Home?

Nursing Home Cited For Mistreatment Of Resident Following Investigation Of Resident's Fractured Neck

Today marks the fourth annual World Elder Abuse Awareness Day sponsored by the International Network for the Prevention of Elder Abuse (INPEA).  WEAAD seeks to promote awareness of elder abuse and neglect in all settings around the world by bringing together governmental and civic organizations.

INPEA is an organization, founded in 1997, which is dedicated to the global dissemination of information as part of its commitment to the world-wide prevention of the abuse of older people.

Learn more about how you can get involved in preventing elder abuse here.

Know The Signs of Elder Abuse:

• Unexplained bruises, cuts, burns, sprains, or fractures
• Frozen joints
• Unexplained venereal disease or genital infections, vaginal or anal bleeding
• Bloody clothing
• Sudden changes in behavior
• Staff refusing to allow visitors to see resident or delays in allowing visitors to see resident
• Resident being kept in an over-medicated state
• Sudden loss of an appetite

Some court decisions leave lots of room for future generations of law school classes to debate the subtleties of the Judge's wording.  Yet, other times the the court's action--without rendering an opinion-- can have equally powerful results. What could I possibly be inarticulately blabbering about?  

June 1st marked the deadline by which the U.S. Supreme Court could grant review of an Illinois Appellate Court decision nullifying nursing home arbitration arbitration agreements. Instead, the court decided to leave the Appellate decision untouched-- in essence giving its stamp of approval to a holding striking an appellate court decision that invalidated mandatory arbitration agreements in nursing home negligence cases.

In Sue Carter v. SSC Odin Operating Company, LLC, (885 N.E. 2d 1204, 319 Ill.Dec. 524 (2008), the daughter of a nursing home resident brought a wrongful death and survival cause of action under the Illinois Nursing Home Care Act against the nursing home where her mother was a resident.  Despite the fact that Ms. Carter executed a 'Health Care Arbitration Agreement' on her mothers behalf when she admitted her mother to the facility, the Appellate Court ruled that state law preserved her right to a jury trial. 

The nursing home operator appealed the Appellate Court decision, claiming the mandatory arbitration clause, pursuant to the Federal Arbitration Act, should overrule any state law as the federal legislation should take precedent.

Consequently, nursing home arbitration agreements in Illinois will likely be a thing of the past. Perhaps, this action by the court will dissuade other states from enforcing similar agreements.

Read more about this important case preserving nursing home resident rights here.

Nursing Homes Abuse Blog Posts On Arbitration Agreements

The Invalidity Of Nursing Home Arbitration Clauses

Are Trials Really That Important?

Michigan Court Strikes Nursing Home 'Arbitration Clause' And Allows Wrongful Death Case To Proceed In Court

AARP Joins Fight To Preserve Right To Jury Trial

An English study evaluating the prevalence of MRSA (MRSA stands for methicillin-resistant Staphylococcus aureus) in nursing homes has revealed residents and staff are at risk for contracting the bacteria. The sampling 1,111 residents and 553 staff in 45 nursing homes revealed 24% of residents and 7% of the staff were MRSA carriers.

According to Dr. Paddy Kearney, Consultant Medical Microbiologist with the Northern Health and Social Care Trust, "We decided to carry out the study after noticing an apparent increase in recent years in the number of patients who had MRSA when they were admitted to hospital from nursing homes."

Kearney blames nursing homes' indifference to MRSA as a contributing factor in its prevelence.  "In hospitals routine checks are carried out to identify those most at risk of MRSA colonization  (carrying it on their skin and/or nose) and infection control policies are put in place but this is not always feasible in private nursing homes."

Why MRSA is problematic for nursing home residents

MRSA is a strain of staph that's resistant to most antibiotics commonly used to treat it.  In the older population, the ineffectiveness of certain drugs is dangerous because a weakened immune system has difficulty fighting off serious infection.  The prevalence of MRSA is believed to be related in some respects to the overuse of antibiotics.  MRSA can be fatal.

Medical professionals now use the term, health-care associated MRSA (HA-MRSA) to describe MRSA in a nursing home or hospital setting.   

Most strains of MRSA can still be treated with the antibiotic 'vancomycin'.  However, new strains of drug-resistant MRSA are now becoming more prevalent and the use of vancomycin to treat MRSA is becoming less effective.  If MRSA is isolated to a wound, doctors may chose to drain the would and not presrcibe any vancomycin.

How To Prevent MRSA In Long-Term Care Settings

• Wash your hands.  Scrub hands briskly for at least 15 seconds, then dry them with a disposable towel and use another towel to turn off the faucet.
• Use hand sanitizer containing at least 60 percent alcohol for times when you don't have access to soap and water.
• Don't share personal grooming items, such as towels, razors, toothbrushes, bed sheets or clothing
• Keep wounds covered with dry bandages.
• Shower frequently with soap and water.
• Keep MRSA patients separated from the general population
• Take antibiotics as prescribed and don't share with others

Resources On MRSA

MRSA: Understand your risk and how to prevent infection, MayoClinic.com

Prevalence of Methicillin-Resistant Staphylococcus aureus Colonization in Residents and Staff in Nursing Homes in Northern Ireland. Journal of the American Geriatrics Society. 57(4):620-626, April 2009

A jury awarded $750,000 to a disabled man who was a resident at Cote De Neige Home for Adults after he was sexually assaulted by a worker at the facility.  The lawsuit was brought against the assisted living facility for their failure to conduct an adequate pre-hiring background search before hiring a certified nursing assistant. 

Junious Boyd Batten, the CNA who was allegedly involved in the sexual assault, currently faces five counts of forcible sodomy, three counts of carnal knowledge and one count of abuse and neglect for incidents that occurred between 2006 and mid-2007 while he was employed by Cote De Neige. 

According to claims made in the lawsuit against Cote De Neige, Batten was a known criminal--both before and during his employment at Cote De Neige.  The lawsuit claims Batten was charged with 13 criminal offenses-- including four criminal convictions (public intoxication, two assault and battery charges and one contempt of court charge) during the course of his employment as a CNA.

Too often, in situations such as this, facilities are let off the hook because they claim they lack knowledge about an employees violent tendencies.  While this case may be extreme-- in terms of the extensive list of criminal charges Batten faced before and during the course of his employment-- this verdict should serve as a reminder to all facilities that they must do an pre-employment job screening and continually supervise all employees.

Incidentally, this verdict includes $500,000 in compensatory damages and $250,000 in punitive damages.  Consequently, even if this facility files for bankruptcy the owner of the facility will remain responsible for payment of the punitive aspect of this case.

Read more about this case involving a judgment against an assisted living facility for failing to conduct an adequate pre-employment screening of an employee here.

Nursing Homes Abuse Blog Related Posts

Failure To Properly Screen CNA Could Cost Facility 3.5 Million

Nurse Charged With Sexually Abusing Two Nursing Home Residents

"Nursing Homes Abuse Blog" Quoted In Article On Nursing Home Abuse

A very informative, and frankly disheartening, investigative article on race in Chicago Nursing Homes was recently published in The Chicago Reporter.  The article's author, Jeff Kelly Lowenstein, concluded that black nursing home residents received inferior care compared to their counterparts in predominately white facilities-- even when the facilities were owned by the same person.

Lowenstein analyzed the care rendered to residents at Alden Nursing Home, a well known chain of Chicago facilities owned by Floyd Schlossberg.  Lowenstein obviously did his homework, he analyzed data from: the Illinois Department of Public Health's website, staffing levels on the Centers for Medicare and Medicaid Services (Nursing Home Compare) and racial composition data from the Department of Community Health at Brown University.

The research conducted by Lowenstein, reveals the following disparities between predominately black v. predominately white nursing homes:

• Each of the three predominantly black facilities received the lowest possible rating in 2009 from Nursing Home Compare, a federal database to evaluate nursing homes that are Medicare- and Medicaid-certified. Less than half of Schlossberg’s 16 predominantly white facilities received that same rating.
• Two facilities received the highest ratings. At both facilities, located in Evanston and Skokie, at least 84 percent of the residents were white.
• Residents at Schlossberg’s predominantly black homes received much less staff time than residents of his predominantly white facilities. For example, residents at Alden Estates of Evanston received an average of 5.53 hours of care per day, compared with 2.04 hours at the Greater Grand Crossing facility and 1.73 hours at the Heather Health Care Center in Harvey, which are both predominantly black. The combined total of daily care given at the three, predominantly-black homes was just 19 minutes more each day than the time at the predominantly-white facility in Evanston.
• Sclossberg's predominately black facilities has three times as many lawsuits filed against them as half of other Chicago nursing homes.

I hope the public will put pressure on Schlossberg to raise standards in all of his facilities.  Why should the quality of care be based on race?

Resources:

Disparate Nursing Home Care, by Jeff Kelly Lowenstein

Map Of Alden Nursing Homes and racial composition, from The Chicago Reporter

Related Nursing Homes Abuse Blog Articles

Nursing Homes With Higher Percentage Of Hispanic Residents Have Higher Rate Of Bed Sores

Chicago Nursing Homes Not Making The Grade

Man Falls From Fourth Floor Window To His Death At Alden Nursing Home

See the Alden facilities below:

Continue Reading

Adelita Rosas, a manager at an Austin nursing home stands accused of stealing more than $2,000 from an elderly resident at Maggie Johnson Nursing Home.  Rosas admittedly endorsed and cashed a check made payable to a resident and then gave the funds to the resident's family, yet she claims the situation is an innocent misunderstanding.  "Of course, I had to sign the back of the check.  Because he (the resident) didn't have his ID, they wouldn't cash it for him," said Rosas.

At the very least, Rosas violated the nursing home's policy when she gave the money to the resident's family.  According to Cheryl Lillian, President of Legacy Care Centers, the nursing homes parent company, "It's all they have, and they entrusted it to us to take care of.  The preponderance of the evidence says she did it.  I believe she did it."

Rosas was removed from her position at Maggie Johnson shortly after administrators became aware of the incident.  No word if Rosas will face any criminal charges from her alleged theft from the elderly.  Read more about this case involving a Texas nursing home here.

Financial Abuse Amongst The Elderly

Financial abuse is the most common type of abuse in the elderly population.  Financial abuse is generally considered to be the theft or conversion of money or other property by caregivers, relatives, or other people the elderly person trusts. Many cases of financial abuse remain undocumented because those initiating the fraud have become sophisticated in evading authorities.  For example, parties involved in financial abuse may sign over the title to the older person's home or other assets to the abuser and then sold. Other examples of financial abuse include unauthorized removal of funds from: checking, savings, and investment accounts. Another major area of financial abuse amongst the elderly is the alteration of wills.

The National Institute on Financial Issues and Services for Elders, a Unit of the National
Council on the Aging, says to watch for these signs of financial abuse:

• The elderly person's living conditions are well below his or her financial resources.
• Unusual or inappropriate bank account activity is reported.
• Frequent checks for cash are written to a caregiver or financial professional.
• Bills go unpaid or are overdue when someone is supposed to be paying them.
• The elderly person transfers title of his or her home or other assets for no apparent
  reason.
• Large, frequent gifts are made to a caregiver.
• The person is reluctant to talk about once-routine topics.
• Personal belongings are missing.
• Attempts are made by a caregiver, friend, or relative to isolate the person from
  others.
• Changes are made in a will when the person appears to be incapacitated.
• The older person takes out large, unexplained loans.
• A live-in caregiver refuses to leave or is evasive about financial arrangements. 

When it comes to financial abuse in the elderly population, nothing can take the place frequent monitoring of you loved ones.  If you suspect financial abuse, notify authorities immediately before the property or funds are forever lost.