Vulnerable and elderly adults have been the victims of abuse, neglect and fraud in nearly 14,000 cases in Arizona, with the number of cases reported in 2015 increasing 19 percent over the year before, according to a Cronkite News analysis.
Over 4,000 cases involved financial exploitation, and another 3,661 reports involved vulnerable adults being physically abused. There were 9,408 cases that involved neglect, including self-neglect cases.
Physical abuse cases included reports of a nursing home employee who used a bungee cord to confine a patient to his room, to a caregiver who dragged a vulnerable adult from her bed to the kitchen in her home. One man was choked and strangled by his caregiver.
Another neglected a vulnerable adult for so long that he was found with rotting skin on his hands, feet, legs and buttocks. He also was malnourished and suffered from severe, painful gangrene.
Earlier this week, two employees of the Arizona Department of Economic Security were involved in a “horrific case of abuse of an elderly individual,” according to a DES press release. Detective Doug Matteson, spokesman for Maricopa County Sheriff’s Office, said that an 86-year-old woman was found in an “unlivable” house in Mesa. So far, one DES employee identified as Carol Brown was fired after DES learned of the incident. An investigation is underway.
In hundreds of other cases, money was stolen and used for everything from casino gambling to a motorcycle purchase. One caregiver made more than $36,000 in illegal debit transactions.
The cases reviewed by Cronkite News are documented on the Arizona DES’s Adult Protective Services registry, made available to the public last year.
APS investigates cases of all vulnerable adults, which under state law, includes people 18 years of age or older who are unable to protect themselves because of either physical or mental impairment. In 2015, 72 percent of APS clients were over 60 years old.
Some caregivers cashed in Social Security checks. Others added themselves and their own children as beneficiaries on a vulnerable adult’s accounts without consent.
That’s what Tinna Kay Lujan did.
While employed as a Certified Nursing Assistant at Amber Lights, an assisted living facility in Tucson, Lujan, 56, took 87-year-old Donald Hansen out of the facility into her own home, where the vulnerable adult later was found dehydrated and suffering from an infection.
According to the court records, at about 11 p.m. on March 23, 2014, Amber Lights staff called Pima County Sheriff’s Department to report the abduction of Hansen.
Minutes before, Hansen telephoned the staff Amber Lights to tell them he was okay. Staff heard Lujan coaching Hansen before she took the phone and said a moving company would be picking up his belongings the following week.
A confused Hansen approached staff earlier that morning. “Why do I have to move? I don’t know why I have to move,” he said. “I was approached to move into this person’s home who I don’t really know.”
That day, Lujan had checked out the keys to Hansen’s apartment.
Lujan was immediately suspended. She admitted to her employers that she removed Hansen from the facility, but said he approached her to be his caretaker.
Lynn Larson, assistant director of the Division of Aging and Adult Services, part of the Department of Economic Security, says the 2015 caseload is an all-time high.
In March 2015, APS had 12,767 open cases. Since then, APS has utilized temporary caseworkers to ensure they would be able to tackle the caseload, she said.
Larson said the number of open cases was down to 4,500, as of earlier this month and are now more aligned with the nation’s standards.
According to the APS Annual Report, APS reports have increased by 79 percent in the last five years. The report also said the agency has closed 13,394 cases after investigations. In Maricopa County alone, 7,204 elder abuse cases were reported. APS said they closed 6,548 cases of the Maricopa County cases. Only 565 of those cases were reported as substantiated.
She attributes the increase in cases in the last year to more attention and knowledge of the problem and therefore, more people reporting cases to APS.
“Nationally, there is the Elder Justice Act,” Larson said. “There’s greater attention being paid to that act and insuring that there’s a level of financing for services such as adult protective services throughout the nation, and part of that is just through the Older Americans Act as well.”
The Elder Justice Act, under the Patient Protection and Affordable Care Act issued in 2010, is an elder abuse prevention law. The Older Americans Act of 1965 also created the National Aging Network and agencies on aging at the federal and state levels to provide resources and outreach to aging adults.
Even so, Rhonda Coates, deputy assistant director of the Arizona Division of Aging and Adult Services, says abuse still is underreported. According to the National Center on Elder Abuse, only one in 14 cases are reported.
The U.S. Census Bureau estimates that the national aging population is growing expected to be reach 83.7 million in 2050, almost double its estimated population in 2012.
Vice President of Programs and Services for Arizona’s Area on Aging Region One, Melissa Elliott, said services haven’t kept up with the growth rate of the national aging population. The Area on Aging works closely with APS to provide resources and programs to enhance the life of vulnerable adults and caregivers in Maricopa County.
“I think that we also need to do a better job of helping people understand what elder abuse looks like,” Elliott said.
Hilary Weinberg, Family Violence Bureau chief for the Maricopa County Attorney’s office, said there are challenges when prosecuting cases in court.
“Sometimes distinguishing from a normal injury versus an actual abuse case can be a little bit tricky,” she said. “[Elders] bruise incredibly easy. It can be something as simple as moving someone from one chair to a wheelchair and they will be completely bruised and marked up and someone seeing that may say, ‘Oh my gosh, something happened to this person…” when basically their skin tears so easily that even very gentle handling of the person can look like abuse.”
Weinberg said victims who suffer from some sort of dementia is common and will sometimes prevent a victim from giving accurate information.
“Financial exploitation can be very hard to detect, so I think that we need more skilled people,” Elliott said. “And it can’t just be professionals, it has to be people in the first line of defense.”
In Hansen’s case, Washington Federal Bank staff contacted deputies because they were suspicious when Lujan and Hansen, a long-time customer, visited the bank together. Lujan provided the bank with a “power of attorney” document dated by Hansen.
Lujan requested checks and bank cards from Hansen’s accounts and added Hansen’s “grandchildren” as beneficiaries. The bank staff knew Hansen had no grandchildren and later learned the beneficiaries were, infact, Lujan’s children.
Financial abuse is becoming more prevalent, not only in Arizona, but nationwide.
Elliott said that the 2008 recession offered a new kind of vulnerability for the older population because resources were already scarce prior to the drop in the economy and so it caused them even more of a struggle.
“People who are looking to exploit older adults are capitalizing on two things,” Elliott said. “They are capitalizing on the desperation and the vulnerability but they are also capitalizing on the fact that there are more older adults and more opportunity.”
Nationally, older adults lose about $2.9 billion each year through financial abuse and exploitation, according to a 2011 MetLife Study of Elder Financial Abuse.
There are perpetrators without malintent who are reported. Some caregivers are overwhelmed and overworked and that leads to vulnerable situations.
“We definitely recognize, especially if the family member or the significant other has been in a caregiving capacity, that there definitely is caregiver fatigue,” Coates said. “It might have been that the caregiver was the one who abused or neglected the individual but I believe most of the time it’s not done purposefully if it is the caregiver.”
In 2015, APS reported 30 percent of alleged perpetrators are family members.
“A certain segment of the reporting sources are family members themselves,” Coates said. “There may be some hesitation there because they don’t want their loved one or a person that they know to be arrested or to go to jail.”
On Jan. 5, 2015, Lujan was sentenced to three years probation for “vulnerable adult abuse” and served 15 days in Pima County Jail.
Lujan’s plea agreement included special terms prohibiting her from working in a position where she has access to elderly or vulnerable adults and she must inform her employers of this conviction. She also must pay restitution of over $16,000 to Hansen and complete 200 hours of community service at a rate no less than 30 hours per month.
There is no unique sentencing code for vulnerable adult abuse cases. These cases have the same potential felonies as any other crime in Arizona, Weinberg said.
“The fact that it’s an elderly person or a vulnerable adult may make it more of somewhat of an aggravating factor that we can use to try to get a court to enhance a sentence because it’s one thing to punch a fairly healthy 45-year-old person, but to do something to someone who may be very frail and in their 80s that becomes a different story,” Weinberg said.
In her court statement, Lujan said Hansen approached her during January 2014 to be his caretaker and she viewed this as an opportunity to escape from her failed marriage. She admitted to taking advantage of Hansen but said she was unaware of he had contracted an infection under her care.
“I’m very ashamed I put the victim in harm’s way because of my impulsive actions,” Lujan said in her court statement.
In Arizona, between 4,600 and 6,900 seniors will experience some type of abuse each year, according to a report by the Arizona Elder Abuse Coalition.
“It takes more than one state agency to protect these individuals,” Coates said. “It really takes the larger community, from the community stakeholders to the churches and the faith-based communities to the family and the caregivers and all these different agencies that support these individuals.”