Fraud victimization across the lifespan: evidence on repeat victimization using perpetrator data.

Older adults are thought to be more susceptible to scams, yet understanding the relationship between chronological age and victimization is limited by underreporting. This study avoids underreporting bias by merging four longitudinal databases of Americans (N = 1.33 million) who paid money in response to mail scams over 20 years. We investigate the risk of repeat victimization and victimization by multiple scam types over the life course. Victims in their 70s and 80s are 9% more likely to experience another victimization incident than those in their 50s. Those age 18 to 29 are 24% less likely to experience another victimization incident. Relative to adults in their 50s, the odds of victimization by multiple scams are greater for those in their 60s and 70s, but lower for those 80 + . This study demonstrates the research potential in using scammers' data to understand patterns of victimization. Fraud prevention efforts should target older individuals who are at higher risk of repeat victimization and suffer greater losses as a result.

Development of short-form measures to assess four types of elder mistreatment: Findings from an evidence-based study of APS elder abuse substantiation decisions.

Improving the standardization and efficiency of adult protective services (APS) investigations is a top priority in APS practice. Using data from the Elder Abuse Decision Support System (EADSS), we developed short-form measures of four types of elder abuse: financial, emotional/psychological, physical, and neglect. The EADSS data set contains 948 elder abuse cases (age 60+) with yes/no abuse substantiation decisions for each abuse type following a 30-day investigation. Item sensitivity/specificity analyses were conducted on long-form items with the substantiation decision for each abuse type as the criterion. Validity was further tested using receiver-operator characteristic (ROC) curve analysis, correlation with long forms and internal consistency. The four resulting short-form measures, containing 36 of the 82 original items, have validity similar to the original long forms. These short forms can be used to standardize and increase efficiency of APS investigations, and may also offer researchers new options for brief elder abuse assessments.

The Forensic Lens: Bringing Elder Neglect Into Focus in the Emergency Department.

We present 2 case studies of older patients who were brought to the emergency department (ED) in severely debilitated states. Both presented with severe malnutrition, contractures, and decubitus ulcers, and were nonverbal, with histories of dementia and end-stage disease. Their primary caregivers, adult children, were uncooperative with Adult Protective Services and disregarded treatment recommendations. Although both elders had signs suspicious for neglect, a comprehensive review revealed many layers of complexity. We use these cases to illustrate an approach to the assessment of possible elder neglect in ED settings and how to intervene to ensure patient safety. We begin with a discussion of the differences between willful, unintentional, and unsubstantiated neglect by a caregiver and then describe when to suspect neglect by evaluating the elder, interviewing the caregiver and first responders, assessing the caregiver's ability to meet the elder's needs, and, if possible, obtaining medical history and information about the home care environment. These cases illustrate the importance of careful documentation in cases of suspected neglect to assist investigative agencies, reduce the risk of further harm, and improve patient outcomes.

A Microsimulation of Well-Being and Literacy Interventions to Reduce Scam Susceptibility in Older Adults.

Poor financial and health literacy and poor psychological well-being are significant correlates of scam susceptibility in older adults; yet, no research has examined whether interventions that target these factors may effectively reduce susceptibility. Using longitudinal data from older adults in the Rush Memory and Aging Project (MAP) (N = 1,231), we used microsimulations to estimate the causal effect of hypothetical well-being and literacy interventions on scam susceptibility over six years. Microsimulations can simulate a randomized trial to estimate intervention effects using observational data. We simulated hypotheticalinterventions that improved well-being or literacy scores by either 10% or 30% from baseline, or to the maximum scores, for an older adult population and for income and education subgroups. Simulations suggest thathypotheticalinterventions that increase well-being or literacy cause statistically significant reductions in scam susceptibility of older adults over time, but improving well-being caused a greater-albeit not significantly different-reduction compared to improving literacy.

Reimagining Senior Centers for Purposeful Aging: Perspectives of Diverse Older Adults.

Senior centers must re-envision their programs to appeal to today's increasingly older and more diverse older adults. Using a purposeful aging framework, this study aims to inform senior center programming by capturing diverse older adults' perspectives on future goals, perceptions of aging, attitudes about senior centers, and experience with technology. Participants age 70 and older (N = 64) joined one of eight focus groups organized by race/ethnicity and preferred spoken language. Transcripts were coded using a grounded theory approach to identify perspectives in each domain. Across groups, shared perspectives included aspirations to make a difference, maintain health and independence, continue learning, and embrace positive perceptions of aging. However, both positive and negative attitudes about participating in senior centers and the effects of technology were presented. We discuss how to redesign senior center programming to meet members' proactive approach to aging and future goals, and facilitate more confidence with new technology.

The Financial and Psychological Impact of Identity Theft Among Older Adults.

BACKGROUND AND OBJECTIVES: Society's growing reliance on technology to transfer private information has created more opportunities for identity thieves to access and misuse personal data. Research on identity theft specifically among adults aged 65 and older is virtually nonexistent, yet research focusing on victims of all ages indicates a positive association between age, minority status, and more severe economic and psychological consequences. RESEARCH DESIGN AND METHODS: Identity theft measures come from a sample of more than 2,000 self-reported victims aged 65 and older from the nationally representative National Crime Victimization Survey Identity Theft Supplements administered in 2014 and 2016. Regression was used to examine how socioeconomic status, demographic characteristics, and incident-specific factors relate to how much money is stolen, the likelihood of experiencing out-of-pocket costs, and emotional distress among older identity theft victims. RESULTS: Older Black identity theft victims were more likely to have greater amounts of money stolen and were more likely to feel distressed by the incident than older White victims. The most disadvantaged older adults living at or below the federal poverty level were significantly more likely to suffer out-of-pocket costs. The length of time information was misused, experiencing subsequent financial problems and problems with friends/family, and the hours spent resolving identity theft were positively associated with emotional distress. Among those aged 65 and older, age was not significantly associated with losses or emotional distress. DISCUSSION AND IMPLICATIONS: Older adults living in poverty need more resources to assist with recovery and reporting identity theft to law enforcement. Limiting the extent of losses from identity theft and reducing the length of time information is misused may reduce the emotional toll of identity theft on older victims.

Risk and protective factors of identity theft victimization in the United States.

Identity theft victimization is associated with serious physical and mental health morbidities. The problem is expanding as society becomes increasingly reliant on technology to store and transfer personally identifying information. Guided by lifestyle-routine activity theory, this study sought to identify risk and protective factors associated with identity theft victimization and determine whether individual-level behaviors, including frequency of online purchasing and data protection practices, are determinative of victimization. Data from sequential administrations of the U.S. National Crime Victimization Survey-Identity Theft Supplement (ITS) in 2012 and 2014 were combined (N = 128,419). Using multivariable logistic regression, risk and protective factors were examined for three subtypes: 1) unauthorized use of existing credit card/bank accounts, and unauthorized use of personal information to 2) open new accounts, or 3) engage in instrumental activities (e.g., applying for government benefits, receiving medical care, filing false tax returns). Existing credit card/bank accounts and new accounts identity theft victimization were associated with higher levels of online purchasing activity and prior identity theft victimization. All identity theft subtypes were associated with government/corporate data breaches and other crime victimization experiences. Routine individual-level preventive behaviors such as changing online passwords and shredding/destroying documents were protective. Identity theft subtypes showed divergent socio-demographic risk/protective profiles, with those of higher socioeconomic status more likely to be victims of existing credit card/bank account identity theft. Identity theft is a pervasive, growing problem with serious health and psychosocial consequences, yet individuals can engage in specific protective behaviors to mitigate victimization risk.

Financial Fraud Among Older Americans: Evidence and Implications.

OBJECTIVES: The consequences of poor financial capability at older ages are serious and include making mistakes with credit, spending retirement assets too quickly, and being defrauded by financial predators. Because older persons are at or past the peak of their wealth accumulation, they are often the targets of fraud. METHODS: Our project analyzes a module we developed and fielded on people aged 50 an older years in the 2016 Health and Retirement Study (HRS). Using this data set, we evaluated the incidence and prospective risk factors (measured in 2010) for investment fraud and prize/lottery fraud using logistic regression (N = 1,220). RESULTS: Relatively few HRS respondents mentioned any single form of fraud over the prior 5 years, but 5.0% reported at least one form of investment fraud and 4.4% recounted prize/lottery fraud. Greater wealth (nonhousing) was associated with investment fraud, whereas lower housing wealth and symptoms of depression were associated with prize/lottery fraud. Hispanics were significantly less likely to report either type of fraud. Other suspected risk factors-low social integration and financial literacy-were not significant. DISCUSSION: Fraud is a complex phenomenon and no single factor uniquely predicts victimization across different types, even within the category of investment fraud. Prevention programs should educate consumers about various types of fraud and increase awareness among financial services professionals.

Elder Fraud and Financial Exploitation: Application of Routine Activity Theory.

Background and Objectives: Elder financial exploitation, committed by individuals in positions of trust, and elder fraud, committed by predatory strangers, are two forms of financial victimization that target vulnerable older adults. This study analyzes differences between fraud and financial exploitation victims and tests routine activity theory as a contextual model for victimization. Routine activity theory predicts that criminal opportunities arise when a motivated offender and suitable target meet in the absence of capable guardians. Research Design and Methods: Fifty-three financial exploitation and fraud cases were sampled from an elder abuse forensic center. Data include law enforcement and caseworker investigation reports, victim medical records, perpetrator demographic information, and forensic assessments of victim health and cognitive functioning. Results: Fraud and financial exploitation victims performed poorly on tests of cognitive functioning and financial decision making administered by a forensic neuropsychologist following the allegations. Based on retrospective record review, there were few significant differences in physical health and cognitive functioning at the time victims' assets were taken, although their social contexts were different. Significantly more fraud victims were childless compared with financial exploitation victims. Fraud perpetrators took advantage of elders when they had no trustworthy friends or relatives to safeguard their assets. Discussion and Implications: Findings support an adapted routine activity theory as a contextual model for financial victimization. Fraud most often occurred when a vulnerable elder was solicited by a financial predator in the absence of capable guardians. Prevention efforts should focus on reducing social isolation to enhance protection.

The positivity effect: a negativity bias in youth fades with age.

Relative to younger adults, older adults attend to and remember positive information more than negative information. This shift from a negativity bias in younger age to a preference for positive information in later life is termed the 'positivity effect.' Based on nearly two decades of research and recent evidence from neuroscience, we argue that the effect reflects age-related changes in motivation that direct behavior and cognitive processing rather than neural or cognitive decline. Understanding the positivity effect, including conditions that reduce and enhance it, can inform effective public health and educational messages directed at older people.

Using Latent Class Analysis to Identify Profiles of Elder Abuse Perpetrators.

Objectives: Research suggests that abuser risk factors differ across elder mistreatment types, but abuse interventions are not individualized. To move away from assumptions of perpetrator homogeneity and to inform intervention approaches, this study classifies abusers into subtypes according to their behavior profiles. Method: Data are from the Older Adult Mistreatment Assessment administered to victims by Adult Protective Service (APS) in Illinois. Latent class analysis was used to categorize abusers (N = 336) using victim and caseworker reports on abusers' harmful and supportive behaviors and characteristics. Multinomial logistic regression was then used to determine which abuser profiles are associated with 4 types of mistreatment-neglect, physical, emotional, and financial-and other sociodemographic characteristics. Results: Abusers fall into 4 profiles descriptively labeled "Caregiver," "Temperamental," "Dependent Caregiver," and "Dangerous." Dangerous abusers have the highest levels of aggression, financial dependency, substance abuse, and irresponsibility. Caregivers are lowest in harmful characteristics and highest in providing emotional and instrumental support to victims. The 4 profiles significantly differ in the average age and gender of the abuser, the relationship to victims, and types of mistreatment committed. Discussion: This is the first quantitative study to identify and characterize abuser subtypes. Tailored interventions are needed to reduce problem behaviors and enhance strengths specific to each abuser profile.

Emotional arousal may increase susceptibility to fraud in older and younger adults.

Financial fraud is a societal problem for adults of all ages, but financial losses are especially damaging to older adults who typically live on fixed incomes and have less time to recoup losses. Persuasion tactics used by fraud perpetrators often elicit high levels of emotional arousal; thus, studying emotional arousal may help to identify the conditions under which individuals are particularly susceptible to fraud. We examined whether inducing high-arousal positive (HAP) and high-arousal negative (HAN) emotions increased susceptibility to fraud. Older (ages 65 to 85) and younger (ages 30 to 40) adults were randomly assigned to 1 of 3 emotional arousal conditions in a laboratory task: HAP, HAN, or low arousal (LA). Fraud susceptibility was assessed through participants' responses to misleading advertisements. Both HAP and HAN emotions were successfully induced in older and younger participants. For participants who exhibited the intended induced emotional arousal, both the HAP and HAN conditions, relative to the LA condition, significantly increased participants' reported intention to purchase falsely advertised items. These effects did not differ significantly between older and younger adults and were mitigated in participants who did not exhibit the intended emotional arousal. However, irrespective of the emotional arousal condition to which older adults were assigned (HAP, HAN, or LA), they reported greater purchase intention than did younger adults. These results inform the literature on fraud susceptibility and aging. Educating consumers to postpone financial decisions until they are in calm emotional states may protect against this common persuasion tactic. (PsycINFO Database Record

Tricks of the Trade: Motivating Sales Agents to Con Older Adults.

PURPOSE OF THE STUDY: Financial fraud is estimated to cost consumers approximately $50 billion annually. To examine how new hires are trained to engage in fraud, this study analyzed a sales training transcript from Alliance for Mature Americans (Alliance). In 1996, Alliance was charged with using deception and misrepresentation to sell more than $200 million worth of living trusts and annuities to 10,000 older adults in California. DESIGN AND METHODS: Transcribed recordings from a 2-day Alliance sales training seminar were analyzed using NVivo10, coded inductively, and examined to identify emergent themes. RESULTS: Predominant themes were as follows: (a) indoctrination using incentives and neutralization techniques and (b) training on persuasion tactics targeted at older adults. Findings suggest that sales training focuses on establishing the company's legitimacy, normalizing unethical sales practices, and refining trainees' knowledge about how to influence older consumers. IMPLICATIONS: Predatory and fraudulent businesses peddling ill-suited products threaten the economic security of older Americans. Improved insights into sales manipulation strategies can guide the development of protective policies including educational approaches to help older adults detect scams and resist purchasing fraudulent products.

Prosecutors' Perspectives on Elder Justice Using an Elder Abuse Forensic Center.

Prosecution is a rare outcome in elder financial exploitation. Previous studies have shown that elder abuse forensic centers-multidisciplinary teams that help investigate and respond to elder mistreatment-increase prosecution rates by enhancing teamwork across agencies. Research is needed to identify what aspects of this intervention model lead to better elder justice outcomes. Six District Attorneys (DAs) were interviewed about their experiences working with other agencies at an elder abuse forensic center (the "Center") and how participating in case discussions influenced their professional perspectives on elder abuse. Transcripts were analyzed qualitatively revealing three themes: (1) "goal-driven" versus "mission-driven" professional orientations; (2) role blurring; and (3) value added from participating in the Center team. Important factors for increasing rates of prosecution were: (1) having key decision-makers present at the meeting; (2) the forensic expertise provided by the geriatrician and neuropsychologist; and (3) cross-discipline learning. Influenced by the other disciplines, DAs sought goals beyond prosecution as the default approach to resolving elder financial abuse and advocated for interventions that could best respond to the victim's needs, such as restitution or protection.

Inside the Black Box: The Case Review Process of an Elder Abuse Forensic Center.

OBJECTIVE: Preliminary evidence suggests that elder abuse forensic centers improve victim welfare by increasing necessary prosecutions and conservatorships and reducing the recurrence of protective service referrals. Center team members gather information and make decisions designed to protect clients and their assets, yet the collective process of how these case reviews are conducted remains unexamined. The purpose of this study is to present a model describing the interprofessional approach of investigation and response to financial exploitation (FE), a frequent and complex type of abuse of vulnerable adults. METHODS: To develop an understanding of the case review process at the Los Angeles County Elder Abuse Forensic Center (Center), a quasi-Delphi field study approach was used involving direct observations of meetings, surveying team members, and review from the Center's Advisory Council. The goal of this iterative analysis was to understand the case review process for suspected FE in Los Angeles County. RESULTS: A process map of key forensic center elements was developed that may be useful for replication in other settings. The process map includes: (a) multidisciplinary data collection, (b) key decisions for consideration, and (c) strategic actions utilized by an interprofessional team focused on elder justice. DISCUSSION: Elder justice relies on a complex system of providers. Elder abuse forensic centers provide a process designed to efficiently address client safety, client welfare, and protection of assets. Study findings provide a process map that may help other communities replicate an established multidisciplinary team, one experienced with justice system outcomes designed to protect FE victims.

Beware of Data Gaps in Home Care Research: The Streetlight Effect and Its Implications for Policy Making on Long-Term Services and Supports.

Policy initiatives increasingly seek greater use of home- and community-based services for older persons and those with chronic care needs, yet large gaps persist in our knowledge of home care, an indispensable component of long-term services and supports. Unrecognized data gaps, including the scope of home care provided by private hire and nonmedical providers, can distort knowledge and poorly inform long-term services and supports policy. The purpose of this article is to examine these gaps by describing the universe of formal home care services and provider types in relationship to major national sources. Findings reveal four distinct home care sectors and that the majority of formal home care is provided in the sectors that are understudied. We discuss the policy implications of data gaps and conclude with recommendations on where to expand and refine home care research.

Multicultural voices: Attitudes of older adults in the United States about elder mistreatment.

Despite international growth in policies to increase the identification and response to elder abuse and neglect, there remain considerable barriers to treating the problem. Some of these barriers may be attributed to how older adults from different racial/ethnic backgrounds define, experience, and seek to remedy elder mistreatment. Using focus group discussions based on case vignettes, this paper examines how older adults from different racial and ethnic backgrounds in the United States perceive elder mistreatment. Five focus groups were conducted with African Americans, English-speaking Latinos, Spanish-speaking Latinos, non-Latino Whites and African American caregivers for older adults. While similar definitions and meanings of elder abuse were expressed across the different racial/ethnic groups, Latino participants introduced additional themes of machismo, respect, love, and early intervention to stop abuse, suggesting that perceptions/beliefs about elder mistreatment are determined by culture and degree of acculturation in addition to race/ethnicity. Most differences in attitudes occurred within groups, demonstrating that perceptions vary by individual as well as by culture. In identifying scenarios that constitute elder mistreatment, some participants felt that certain cases of abuse are actually the persistence of intimate partner violence into old age. Participants also indicated that victims may prefer to tolerate mistreatment in exchange for other perceived benefits (e.g., companionship, security); and out of fear that they could be placed in an institution if mistreatment is reported. Findings suggest the need for person-centred intervention and prevention models that integrate the cultural background, care needs, and individual preferences of older adults.

Determining prevalence and correlates of elder abuse using promotores: low-income immigrant Latinos report high rates of abuse and neglect.

Low-income Latino immigrants are understudied in elder abuse research. Limited English proficiency, economic insecurity, neighborhood seclusion, a tradition of resolving conflicts within the family, and mistrust of authorities may impede survey research and suppress abuse reporting. To overcome these barriers, promotores, local Spanish-speaking Latinos, were recruited and trained to interview a sample of Latino adults aged 66 and older residing in low-income communities. The promotores conducted door-to-door interviews in randomly selected census tracts in Los Angeles to assess the frequency of psychological, physical, and sexual abuse; financial exploitation; and caregiver neglect. Overall, 40.4% of elderly Latino adults had experienced some form of abuse or neglect within the previous year. Nearly 25% reported psychological abuse, 10.7% physical assault, 9% sexual abuse, and 16.7% financial exploitation, and 11.7% were neglected by their caregivers. Younger age, higher education, and experiencing sexual or physical abuse before age 65 were significant risk factors for psychological, physical, and sexual abuse. Years lived in the United States, younger age, and prior abuse were associated with greater risk of financial exploitation. Years spent living in the United States was a significant risk factor for caregiver neglect. Abuse prevalence was much higher in all mistreatment domains than findings from previous research on community-dwelling elderly adults, suggesting that low-income Latino immigrants are highly vulnerable to elder mistreatment or that respondents are more willing to disclose abuse to promotores who represent their culture and community.