Published in the Manchester Union Leader, February 2013
Q: I work as a physician's assistant and a longtime
patient, now 85 years old, presents with depression. She confided
in me that she is getting nightly calls from bill collectors
threatening to take action against her for non-payment. She tells
me she had over a million dollars in her retirement account when
she turned it over to her son to manage six years ago. Now he is
telling her there’s not enough to cover the bills and she is
going to have to sell the home she’s lived in for the past
fifty years. She thinks she gave her son some kind of power of
attorney. While her mental acuity seems fine, I wonder whether I
have any obligation to report what I’ve
learned?
A: Last estimated in 2010, annual losses to the elderly caused
by financial exploitation were in the vicinity of $2.9 billion.
This is a devastating (and, sadly growing) problem, and medical
professionals and caregivers are often in the best position to help
protect against it. The law therefore requires healthcare workers
to report to the New Hampshire Department of Health and Human
Services if they know or suspect abuse, neglect or exploitation of
an “incapacitated” adult. The reporter must follow-up
their oral report with a written report, if so requested.
The first question in deciding the duty to report is whether your
patient is incapacitated. “Incapacitated,” under the
law, means the individual is unable to act in her own best
interests, a circumstance that can be emotionally based. A
good argument can be made that your patient is emotionally unable
to confront her son about his management (or mismanagement) of her
finances, so that she cannot act in her own best interests to
recover control of her finances. You might confirm this emotional
incapacity by inquiring about what conversations, if any, she has
had with her son about these problems. If she has asked for little
or nothing, you should find out why that is.
The next question is whether these facts amount to abuse or
exploitation. There are a number of red flags that suggest that is
the case, especially since it appears that your patient’s
assets have been misapplied causing her emotional distress as a
consequence. You should ask for additional details that may be
helpful to the authorities in investigating and assisting you
patient in recovering control of her finances, like the names of
any financial institutions involved and whether she has ever worked
with an independent financial person like an accountant or other
advisor.
In deciding whether to report, consider that anyone who knowingly
fails to make a required report can be found guilty of a
misdemeanor. On the other hand, if you report, you will be immune
from any liability that might otherwise result so long as the
report is in good faith.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.