“M is for the million things she gave me . . . ”

She was nearing her 90th birthday, lonely and grieving the loss of her husband. Her 55-year-old son came by frequently to remind her not to move furniture or stand on the kitchen step stool. He sometimes brought flowers. He always brought a tale of woe. He needed money to avert foreclosure on his home. His van broke down. His tools were stolen, and he couldn’t work. Each time she hesitated, then wrote a check for thousands of dollars. And each time, he said it would be the last ask. Pressed by others to stop being her adult son’s ATM machine, she explained, “You don’t talk about the family. You share what you have. That’s not being a victim. He is borrowing because of emergencies. Look, there are written IOUs.” On the other hand, she wanted to protect herself and her savings without getting him into trouble. “He is sick,” she said. “He is an addict. I feel embarrassed and stupid.”

This is the sad reality of families in every community. The most extensive financial exploitation faced by the elderly, particularly elderly women, is not the stranger scam or commercial fraud. It is the pressure, deception, cash and property losses at the hands of hapless or malicious people who are known to and trusted by the victim. Family secrets and habits stand in the way of reports to authorities. Limited reports yield few prosecutions. Data and case law are sparse.

Ultimately, financial exploitation by daughters and sons, grandchildren, old friends, new friends, financial advisers and clergy reaches the headlines when victims are helped to come forward. Advocacy and support for victims begins with our ability to recognize the signs of financial exploitation. These are illustrative, but by no means exhaustive, examples of the signs of victimization.

Sometimes, we hastily dismiss an elder’s reports of missing money, credit cards or important papers, particularly when memory loss is present. We may assume that the complaint that the “mail isn’t coming anymore” is no more than forgetfulness about the day of the week. Perhaps these events are accompanied by agitation after family or a friend visits or after that individual brings him or her back from an outing. Perhaps there is significant decline in grooming, clothing, or home maintenance when arrangements have been made for assistance and services.

Some signs are very telling. We observe an elder pressured into a decision or signature that has to be made now. We overhear threats that unless a document is signed, the family or visitor will stop taking care of the elder. We encounter “chaperoning,” someone who lets others visit only when he or she is there to monitor, or “prompting,” someone who tells the elder what to say or is overheard scripting the elder’s answers in the background on a phone call. There may be a new acquaintance showing extreme affection, cutting an elder off from others, or moving into the homestead.

Health care providers, staff of financial institutions, accountants, attorneys and financial planners often recognize financial exploitation in the family. Previously uninvolved relatives show up claiming authority to manage finances, claiming rights to real property or possessions. There are conflicts between an elder’s adult children over money or abrupt transfers of titles to property or frequent changes to beneficiary designations in a will.

Medical and pharmacy bills are piling up. There are threats of eviction or utility cut-off. The elder is accompanied by someone new to the bank, the safe deposit box, or to financial planning meetings, without plausible explanation. Overdrafts become frequent and are out of character with the account holder. There are substantial, unexplained withdrawals of large sums, unexplained transfers of assets and abrupt account closures. Powers of attorney are executed when the elder is unable to understand the transaction.

These are signs that attention should be paid, although “maybe” is a good place to start. The concern should rise when the elder is depending on a suspected person for housing or basic needs. Another likely scenario is one where the suspected person is depending on the elder for housing and basic needs.

Other risk factors for exploitation include an elder’s physical frailty, mental impairment, and overall isolation. A history of gambling or substance abuse by either the elder or the suspected person is another potential characteristic.

Elders victimized by exploitation are typically unable or afraid to seek help. They may not recognize that they have been hurt. They may want relief but do not want to go to the authorities. They may not know whom to trust. They may fear that no one will believe them or that people will fault them for being gullible. They may fear that telling their story will take away their independence. In fact, it is the unabated loss of resources and the effects of those losses on the victim’s health that are more likely to erode independence.

Mother’s Day is a symbolic reminder. The opportunity to combat elder financial exploitation is year-round and not confined to adult protective services and law enforcement. Bank tellers and bus drivers, grocers and hairdressers, nursing assistants and mail carriers, family, friends, and neighbors are among the front-line figures in reducing elder financial abuse.

A victim or anyone who witnesses or suspects a crime should make an immediate report to their local police department. The Cape and Islands district attorney’s office has a program for senior victims in Barnstable, Dukes and Nantucket counties. The telephone number is 508-362-8113. Anyone who experiences, witnesses or suspects elder abuse, neglect or exploitation should contact Elder Services of Cape Cod and the Islands at 1-800-244-4630 during business hours, or at their hotline number, 1-800-922-2275.

Iris C. Freeman is the associate director of the Elder Justice and Policy Center at William Mitchell College of Law in St. Paul, Minn., and a member of the board at Martha’s Vineyard Community Services. She is a part-time resident of Edgartown. This is the third of a three-part commentary she is writing for the Gazette about scams and exploitation of the elderly. Previous pieces appeared on Jan. 20 and March 2.