Elder Abuse & Neglect in HOAs: When Should the Board Step In?

Discussion with Legal Expert Jennifer Cunha, Esq. and Board-Certified Psychiatrist Dr. Ivan Cichowicz

Do you know the warning signs of elder abuse in your community? Could someone in your HOA or condo be quietly suffering — neglected, exploited, or mistreated — without anyone noticing?

Florida’s aging population makes elder abuse a growing concern for community associations. From financial exploitation to emotional or physical harm, abuse can happen anywhere — even next door.

In this discussion, we'll uncover the realities of elder mistreatment, what every HOA and condo board should watch for, and how to respond responsibly and legally when something seems wrong.

Learn how to recognize red flags, understand mandatory reporting laws, and create a safer, more compassionate community for older residents.

Protect your neighbors. Protect your association. Awareness is the first step toward prevention.

Here is a link to our handout: https://tinyurl.com/5n7t9hr4

Check out our website: https://jennifercunhalawoffice.com/ 

Transcript

Welcome And Series Updates

SPEAKER_00 0:05

Good afternoon. Welcome to Association Law Talk. This is the mental health and law podcast. It's so good to see you guys. I've missed you. Um, so Zoom is just adding everybody in and then we will start in just a moment. Zoom is still adding people. I'm very, very, very excited to have Dr. Chikowitz with us today.

SPEAKER_03 0:29

Hi, everyone.

SPEAKER_00 0:35

That I think impacts a lot of associations, associations, which is elder abuse. And adult neglect, right? Like what happens when the kids abandon the adults. That's kind of abuse as well. Um, okay, so I think we're gonna go ahead and get started. Welcome back. Um, we have been on hiatus this summer uh on our weeklies, and we will be starting back October 2nd, will be our next mental health and law podcast. And after that, starting October 9th, we will have regular um regular lectures again, but they will be in podcast style with professionals joining us and all kinds of different topics. We're really excited about it. So save your Thursdays, save the calendar. It's going to date starting October 2nd. We'll be diving back into our regular, regular um meetings. And for today, um, Dr. Tikowitz, tell us about yourself.

Guest Intro: Geriatric Psychiatry

SPEAKER_03 1:28

So good afternoon, everyone. I'm Ivan Chikkowitz. I'm an adult and geriatric psychiatrist. I own a practice in Boca Raton, Florida, mindful behavioral health. And I spent 99% of my time treating geriatric patients, um, everything from dementia, behavioral issues related to that, to just difficulty coping with retirement. So elder abuse and prevention is something that I deal with on a daily basis. So really looking forward to our conversation today.

SPEAKER_00 2:00

Awesome. Thank you. I'm gonna put the handout for everybody in the chat. And if you have questions um throughout the lecture or throughout the podcast, please feel free to ask them in the QA. I'll see the QA most easily. Um, but yeah, please feel free to dive into any questions you may have or examples in your associations. Um, so we can we can assist you know more readily with your situation. I also have the questions that came in ahead of time. Okay, so elder abuse in associations, um, not something that's often talked about, but Dr. Chica was how often do you see elder abuse? You see patients day in, day out. How often do you see elder abuse?

How Common Is Elder Abuse

SPEAKER_03 2:42

So it's actually pretty common in Florida. And the reason for this is like we basically have one of the highest geriatric populations of any of the states. I think it's around 4.7 million residents here, are 65 over. And most of these residents are here for retirement. So that means they are not people who were born and raised in Florida, so they don't have a lot of family connections and family support. Um, and as they get older and develop more medical complications, they just become at much, much higher risk. So this is literally like a daily issue. And I I believe that the numbers are anywhere between 8 to 12,000 cases are reported in Florida every year. But we have to remember that we only report about maybe one in 24 cases because it's hard to figure out. People don't want to be identified as the person who reported this. So for every case that's out there, there's a bunch of them that we're just missing, or I'll use the word we're afraid or uncomfortable to report.

SPEAKER_00 3:57

Okay, so that's terrifying. I I I expected to say something like one in four are reported, or you know, half or something, but one in 24 is basically like four percent.

SPEAKER_03 4:10

Yeah, that's uh it's a very small number.

SPEAKER_00 4:12

This is this is yeah, that's terrifying. Okay, because it's terrifying because you know, so many of us have parents that are this age, or are this age, or will be this age. And and and when we think about the most vulnerable, some of the most vulnerable years of our whole life, what does that look like? Um and then as community members, what does it look like to try to support people in this kind of circumstance when there's so little reporting? Okay, so um what is elder abuse?

What Counts As Abuse And What Doesn’t

SPEAKER_03 4:43

So I mean, it's not this is the part of the issue. It's not just one thing. Elder abuse is when someone who is above the age of 65 is being taken advantage of or being mistreated, but there's a lot of realms. Maybe the most classical that we associate with this is physical abuse. And a lot of times this is the easiest one to see when someone is being hit, they show up with a bruised eye at the emergency room, or when they say things like, oh, they're holding me down. But there's a elder abuse is much more complex. We have like emotional abuse. When someone is in a relationship where they're constantly being put down or told that they're bad, or any negative remarks, the most common that we see in Florida by far is the financial exploitation. And this usually happens from bad actors outside the United States that will concoct usually like love stories or emergency situations and get money from elders here, or usually by family members who can, you know, manipulate and put some of these pati elder people at risk of not being able to live or fund their retirement because they want to buy a new car or they want to do some bad investment. We also though see things like neglect, where they can't take care of themselves, family just disappears. We see sexual abuse, particularly from caregivers and AIDS, where they use sex as a way of coercing some elders. And and then it's sometimes, I'll use the word just mental health and physical health. People don't want to engage with their doctors, don't want to engage with their families, and they just slowly, I'll use the word kind of like fall apart. They're unable to cook, they're unable to clean the house, but they're refusing to accept help. So the situation just keeps getting worse and worse.

SPEAKER_00 6:52

Okay. Um, so I mean, when I think, you're right, when I

Self‑Neglect And Refusing Help

SPEAKER_00 6:57

think of like health abuse, I think of the physical, really like the physical abuse. And I mean, I didn't really cross my mind a lot of the other types from you know, co sexual coercion, basically, to um neglics, but there's a large spectrum. So what kinds of things are not abuse? Is there anything that somebody might think is abuse but isn't? Or is anything you can think of abuse?

SPEAKER_03 7:22

Well, and this is why I'm gonna say it's really hard to sometimes fully determine what is and what isn't, because unless you're there, unless you're interacting with people on a regular basis, all we can do is have suspicions. And I believe if you have a suspicion, we should report it to be safe just in case. But I'll give you examples of things that are not abuse. If someone needs to be held down to give them a shot of an antibiotic that they need, that's not abuse. Without the antibiotic, this person would likely have a worsening infection and they could actually die. If someone decides that they want to give whatever amount of money to a grandchild or to a child, but they do it willingly, that's not financial exploitation or abuse. It's financial exploitation or abuse when the money is kind of like gotten in a way that it's manipulative or that you know the elder does not really understand what's going on or what happened to the money. Another example is someone who has dementia and the kids take over the finances, that's very different than someone who has their cognitive capacities and the kids try to take over their finances. And even though someone who has dementia, we still need to make sure that the kids are doing right for the elder,

Why People Don’t Report

SPEAKER_03 8:45

but they're just different situations. We can't just say everything is the same. And the same thing with the sexual issue. Um there could be situations where people have relationships with their caregivers and decide to include them in wills or things like that. But in general, we have to assume that there's usually manipulation here. So it uh it's hard to say 100% of the time, but we always want to be wary when one of these things are going on.

SPEAKER_00 9:16

Okay. So Diane says, How do you handle elderly who refuse to go outside to allow outside help if needed? So somebody who maybe refuses to see the doctor, refuses to allow care. Um, I mean, these speaking of things that aren't abuse but could sound like it, um, protesting.

SPEAKER_03 9:37

No, and and I actually think that in a way that is a form of abuse. That's what we call self-neglect. Um, and the challenge here is there's two things that we can do. One, we can try to see if there's a family member that has, I'm gonna say, a little bit of more either uh relationship or authority over the elder and can kind of convince them to get help. And if not, this is where using DCF or the Department of Elder Affairs can have value because usually when they knock on the door, people are like, okay, so this is serious. Um I maybe have to do what I don't want to do, and they're likely to cooperate more with a government agency than they are with, you know, a neighbor or the HOA, which they

Who To Call And What DCF Does

SPEAKER_03 10:28

may feel as, oh, what are they going to do?

SPEAKER_00 10:30

Okay. Now, what are some reasons people wouldn't report? And I one of the things that I can imagine is that if you have, you know, like family that's very far away, and they have maybe a local caregiver and it's the only real person that everybody knows, but maybe this person's a little gruff and it, you know, probably more. And they don't they don't want to like rock the boat. So, so what are some of the reasons that people don't report? Maybe they're afraid of not being anonymous. Um yeah.

SPEAKER_03 11:03

So first I want to clarify reporting like will be anonymous. Of course, when you call DCF, they will take down your name, but they will not tell um anyone involved in the case who reported. But the real issue is one, I'm gonna say people don't want to be bothered, unfortunately. You know, reporting does require you to pick up the phone, to call, to maybe go on hold, to provide a lot of like demographic information, to give history, to explain what your concerns are, because the person at DCF needs to make a judgment call about whether this is something that's valid and that they feel rises to the level of them needing to investigate or not. And I'm gonna say that's unfortunately is a very common reason, but other super common reasons are what fear of retribution. People are like, oh, I don't want to report, you know, mom or dad, because then they're gonna get angry at me and they're gonna write me out of the will, or if I report the neighbor, then they're not gonna talk to me. And then finally, the other thing that tends to be an issue here is a lottimes we just don't know what to do or how to report. So we say, oh, someone should do something about this, but we're not sure who should do it, how to do it, and what's the mechanisms to kind of do these things.

SPEAKER_00 12:25

Well, right along those lines, John says, Who is the reporting agency? We'll go more into resources in a little bit, but just for right now, like what's the main reporting agency?

SPEAKER_03 12:34

I mean, so the main place is DCF, the Department of Child and Family, um, they have a division called the Division of Elder Affairs. And because this is Florida, retirement capital of the world, they take senior health very seriously. If you submit a report and there's a little bit of validity to it, they will investigate, they will make sure that the seniors are safe. They do not want Florida to be known as a place where seniors come down here and no one knows what happened to them. So it is an amazing resource. Not a bad thing to just familiarize yourself. We have the phone number and the flyer, and I can guarantee you that they will do everything in their power to help.

SPEAKER_00 13:21

Okay, I just put the phone number into the chat as well. So the flyer that I um is in the chat has a lot of resources and also has the information we're talking about right now. Um and then um the flyer or the um sorry, the handout. Yeah, no, you're good. Yeah, it's the same. I shouldn't have put flyer. Um, so DCF, the phone number is

Financial Exploitation And Scams

SPEAKER_00 13:46

in the chat as well. Okay, so we talked about what is abuse, what is an abuse, some like barriers people might have to reporting. And that it is anonymous if people report. Um, another barrier again that might come up is like who else is going to care for this person, if not the person who's caring for them, maybe their husband, their wife, their family, their child, who, you know, if there's some abuse going on, who else would do it? So who else would do it? You report, they find out there's abuse. Who else do they set in?

SPEAKER_03 14:17

So this is a the thing, like if DCF or the Department of Elder Affairs kind of determines that there is abuse, they will make sure that the elder is in a safe situation. So that may mean removing a person from the house. It may mean removing the elder from the house if the house does not belong to them, or if it is their partner. It may mean getting someone else to take care of the elder. It may mean assigning a case management or a social worker to oversee interactions and do regular assessments. And in some cases, uh, we had a patient recently that it meant moving the person to where their family was from, in this case up north, and getting a nursing home for the patient for you know our patients there. And because the kids didn't want to be involved in any other process, DCF just took it upon themselves to find a location. Um, they did an assessment, they took over the patient's finances, and they coordinated the travel, the transportation. And now the patient is up north, close to family.

SPEAKER_00 15:30

That's amazing. So, so if it's reported and for whatever reason, you know, in the worst case situation you can think of is it's your spouse, you know, and like this trusting relationship. But the worst, worst case scenario, DCF still steps in, they'll find a place for the person to live, they'll they'll set things up so that they're okay, which is incredible. Um okay, so I will say that when we have stuff come up in like collections, um, a lot of times people, you know, don't pay their bills because they have dementia or something's going on. So we I mean, we don't throw out someone who's older, right? Like you we we contact elder services, we get, you know, we get people involved, family involved. We've never had a situation where it didn't end up with somebody figuring it out.

SPEAKER_03 16:24

Um, but in all the circumstances, the idea that TCF will step in for Yeah, and in my experience working with the Department of Elder Affairs, this is the only case that I can remember in the recent maybe 10 years that DCF has had to do all of this. Normally, there is some type of a family member who is willing to, I'll use the word step up and be involved in the process. And DCF can arrange guardianship and make this family member a guardian. So I don't want anyone to think that DCF just takes over and ships you to wherever they want to. No, usually they'll work with family first, trying to secure a family member as the guardian.

Caregiver Boundaries And Sexual Coercion

SPEAKER_03 17:07

But when that's not available, they will make sure that the elder is okay. They're not just gonna let the elder stay at their house. And in this case, it was a lady with dementia who was refusing to leave her house.

SPEAKER_00 17:16

Okay, that's amazing. So let's talk about risk factors um that make people potentially more likely to be abused. And this is in the the handout um on the second page or anybody who's following along.

SPEAKER_03 17:34

Yeah. So I I mean, in my experience, the biggest risk factor are cognitive problems or memory problems. Because when this happens is when one is significantly susceptible for the most common type of abuse, which is really financial. Okay. Because not only can you be taken advantage of by family members, but you can now be taken advantage of by, again, by an email scam, a cold call scam, packaging scams, like love scams. These are just there's they're everywhere nowadays. So when patients have cognitive impairment, they're just at super, super high risk of this.

SPEAKER_00 18:16

So let's talk about how common this is. I'm gonna I'm gonna tell you the anecdotes that I have, not even in your world, just people I know. One of my close friends is a woman over 60, and she met a guy on Facebook who was um, you know, working for the government. I think he was like a soldier overseas in Iraq, and they fell in love, and then he was taken prisoner and he needed a lawyer. And she ended up sending him, I think, $7,000. And then, and this is my friend who doesn't have any cognition challenges at all. She's just my friend. And then another person, the family friend, recently lost $60,000, which is her whole savings to move into a condo, because somebody said that he was funding a condo for both of them and that they have they fallen in love on the internet. He had her wire him all of her money, all her money, $60,000 saved. And now she is nowhere. She's like, she's got nothing.

SPEAKER_03 19:12

Yeah.

SPEAKER_00 19:12

So it's everywhere.

SPEAKER_03 19:14

Unfortunately, I see this like every single day here in South Florida. Um, love, you know, love scams. I kind of just tell my patients, as soon as they say, Oh, I met someone online, I usually just say, if it's on Facebook, it's a scam. There's nothing else to talk about. It is just so common. Uh, but all these, like, I'm gonna say, internet technologies, elder patients just have to be so careful, particularly when it's that there's younger people falling in love with them. This is the you know, the classic story, an 85-year-old lady and has a 21-year-old guy that looks like a supermodel um sending her love messages, or the 87-year-old guy who has a 19-year-old girl that looks like a supermodel sending him love messages, and there it's just so easy to end up in in a scam, but it doesn't have to be like that. I had a client recently who was at a fast food. Young kids come up to him and say, Oh, can you give us some money to eat because we, you know, we lost our wallet? And he's like, Oh, I don't have any cash, and they're like, Oh, we'll take you to the ATM. And he's like, Oh, that seems reasonable, thinking that he was going to give them like 20 bucks to help them with lunch. They took out five hundred dollars.

Red Flags For Boards And Managers

SPEAKER_03 20:40

And he has no understanding of what was going on. His wife figures this out when she's looking at the finances later on, and she's like, Why did you take out $500? And his answer is, oh, there were some young kids who needed money, and I gave them my card and explained to them how to get money, but they told me they were only going to take $20. So it's simple things like this that sometimes we don't imagine. But it could also be that they walk into a store and they get taken advantage of by the person there who's like, oh, you know what, we need to add this coverage and you're buying the radio. No, you need to add the protection plan for 20 years for this radio. And they just don't have the ability sometimes to discern this is not uh you know a good use of my money. And and then finally, of course, the the problem with cognitive impairment is it can become an issue between family members to try to see who gets control of the finances, particularly if there are financial assets or if there is a family member who is not doing financially well. And this can create a lot of chaos. And because there's cognitive impairment, the patient or the person can't really advocate for themselves well. So this is why I think this is the the most the scariest and the most common. Uh, but that segues a little bit also into what I'm gonna call that, you know, the loneliness issue. Because when we're lonely, we're also susceptible to people taking advantage of us and we just don't want to complain because we're afraid that we're gonna go back to being lonely. So we're like, ah, you know, let that person take whatever they need as long as they come back tomorrow and spend the afternoon with me again, which is what happens with a lot of caregiver surveys. Oh, if you don't help me, you know, with my car payments, I can't come back to, you know, to work here tomorrow. And they're like, oh, okay, so here, yourself $300, sir.

SPEAKER_00 22:41

Tell me more about caregiver, caregiver abuses that can happen. So we we have we have if somebody's lonely and has and or somebody's maybe single or unhappy in a relationship, and or has cognitive challenges, they're high risk for financial.

SPEAKER_03 23:00

Yeah, I think the challenge, the challenge with care with the caregiver situation is that when you have, I'm gonna use the word like lonely, and I I'm gonna say rare when there is a partner or a child living at the home at the home, it's mostly when it is a single male or a single female with a caregiver of the sex that they are of the opposite sex that to what they're attracted to. So if it's a man with a woman, or if it's a gay man, then uh a male caregiver. And what can happen is they'll take advantage of the fact that it it almost becomes like a I'm gonna say parent-child relationship, where the caregiver is the one that makes sure that you have food, the caregiver is the one that takes you to the doctor's appointments, takes you to the supermarket, maybe they're the one that uses your credit card to pay the bills. And little by little, it could kind of like intimate that there's feelings, and the lonely person is going to likely read more into that, and then they can try to

Mandatory Reporting And HOA Duties

SPEAKER_03 24:11

buy the other person's affection, or the other person can just kind of say, if you help me financially, I'll let you, you know, touch me in a sexual way. And because of loneliness, a lot of elders are just going to like be okay with this or accept this.

SPEAKER_00 24:28

So you say that sometimes they end up even sharing a bed.

SPEAKER_03 24:31

Yeah. We've had people end up being like, well, we we sorry, we we've had situations where patients like acknowledge that they're paying their caregiver extra for almost like if it were prostitution, to be honest, sleep in the bed with them to let them see their breasts, to you know, touch them in their genital areas. And again, this kind of becomes an issue because these people are living alone with these caregivers, and a lot of times it only comes to the light where something happens that you know this information is made public.

SPEAKER_00 25:09

Okay. So, so I think that um, I mean, you're kind of shedding light on this iceberg that we we all see the little bit at the top, but there's so much more. I almost want to like wrap every single vulnerable older person and bubble wrap and just be like, I hope nothing bad ever happens to you. But now, you know, we see like all the different types of abuse. Um so what we what would somebody look for? I mean, we look at cognitive decline, we look at loneliness. If I'm a board member, I'm a property manager or a community association manager, and I live in a community with lots of older people. What kinds of things flag it for us?

SPEAKER_03 25:55

I mean, so I'm gonna say number one, social isolation. So when you have someone who's not engaged in any type of community activity, who's not participating in any type of socializing with neighbors or anything, again, we don't want to say that's abuse, but I think there's a higher chance that there is some abuse going on there. Um, when you see someone who has a caregiver and the caregivers' interactions are more like a gonna say parent-child interaction where they're being told no and this is not the way you do it, and they're I'll use the word kind of mean or demeaning, this always has to raise a concern about possible about possible abuse. And and when we have grown children who are, I'm gonna use the word kind of like moving in for reasons that are I'm gonna say not valid. So if you know mom or dad has surgery, kid comes in for the next two or three weeks to make sure that recover recovery goes okay, that makes sense. But if you have a parent who just has one of their kids move in for no apparent reason, the always question is is there exploitation abuse? Um, why are they living with their parents as opposed to

Abandonment Cases And DCF Thresholds

SPEAKER_03 27:18

finding their own place or kind of doing their own thing and just visiting the parents to check in on them on a regular basis? So it it's hard, but these are the kind of sometimes little tidbits. And then the last one, but this is more on the medical side. Patients that are constantly coming in with a lot of distress, um, they just seem super anxious, they they can't be left alone, and and who they just say that they're unhappy with the level of care that they're receiving. This is us as caregivers, as you know, as medical providers, we have to be aware that we just can't dismiss it as, oh, that's just you know, you acting out.

SPEAKER_00 27:59

Okay, so so in everyday, in the everyday world, if a board member or community association manager um has on their radar someone who is not engaging with the public, someone who has a relationship with the caregiver where the caregiver is gruff in public, demeaning in public, or an adult child moves in, but not for caregiving, but because they, you know, we call it sometimes like failure to launch syndrome where they just can't make it in the world. We see a lot of abuse there with kids who move in with their adult, you know, I mean their elder parents, elderly parents. And then we end up a lot of times having to evict the kid.

SPEAKER_03 28:39

Yeah.

SPEAKER_00 28:39

So we try to evict the whole family or to eject the whole family, but the the family gets involved and they'll move that person out. But we see a lot of times um that scenario. So so on the radar would be those people who are lonely, isolated, demeaning relationships, and then um, and then the kids.

SPEAKER_03 28:56

Um and and I'll give an easy example. The other day we had a a patient whose son's kind of failure-to-launch syndrome um was living with her. He needed a car to go visit a friend out of state. He takes the patient's car, or like, you know, the elder's car, goes out of state, decides that he's gonna stay there longer because he had a work opportunity. And in the meantime, our patient is saying, like, I had to cancel my appointment with the cardiologist because I couldn't go in because I don't have transportation, and she doesn't know how to use Uber or any of these ride shares. And she calls the son, and what the son says is, Oh, like, you know, you're putting your your priorities before mine. And she's but it's my car. So these are the types of things that are sometimes, you know, not I'm gonna say, as easy to see, but they are a form of like elder abuse.

SPEAKER_00 29:52

For sure. A lot of times the kids who are like that, who are abusing their parents, are also really awful in the neighborhood. So we end up getting Involved because the board um you know is alerted that people are afraid of this kid, the kid is threatening to kind of you know fight with people, they're abusive to just the neighbors, they're breaking into cars. Um, you know, so so when we get involved at that angle, we also know we're probably helping the parent. But the idea of just jumping in and saying, this son

How To Document And Escalate Concerns

SPEAKER_00 30:24

or this daughter look like they're abusing the parent, let's call DCF, you know, doesn't always, you know, go on the radar because what does that look like? And and who what's anybody's role on that? We have some questions. Um we have an owner who we understand spent time in jail due to elder abuse. This person, this owner, is back in the unit and has in the past yelled at a girlfriend in public. And this girlfriend also lives in the unit. Do you have any ideas about what the board of directors should or could do? I mean, on a legal side. So let's let's use this as a springboard to talk about the legal obligations that people have generally, and the board and community association managers have. So, Dr. Tikowitz, tell us about reporting.

SPEAKER_03 31:12

So, I mean, medical providers or anything, I'm gonna say emergency providers, like you know, police, um, firefighters, we all have the responsibility. We're kind of like I'm gonna say, mandated to report any suspected case of elder abuse. Um, but my understanding is HOAs and Jed, you can calify also have a responsibility to report if they believe that there's elder abuse going on in the community.

SPEAKER_00 31:41

It's a little nuanced. It it really just depends on whether a community association manager or a board member um is in a supervisory role over somebody's care. One, two, um, you know, has a fiduciary obligation. So a fiduciary obligation would be you're about to do a foreclosure on someone that you also know is being financially abused. Um, so so if you have a fiduciary obligation over a situation, you may have mandatory reporting requirements. Um the third that's a little bit of a gray area, but I would err on the side of caution, is when um like there are some cases where neighbors abused or harassed other neighbors who were vulnerable people. Um it was a that those were sometimes like handicapped situations, persons with disabilities, um, racial, like um racial differences. And in the instances when the boards did not step in and they got sued by the owners, um, they actually were found liable, that they have a duty to ensure um quiet enjoyment of the property. Now, this this is between neighbors, it wasn't wasn't necessarily, you know, within the community with one unit. Um, but there is a possibility that somebody could say that they have a fiduciary obligation, that you know, courts would be very lenient in their discretion

Prevention Through Community And Education

SPEAKER_00 33:11

on whether somebody has a has a role or duty to report. I do think that when you're going to do a foreclosure or you're going into collections and you think that you have some sort of financial abuse situation of the owner, that could be a really good trigger to report. And I also think you should just report no matter what, if you suspect it, almost nobody has better eyes in the situation than you guys. If you're a board member, you're a community association manager, you're already out there looking for violations. You also see all kinds of things. Um, and I think like, what would we want if we were in that situation?

unknown 33:48

Okay.

SPEAKER_03 33:48

And I I want to add one more thing, and I forgot to put this in the in the handout, but I I think it's just super important to always remember, and that's power of attorneys. I see a lot of case people come into my practice and their kids will tell me, I have power of attorney, so if they don't do what I want, I am going to force them to do it anyway. And it's a matter of understanding that power of attorney doesn't mean anything unless the person who signed the power of attorney is declared incompetent or is found to lack capacity. So I see a lot of particularly like you know, kids using power of attorneys over their parents as a way to kind of try to control them, where this has no, I'm gonna use the word medical or at least kind of standing.

SPEAKER_00 34:37

That's good to know. That's so so just because someone has power of attorney doesn't mean that they can actually go in and do everything actually have to have somebody declared incompetent. Is that right?

SPEAKER_02 34:48

Yeah.

unknown 34:49

Okay.

SPEAKER_00 34:50

Um, we have a couple of questions here. Diane says, what do you do when a family warehouses is basically like leaves someone, a parent, on their own in senior housing in a condo, but they're clearly not able to take care of themselves. So again, you have like the families abandoned somebody um in a unit.

SPEAKER_03 35:10

Yes, and so so these are hard. And I'll I'll give an example. We had a lady the other day who, you know, significant, I'm gonna say moderate dementia, but unable to care for herself, living in her condo where she'd been living for the past 20 years. The neighbors would come in, would clean for her, would go to the supermarket, would fill her fridge, would do her laundry. Um, family was, you know, just refusing to take the phone. We had reached out to them multiple times, and they're like, you know what, she was a horrible mother, we don't want to be involved. Um, the siblings are, we have our own problems. And and the challenge is we tried to talk to what our patient about, you know, alternatives, but she would just not hear it. She's, I've been living here, I'm not going to move. And the only real option that you have is kind of getting DCF involved. And then DCF can come in, and they initially spoke with the neighbors, and the neighbors were like, well, like if we get some help, we'd be happy to continue to help. And DCF

Vendor Policies And No‑Solicitation

SPEAKER_03 36:18

agreed to have an aid. Um, unfortunately, she fired the aide. And once that happened, the DCF said we have to like kind of like remove her from you know from the property and put her in like a nursing home.

SPEAKER_00 36:32

Okay. DCF's amazing. Amazing. Now I have a question for you. Sometimes we hear from our board members that DCF didn't listen to them. But I wonder whether under a doctor's care, like DCF is more likely to listen to you. Do you think that the board should try to get someone to like pester them a little bit in a gentle, loving way to go see a doctor, and then the doctor can, you know, can intervene a little more? What do you or do you do you think that DCF is is pretty expensive?

SPEAKER_03 37:01

So yeah, I'll I'm gonna say I I'll prefix this by saying my interaction with DCF is we usually say this is you know Dr. Chikkowicz from Mindful Behavioral Health calling on one of our patients, which may be a little bit of a different interaction than than anyone else. And and not to say that there's never hiccups, because I've had situations where they've said, you know, oh, we'll we'll intervene when the abuse happens, and we're like, look, we see we think this patient is at super high risk of being abused. Can you assess? And they're like, no, that's not good enough. You have to say you know that abuse has happened. So it it's it's not always super straightforward and easy, but in general, I think these are good people who always try to do a good job. But yes, I I get it that it may not always be super straightforward and easy. And as a reminder for people, they may not respond if you say, I think there is abuse. You have to say, look, I believe there is abuse, and

Dementia Care, Diagnosis, And Treatments

SPEAKER_03 38:04

this is why I believe there is abuse. We were um at, you know, there's a card game going on. She said she wanted to continue to play. The caregiver said, No, I have to go and do whatever it is, you are leaving now. The you know, the elder was like, but please, this is my favorite card game, and she just grabbed her and wheeled her away. You have to have some type of interaction like that that can give DCF a feeling of, okay, there could be something going on here. If you just call and say, Oh, her son, who, you know, I'll use the word is a bum just moved in, there they might say, like, we're not going to investigate that. But if you're saying things like she's now struggling to make her, or she's not able to, you know, make her HOA payments or to make her rent, or she's voiced the fact that the son is being abusive or taking advantage of her, those are concrete things that we can and we should report.

SPEAKER_00 39:04

That's amazing. Okay, so so if we say, you know, the caregiver who's living there is breaking the rules and is putting her at risk of losing her housing, or she's not making the rent anymore, she's not making her payments anymore, she's at risk of losing her housing, or I saw these interactions. Um, and just really be very detailed about what would be.

SPEAKER_03 39:27

Exactly. Or in an hoa setting, you may just be able to say, look, they're breaking the HOA rules. And when we try to engage with the homeowner, we get the angry family member saying, I'm gonna sue you, or I'm gonna like beat up whoever one tries to come and mess in. Because that's a clear sign that there's some type of, I'm gonna say, abuse going on versus when you just say, Oh, you know, the the kids moved in and they, you know, they play loud rock music at two in the morning.

unknown 39:59

Right.

SPEAKER_00 40:00

Okay, well, that's that's really helpful for articulating the the problems with DCF or the problem to DCF. Um, we have a question from John. He says these relationships, the caregiver relationships, the adult child who's moved in with the elderly parent, are difficult to discern as board members. Do you have any suggestions? And I think you've mentioned before, just like seeing somebody complaining, um, seeing bad treatment in public, that these are enough. Do you have any other thoughts around this question?

SPEAKER_03 40:33

Yeah, and I'm gonna start first of all, like I acknowledge that this stuff is hard because you know, we're human beings. We can argue one day, we can have a bad moment, and it doesn't mean that we're abusive in general, but we do have to be aware that there's patterns of behavior. If there's an elder in the community who's constantly, you know, complaining about their aid, and and and again, so it's a matter of putting in perspective,

Collections, Family Outreach, And Flexibility

SPEAKER_03 41:03

complaining that, oh, I I can't come to the card game because the aid doesn't let me, that is a complaint. Saying that, you know, she makes me eat the mashed potatoes that are not my favorite food mm food is usually not something that rises to that level because it could just be that when the kids hired her, they said she's gonna, you know, eat healthy as opposed to eating, you know, pizza and McDonald's like every day. Nothing against McDonald's. Um so we want to just keep an eye out for patterns of behavior, loud voice, you know, always talking down, never trying to like listen to the other person's kind of point of view as as possible signs. But I acknowledge that this is hard and really it's kind of time. The the reason that I have an ability to kind of figure some of this stuff out is because I meet with my patients on a regular basis, and maybe they won't say anything the first two or three appointments, but in appointment number five, they bring something up. So it's just a matter of one, you know, not feeling bad if we miss something, but also being aware that if there's something that we kind of say that's not okay, that should be a sign that there could be abuse going on.

SPEAKER_00 42:20

Okay. So let's get into some of these prevention strategies for HOEs and condos. Um we have on here encourage community awareness and education sessions and newsletters. Uh, what kind of information and literature do you see and recommend?

SPEAKER_03 42:40

Okay, so I I'm gonna first start by I want to give what I think is the best antidote to this and its community.

SPEAKER_00 42:47

Okay.

SPEAKER_03 42:48

You know, knowing who your neighbors are, knowing who the HOA team is, just knowing who people are, interacting with them, you know, having a two or three minute conversation with their caregivers, because it gives you a little bit of a flavor of who people are. And after you've seen someone multiple times, it's a whole lot easier to say, oh, something's wrong, than someone who you've never seen before. So the best antidote is really for these HOAs or senior communities to try to get everyone to like interact, to mingle, um, and just try to get people out the out of the door. So I've I've had patients who live in communities where there's like welcoming groups. And as soon as you move in, there's two or three neighbors who are in charge of meeting with you like once a month just to introduce you around. These kinds of things can make a big difference. Um and and then education, but remember, it's not about educating the victim, it's about educating everyone else. So if there's uh a card room, if there is a dining room, if there's sports, educating the staff that is involved in any of those activities, educating the community at large so neighbors can figure this out because the victim is usually the last person who's gonna bring

Key Takeaways And Next Sessions

SPEAKER_03 44:10

this up, unless they're in a relationship of where they feel I'm gonna say they're gonna be taken care of.

SPEAKER_00 44:16

Okay. Um, so so education can be handouts. Do you think that a lot of associations have bullish and boards and they might have notices and information on them? Um, do you think that literature could be put on that says like report elder abuse that could look like this, um, or some other some other kinds of wording that can promote awareness in the community?

SPEAKER_03 44:41

Yeah, so I think um, and again, these all all depends on the community, but some communities that are more technologically savvy or have people who are more technologically savvy, you know, emails, you know, text messages and websites, um, but bulletin boards, flyers that could be left, or you know, mailers that could just be left in the mailbox could be a great idea for people who are not technologically savvy. And just every now and then, you know, talking about this in a community activity. You know, a lot of times there's people in the community who are looking for things to do, just you know, bringing up different topics that could be of interest, and elder abuse could be one of them.

SPEAKER_00 45:23

That makes sense. Um, we have on here, um, you've mentioned support neighbor friendships through community events, foster a check-in culture where neighbors look out for each other. So, so one of the best ways to prevent it, you've said, is community, but fostering that check-in culture. Um Yeah.

SPEAKER_03 45:42

And that's another way of saying what I was trying to say, that that check-in culture, that's very good. The other pretty good resource that is out there is if you if if a community calls their local sheriff department and they say that they're interested in having someone come in to give a presentation on online scams, the sheriff's department have volunteers that give these presentations and they'll go out to communities and they'll talk to you about the 10 most common kind of scams that are going on at present in Florida. They're keeping track of this stuff all the time. The only challenge, of course, is it's only going to reach maybe the people who go to the presentations, but it's still something that can help the community if 20% of the community knows this. They may be able to get the word out. And it's just usually these scams happen like by clusters. So there's a big bunch of like love scams, and there's you know, IRS scams. And and if you're aware, at least it gives you a little bit of insight. But that's only one type of abuse.

SPEAKER_00 46:54

Okay, that makes sense. Um, let's see. So you mentioned here implement visitor vendor policies to limit unwanted solicitation. What are your thoughts about that?

SPEAKER_03 47:06

Okay, so the challenge with vendors, um, and particularly in our you know, communities that have a lot of elders, is that if there's any little bit of, I'm gonna say, cognitive issues or memory problems, we've ran into the situations where people are having their roofs changed when they had their roof changed three years ago. And it's because a vendor just knocked on the door and said, Oh, we're gonna check your roof for free. And it was like, oh, this roof is horrible. It needs to be updated. And it's not until a neighbor calls the kids to say, look, they're working on, you know, your mom or your dad's like roof, what's going on? And the kids then have to come down and kind of like figure out all these details. Um, so if the community can kind of control some of these vendors, um I just think it makes that a whole lot easier for the community in general. And by that I mean if vendors want to come in or you want vendors, have them where the community people go to the vendors at the clubhouse as opposed to the vendors knocking on people's door, as an example.

SPEAKER_00 48:14

That makes sense. So no solicitation for gated communities is fantastic, or even if it's not gated, if you can have no solicitation signs up and and signs up, that can protect people a lot. Um and then let me ask if somebody has a parent or maybe even is developing dementia themselves, right? So so maybe it's it's on the horizon, it's coming. What do you think they can do preventively for themselves, for their family members to try to limit their vulnerability to abuse?

SPEAKER_03 48:51

I mean, so number one, anyone who suspects that they may be having a memory problem, I think they should seek medical, you know, care. Um, because memory problem can come in many shapes and many sizes. And we want to make sure what's going on. But if you refuse to do anything, I think you should at a minimum you know exercise and try to eat healthy. Um, you know, exercise, eating healthy, sleeping. They don't cure dementia, but they do make it a whole lot better. So at a minimum that, but they should be involved in being assessed by a doctor to make sure that there's nothing going on that we can reverse, or if it is just straightforward dementia. And remember, dementia can be many different types. We can kind of help educate the patient on what to expect and what things to do that can help have better outcomes.

SPEAKER_00 49:44

And there's medication that can help. Can you tell us a little bit more about that? What does it bring more lucidity, or do you stay where you're at?

SPEAKER_03 49:54

So there's recently um new type of medication approved, but this is for Alzheimer's dementia. So this is why you need to see like a doctor. If you're diagnosed with Alzheimer's in particular, you may be able to qualify for a new type of medication. It's an infusion, and it helps remove amyloid plaques from your brain. This can help delay um worsening of memory significantly for some patients. Medicare will cover this, but again, you need to have an actual Alzheimer's diagnosis. It just can't be uh, you know, you you just can't go ask your doctor for a prescription for this. Um but i in addition, there's medications like donempacil, which is ariceps, uh, mementine, which is namenda, that can be helpful. There are supplements like omega-3 fatty acids, um, lithium oritate that can be helpful. And there's a lot of lifestyle interventions that can also help patients just live a better life. So when you combine all of these, people can have significantly better quality. We're not talking about curing an illness, but making it a whole lot better than what it can be, but you have to act early. Once the dementia is bad, it's just so hard to change any of these things with lifestyle interventions or with medications.

SPEAKER_00 51:20

And it sounds like if somebody has dementia or has developing some cognitive challenges, if they're regularly seeing a doctor, a doctor really can be very preventive for um or protective for abuse. Because if they're able to relay something to a healthcare professional like you, or you're able to see their affect, you you kind of know what to look for, you have the authority to call DCF, almost just going to the doctor on the regular basis to treat the neurological condition.

SPEAKER_03 51:50

Yeah, and and I'm a psychiatrist, so I'm a specialist in this, but even if it's just going to see their primary, because at their primary's office, a lot of times it's not just the doctor, it's the nurse practitioner, it's the secretary, it's the nurse. They get to interact with all these people. So if they form some type of an attachment to one of these staff members, they can maybe, you know, just make a statement that raises alarms.

SPEAKER_00 52:16

That makes sense. Um, and then the other thing you've mentioned in the past in one of our webinars or podcasts is that um some things parade as potentially dementia when it's not UTIs, um sleep challenges, other things can can make stress, can make something seem like dementia, but it's not.

SPEAKER_03 52:38

Yeah, and we have to remember, like as human beings, we like to, I'm gonna say, cluster things together. So any little thing, oh, that's dementia. And no, dementia is a particular set of diseases that affects memory and and cognition, but we can have vitamin B12 deficiencies, we can have hormone abnormalities, we can have infections, medication, side effects. So we don't want to jump to say that any little memory issue is dementia. We need to like to assess Alzheimer's is the most common type of dementia, but not everyone who has dementia or memory problems has Alzheimer's. Um, it's just the way we I'll use the word kind of talk in you know in community. Oh, it's Alzheimer's. But a lot of times that just means that people are having some type of memory problem.

SPEAKER_00 53:26

Makes sense. So let's recap a little bit um as we close up here today. On the law side, when we're working with somebody who's elderly, we tend to call DCF or get elder services involved in some capacity. If they are having a challenge with paying a bill, um, if we get collections, I'm I'm I just I'm so grateful for you know the collections team we have because they're kind but they're firm and they move things quickly. They're not, they're not like they don't treat people like a number. Every single case is a unique case. And when we get situations, because we're a small boutique firm and we have the time and capacity to look at each case as an individual, when we get one that has an elderly person, we almost automatically, you know, figure out one of the resources that need to be advanced.

SPEAKER_03 54:19

And I'm I'm gonna add something here because recently we had uh a patient who we got a call from their son saying that they just had a call from the community where their mom lives that she's being evicted. And the son is upset because he's like, I I I knew nothing of this until right now. And apparently she's been in collections for months, she owes like a huge amount of money, but the son had no idea about what was going on. And and of course, this creates you know a lot of complexities. So for communities or HOAs, it's always remembering when you're dealing with people who could be vulnerable, like getting some type of family involved can save a lot of headaches. Because the son said, if I would have known this, I would have written the check myself and figured out what was going on with mom, as opposed to now where it's a huge amount and he doesn't have the funds to just, you know, write a big check and kind of solve the problem.

SPEAKER_00 55:23

Right. Um we've had this happen. We've had this happen where somebody got, I mean, in one case, the association was really kind. She was 87 years old, and they didn't do collections on her for six years. And you can imagine how much it was tens of thousands of dollars because they felt bad. And what we ended up doing in that case is like we put a lien on the property so that the debt was secured to the property. But they did a really low payment plan that allowed, you know, some repayment to start immediately with the son because the son got involved, um, what the son could afford. And then at the end, when the unit would be sold, the rest would be paid in balance. So there is some flexibility that can occur. These are one-off cases. It's not every single day. You have some, you know, the in this case it was the association that was like, oh, we don't want to collect on this person who's so vulnerable. Um, but a lot of times, again, like if family know early on and they can get involved when it's a smaller number, when it's a big number, it gets harder. But associations have the ability to do payment plans that work for families. Um, generally speaking, we we also see this, um, we encourage our associations when they do sales and leasing applications, when they create them themselves, to have emergency contacts, especially if it's a 55 plus community. So that, you know, emergency can be contacted. Yeah.

SPEAKER_03 56:44

I'm gonna add something there because when we write down like emergency contacts, and I know this can be hard, but if people are willing to put down the name of their primary care provider, that could also be a huge asset. Because if the community has any worries, it could be a whole lot easier to just reach out to the primary care provider and say, you know, this is going on, than sometimes trying to get someone to follow, you know, instructions or to do something different when it's coming from someone from the HOA versus when it's coming from the primary care provider.

SPEAKER_00 57:21

That's really it.

SPEAKER_03 57:22

I mean, at least in my case, it helps so much when I get called from people's children because they're telling me mom or dad are doing this, which when I see them, it maybe doesn't come out. So just something to think about.

SPEAKER_00 57:33

Um, so potentially they could call the healthcare provider and say, hey, this is what we're seeing, or this is, you know, the problem that's arisen. The healthcare provider can be a point of contact. It's amazing. Um, the other scenario, so we have the collection scenario, which is where you know, we get elder services involved, we'll get the kids involved. Um, nobody's putting elderly people, I mean, certainly not us, we're not putting elderly people on the street and taking away houses. Um, we've always been able to find a solution. But the other thing that comes up again, we see a lot of um abuse from the younger kids who've moved in with their parents. Uh, a lot of times that works its way out just because this kid who's abusing their parents is also probably abusing members of the community. Okay. This is a rule violation. And the family gets involved. But now we understand more that um, you know, that DCF really could be a stronger resource. It could be a stronger resource if the association goes directly maybe to the care provider and says, this is what I'm seeing. And the care provider might be able to make that call. Um, but somehow between these, DCF will get involved. They can find nursing homes for people, they can find aids for people, they can get them into other housing. There's just like so much that DCF can do.

SPEAKER_03 58:47

And and in my experience, usually when DCF shows up, all of a sudden, like family usually kind of like, oh wait, this is serious.

SPEAKER_02 58:56

Yeah.

SPEAKER_03 58:56

Um, let's kind of figure this out. Um, a lot of times we try to get family to help and they're like, I'm too busy. Oh, like I don't have money. But when DCF shows up, uh again, I think that usually kind of helps family say, Okay, don't worry, we've got this, we're gonna figure it out. They don't want DCF involved or right.

SPEAKER_00 59:14

Yeah, for sure, for sure. And now we also understand that if somebody has like um a suspicion of abuse, that they should just go ahead and make the call. They can be anonymous, it will be resolved. I mean, if a DCF gets involved, you know, they'll find a solution. Um, and we think always, you know, what if it was us? What would we want? And also that associations may be responsible legally for reporting, not necessarily that they're a mandatory reporter as per the statute, which can be healthcare providers, lawyers, certainly, other professionals in the community, but that the association may be responsible by way of fiduciary obligation. Um, and uh if they are overseas. Seeing community events or some care for people in some capacity. But also you guys are like, you know, boots on the ground, eyes everywhere. And you really could do a lot of, I think, good in the community.

SPEAKER_03 1:00:12

Yeah. And it's always important to remember like, you know, if we're lucky, we're all going to get to the that age where it would be nice to have someone looking after us. So I mean, I'm going to say we do a good deed now, and maybe someone will do a good deed for us in the future.

SPEAKER_00 1:00:28

So Yeah, yeah, yeah, for sure. I think the heart of all of it though is something that a lot of times in the law we don't think that much about, which is community. I mean, we think about community in the sense like everybody needs to follow the rules and pay the bills. But your the heart of it that you've described is neighbors caring for neighbors, a community that fosters friendship, um, where people are like, oh hey, she's mean to me, or there's card games and someone's getting like taken away from their favorite card games, and people can actually see these kinds of um abuses going on because the community does the quiet, lovely friendship thing that communities only communities can do.

SPEAKER_02 1:01:04

Yeah.

SPEAKER_00 1:01:04

Um, so so you know, not every day am I like, good job, you guys, having card games and all the lovely social events and all the potlucks and all the dances that you do, but this is really the space where you can do the most prevention.

SPEAKER_03 1:01:19

100%.

SPEAKER_00 1:01:20

Super nice. Okay, guys. Well, we have some sweet feedback. Somebody said this is the best class they've ever taken. Um, someone said thank you again. Annette says, Thanks again. This is a bigger problem than people realize. Thank you so much. Thanks for sharing. Um, Wendy, thank you so much for this great information. So, Dr. Chikowitz, thank you for being with us today. I'm really excited about next month. Um, again, everybody will be doing this generally the first Thursday of every single month. We'll be tackling some mental health challenge that we see in associations but don't always directly address. Um, we've recently addressed schizophrenia, um OCPD, um, and dementia. These are the things that are recurring. If you need any help, please feel free to reach out to Dr. Chikowitz. He specializes in geriatric psychiatry, which includes dementia. Dr. Chikowitz, tell us a little bit about what you specialize with in and also your team.

SPEAKER_03 1:02:16

Yeah, so I I specialize in geriatric psychiatry. So I dementia, every anything that has to do with the aging process. Um, but then our team here does a lot of interventional psychiatry, which is for people who have like treatment-resistant depressions that are just not getting better. But Jen, thank you always for hosting these. Yeah, always have a lot of fun here.

SPEAKER_00 1:02:37

I know I'm so thankful to be able to share this information with our community. And guys, if you need any help at all, happy to happy to help. Our team is here. We've gone on a little hiatus as we set up our podcast just for our Thursdays, but our team is here, and we're happy to help in any way we can. Feel free to reach out anytime. Um, and we will see you soon. Save the date, October 2nd. We're up and running again. Um, and we have some fun things in store. Everybody have a really great day, and we'll see everybody again soon.

SPEAKER_03 1:03:04

Take care, everyone.

SPEAKER_00 1:03:05

Bye, guys.