Building A Case

What to Document in Suspected Cases of Financial Abuse

! Make lists of the following things:

• Medications
• Names and contact information of medical providers
• Vision, cognitive and/or mobility impairments
• Function
• Names of caregiver(s)

! Collect:

• Power of attorney (POA) documents for finances
• Any other relevant financial documents available on-scene

What to Document in Suspected Sexual Abuse Cases

! Photograph and write description(s) of any injuries *critically important*

• The appearance of injuries changes over time and may look different to a detective later
• Medical providers may neglect to take photos
• See Photography Tips

! Take victim’s and witness accounts of how the victim was injured

• Can the injuries be satisfactorily explained? Do the explanations make sense?
• DO interview victims with memory problems; abuse memories are often fresh and accurate
• See Recognizing Memory Loss & Emotional Events Research 
• See Interviewing Older Adults

! List or photograph medications  

! List everyone who had access to the victim 

! Arrange an immediate Sexual Assault Response Team (SART) exam

! Cross report to Ombudsman program

What to Document in Cases of Suspected Abuse by Neglect

! Take photos of the environment:

• Living quarters of the victim
• Refrigerator contents
• Bedroom, including sheets
• Incontinence supplies
• Medications
• Medical supplies, including walking aids or wheelchairs
  • See Photography Tips

! Take photos of physical neglect, including evidence of lack of hygiene:

• Nails
• Clothes
• Body filth
• Ulcers and open sores on body
• See Documenting Bed Sores

! Make lists of the following items:

• Medications
• Names and contact information of medical providers
• Vision, cognitive and/or mobility impairments
• Function
• Names of caregiver(s)

! Collect:

• Power of attorney (POA) documents for healthcare and finances

Working with Other Professionals to Build a Case

! Consider speaking with a medical doctor for an opinion on the victim’s bruising patterns

• If possible, consult with a doctor who is knowledgeable about elder abuse

! Request medical records that may reveal important information about the victim’s past function and abilities

• Specifically ask for the following records:
• medical photos
• descriptions and sizes of wounds
• victim’s statements about what happened
• their own opinion about the cause (if possible)

! Seek a capacity evaluation by a physician or psychologist if the decision-making capacity of the victim is a question

• Especially important for cases involving financial abuse or neglect

HIPAA & Law Enforcement Requests

If healthcare professionals express reluctance to share medical information due to HIPAA, refer them to:

• HIPAA: A Guide for Law Enforcement (PDF)
• U.S. Department of Health & Human Services > HIPAA > FAQs > When does the Privacy Rule allow covered entities to disclose protected health information to law enforcement officials?