Financial Coercion in Depressed Elderly Patients

Case Overview

In the following case study, we examine the complex scenario of an elderly octogenarian, with a history of depression. The individual relied on a trustee for certain financial transactions, which unfortunately had unfavorable economic consequences. A trustee inherited property after an individual died under circumstances that raised suspicions of monetary coercion.

The patient’s intellectual capacity to make autonomous financial decisions has been questioned. A further consideration is whether or not they were susceptible to coercion prior to their death. In this case, a specialist in geriatric psychiatry is sought to provide expert insight into whether standard care was violated.

Questions to the expert and their responses

What is your experience with caring for elderly people who are possibly depressed or with impaired decision-making abilities?

As a quadruple board-certified professional in psychiatry, forensic psychiatry, behavioral neurology & neuropsychiatry, and brain injury medicine, I frequently manage the care of elderly individuals with depression and potentially diminished decision-making capacity.

In my previous role as Associate Director of Consultation-Liaison Psychiatry at a renowned university hospital, assessing decision-making capacity in older individuals was part of my regular duties.

Based on your experience, what is the impact of age and prior depression history on the likelihood of diminished financial decision-making capacity or otherwise vulnerability to financial coercion in this patient population?

Age and a prior history of depression can significantly impact an individual’s financial decision-making capacity or vulnerability to monetary coercion. However, assessing financial and/or testamentary capacity in a decedent is challenging unless there exist contemporaneous records (medical, personal documents, collateral) that allow an assessment of decision-making capacity at the time.

Please describe your familiarity with elder abuse statutes applicable in comparable locations like California.

I know elder abuse statutes applicable in comparable locations. These laws are designed to protect vulnerable adults from various forms of abuse, including undue influence and financial exploitation.

Have you ever reviewed a similar case? If yes, please elaborate.

Yes, I have reviewed similar cases involving allegations of undue influence on elderly individuals with neuropsychiatric disorders including depression and dementia. It is more straightforward to assess undue influence than decision-making capacity retrospectively. Influencers use coercion, affection, manipulation, intimidation, isolation, deprivation, and control.

About the expert

This expert is a highly qualified professional with extensive experience in forensic psychiatry, neuropsychiatry, and psychopharmacology. They have earned degrees from prestigious institutions and are board-certified in both general psychiatry and forensic psychiatry. Their career includes roles as a clinical lecturer of psychiatry, director of transplantation psychiatry, associate director of consultation liaison psychiatry at a major health institution, and currently serves as an assistant clinical professor of psychiatry at a renowned California university.