by an older person who is confused or who does not understand or remember the transaction (Carroll, 2001; Central California Legal Services, 2001; Hwang, 1996; National Clearinghouse on Family Violence, 2001; National Committee for the Prevention of Elder Abuse, 2001). Other signs are suspicious or forged signatures on documents and changes in the older person’s property, titles, will, or other documents, particularly if the changes are unexpected, sudden, or favor new acquaintances (National Center on Elder Abuse, 2001; National Clearinghouse on Family Violence, 2001; National Committee for the Prevention of Elder Abuse, 2001; Zimka, 1997). Another signal can be the sudden appearance of previously uninvolved relatives claiming rights to an elder person’s affairs and possessions (National Center on Elder Abuse, 2001).

A fourth cluster of signals is associated with visits to physicians or other health care providers. One such signal is a patient’s unmet physical needs notwithstanding the availability of financial resources (Lachs and Pillemer, 1995). Other identified behaviors are missed medical appointments, dropping out of treatment, uncharacteristic nonpayment for services, declining physical and psychological health, defensiveness or hostility by the caregiver during visits or on the phone, and an unwillingness by the caregiver to leave the elder person alone during appointments (Tueth, 2000).

As is true of most aspects of financial abuse of the elderly, little research has been conducted on the motivations and characteristics of its perpetrators. Nevertheless, there has been considerable speculation about them by professionals interested in reducing this abuse.

One set of motivations widely identified tends to be associated with all forms of elder abuse. Frequently cited motivations include the perpetrator’s substance abuse, mental health, gambling, or financial problems (Dessin, 2000; National Committee for the Prevention of Elder Abuse, 2001; Tueth, 2000). The perpetrator’s actions may be based on “learned violence” or be modeled after the prior behavior of the elder person (Dessin, 2000). Where the perpetrator is a primary caregiver, caregiver stress has been cited as a cause of this abuse (Dessin, 2000).

There are also a number of characteristics linked relatively uniquely to financial abuse. For example, the perpetrator may stand to inherit assets and feel justified in taking an advance or in exercising control over assets that are perceived to be almost or rightfully the perpetrator’s own (Dessin, 2000; National Committee for the Prevention of Elder Abuse, 2001). When the perpetrator is an heir, he or she may conclude that preemptive steps are necessary to prevent the inheritance from being exhausted in paying for medical or other expenses (National Committee for the Prevention of Elder