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Face Lifts, Dementia, and Elder Financial Abuse

It takes a lot for the California medical board to take any action against a physician. They recently revoked a concord, California plastic surgeon’s license when he went too far.

He performed a face lift – a “lifestyle lift” – on an 82 year old gentleman with dementia and many other chronic illnesses. A two week stay in extensive care was needed to save the patient’s life.

While it would appear to be a unique incident that we brush off as one physician’s excess, it reveals a larger truth.

We must remember that physicians are in business. In this matter, the physician was employed by a health care chain based in Michigan. They no doubt had incentives, quotas, and rewards for financially successful physician staff members.

In fact, this is a matter of financial abuse. Regardless of whether this elderly patient or his surrogate gave permission for the operation, it was unnecessary and costly. Cognition was no doubt limited.

This happens everyday as vendors and business people of every stripe – from gardeners to home care providers to financial advisors – take advantage of elders who are simply unable to make reasoned financial decisions.

While we do not want to admit it, any one of us could fall victim to such intrusions and abuse as we age. None of us are immune.

What can be done?

Signing Advance Directives and Durable Powers of Attorney are essential steps. Sometimes more challenging is the question faced by the agent or surrogate: When is it necessary to step in and take over – or at least influence decisions?

These matters are addressed in well drafted Durable Powers of Attorney, Advance Health Care Directives, and revocable living trusts. The responsibility lies with the named agent or successor trustee to be involved and to know when to step in.