King County prosecutor says multidisciplinary teams close gaps left by criminal convictions in elder-abuse cases

Paige, an elder-abuse prosecutor with the King County Prosecutor's Office, described two King County cases to illustrate why criminal convictions alone often fail to meet the needs of older victims and how a multidisciplinary team (MDT) approach has improved outcomes.

The prosecutor opened with an early case involving a 79-year-old widower, Leon, who was befriended and defrauded out of roughly $190,000 after giving a stranger the title to his late wife's Cadillac. Seattle Police investigated and the county filed charges; a jury found one suspect guilty after victim testimony and expert evidence about Leon's capacity. "It was really a successful prosecution for us," Paige said, but she added that Leon returned home alone with his savings gone and little prospect of restitution, no guardianship or money management in place, and no ongoing services.

The contrast came in a more recent case involving Teresa, a 69-year-old woman with a traumatic brain injury whose son sold her house for $368,000. After mortgage and debts, roughly $150,000 remained and $133,000 was wired to her son; the funds were gone within months. Prosecutors filed felony charges, APS made a finding of financial exploitation, and King County's MDT intervened: an AAA case manager, APS, a detective and prosecutors coordinated services, hired a capacity evaluator and engaged a VOCA-funded money manager. U.S. Marshals located and extradited the son from Hawaii; he pled guilty, made restitution payments (an initial $25,000 plus weekly payments that brought the total to $75,000 by January 2025) and received a sentence that included electronic monitoring and community custody in exchange for restitution and compliance. Paige said those steps avoided guardianship and improved Teresa's stability.

Why MDTs? Paige explained that elder-abuse cases commonly involve overlapping medical, financial and legal issues, as well as cognitive impairment. "We simply don't have as prosecutors the knowledge or the ability to deal with these many issues alone," she said, and described the routine partners her office relies on: geriatricians and in-home mental-health assessors, capacity evaluators, forensic accountants to parse thousands of pages of financial records, elder-law attorneys to assist with guardianship or power-of-attorney issues, case managers from the Area Agency on Aging (AAA), Adult Protective Services (APS), and vetted money managers who can work in-home to gain trust and manage bills.

Paige traced King County's evolution: an Elder Abuse Council formed around 2002 to build relationships among agencies; a successful 2009 Office on Violence Against Women (OVW) "Abuse in Later Life" grant to fund training and systemic planning; a 2011 AAA-funded elder-abuse case-manager position; and a 2019 county-funded MDT (veterans and human-services levy) that initially supported a half-time prosecutor, a full-time financial analyst and an MDT coordinator. Those investments, she said, allowed routine referrals to case managers, regular capacity evaluations, involvement of Swedish Hospital geriatricians and other specialists, and the introduction of money managers into many cases.

On specific practices, Paige emphasized that capacity evaluations require the victim's consent, that most people with mild to moderate dementia can still testify, and that cases involving abusive powers of attorney are often easier to prosecute because of the agent's fiduciary duty. She also described a tiered plea strategy used in the Teresa case: the son's sentence recommendation was reduced contingent on restitution and time set for sentencing to allow him to earn and repay some funds, a pragmatic choice aimed at restoring money to the victim.

Paige urged jurisdictions to pursue funding and training because sustained resources make MDTs viable. She pointed listeners to current OVW and VOCA funding opportunities and advised counties with fewer resources to begin by building relationships (for example, forming an elder-abuse council) even before formal funding is in place.

The presentation closed with a practical takeaway: criminal convictions can remove perpetrators, but protecting and restoring victims often requires ongoing social, medical and financial interventions provided through a sustained multidisciplinary response.