The first call came just before Thanksgiving last year. She didn’t recognize the phone number, but she answered anyway.

“The person said he was an officer of the Department of Criminal Investigations looking into drug trafficking and money laundering,” the woman recalled. He seemed to know a lot about her: the states where she and her late husband had lived; his name and occupation; and her current address in Washington County, Rhode Island.

On her phone, he showed her a convincing badge and a photo ID with his name (“‘Frank’ something”), plus an article describing the supposed investigation. The woman, a 76-year-old retiree, denied any involvement.

“You can hire a very expensive criminal defense attorney, or you can cooperate with me,” Frank told her.

“Now, when you think about it, it doesn’t make any sense,” the woman acknowledged recently. But persuaded by the badge and ID, she agreed to cooperate. Otherwise, “I thought they were going to come and arrest me.”

Frank called each morning to learn where she was going, what she was doing. His team would be watching, he warned. The woman, feeling “petrified,” started looking around as she drove to garden club meetings. Was somebody following her?

It was all a scam.

Because victims’ sense of shame often leaves them reluctant to report such crimes, the extent of elder financial exploitation is hard to calculate. The Federal Trade Commission reported losses of $2.4 billion in 2024, largely driven by investment and romance scams and impersonations, with total losses much higher.

Americans age 60 and older lose more than $28 billion annually to financial exploitation, AARP estimated in 2023.

As those numbers rise, because the population is aging and predators are growing increasingly resourceful, banks and investment firms are becoming the first line of defense.

Frank’s initial target: her account at Fidelity Investments. He instructed her to shift about $250,000 into her checking account, telling the financial adviser at her local office that she and her family intended to buy real estate.

That scheme fizzled when the adviser said Fidelity could not approve the transaction without more information on the property.

So Frank sent her to her local branch of Washington Trust Company to take $70,000 in cash from a home-equity line of credit. “We don’t give out that much in cash,” the teller said, quietly messaging the branch manager, who had known the woman and her husband for years.

The manager ushered the woman into her office to talk, and the scam stopped there, with a call to the local police. The woman’s assets remained intact, but the experience proved so mortifying that she has not told even her family how close she came to losing much of her life savings. The New York Times is withholding her name to spare her embarrassment.

“I felt so stupid,” she said. “I felt like a fool.”

Financial predators targeting older adults represent “a heightened focus for us now,” said Mary Noons, president and chief operating officer of Washington Trust.

A regional community bank, Washington Trust cranked up its efforts last fall to advise older customers and their families about finances, including the dangers of elder fraud and exploitation. It published and distributed a booklet called “Age With Wisdom” and brought in an expert on dementia to speak with staff members.

And it became one of the 1,500 financial institutions to date to use BankSafe, a free AARP video program that trains front-line employees to spot the red flags indicating possible elder exploitation and to intervene. Everyone at the branch where the 76-year-old banked had taken the training.

“Some older customers visit their bank far more frequently than they see their health care providers,” Noons pointed out.

Until recent years, financial institutions placed “more of an emphasis on the autonomy of the client,” said Pamela Teaster, director of the Virginia Tech Center for Gerontology and an elder abuse researcher. Their approach was, “an adult has the capacity to make poor choices, and we’re going to let them make them,” she added.

But changes in government and industry policies and practices have encouraged greater vigilance. Congress passed the Senior Safe Act in 2018, protecting banks and financial firms from liability if they reported suspected exploitation to authorities.

That year, the Financial Industry Regulatory Authority began requiring member firms to ask for a trusted contact person when investors open or update accounts. (The account holder isn’t obliged to provide one, however.) And since 2022, it has allowed firms to place holds on older investors’ transactions if they suspect exploitation is involved.

About half of states have enacted laws that permit financial institutions to deny suspicious transactions or impose holds for specified periods to allow investigations, said Jilenne Gunther, the director of BankSafe.

“It adds friction,” she explained. “With space and time, the criminal gets worried and might move on. And the potential mark has time to stop and think.”

Teaster’s analysis of data from BankSafe, during a six-month pilot in 82 financial institutions, found that participants were much more likely to report suspected cases and save customers money than a control group was.

Not all of older adults’ losses result from predators, however. They can, on their own, get caught up in investment fads, take on too much debt, or make otherwise unwise decisions, even without criminals pulling the strings or relatives looting their accounts.

Managing finances presents complex cognitive challenges, said Mark Lachs, co-chief of geriatrics and palliative medicine at Weill Cornell Medicine. “It requires a lot of brain,” he said, including: “Memory, remembering that a bill is due. Executive function, the ability to manage your time. Abstraction, hypothesizing about your future.”

He added, “Financial errors are not infrequently the first sign of impending dementia or a neurocognitive disorder.”

A 2024 study by the Federal Reserve Bank of New York, for instance, found an increased probability of delinquent payments and deteriorating credit ratings in the five years before a dementia diagnosis. Those errors can reduce seniors’ access to credit and raise their interest rates on loans at the very point when caregiving expenses are likely to soar.

Lachs has called on fellow doctors to recognize what he calls Age-Associated Financial Vulnerability, a syndrome that can affect even older people with normal cognition, especially if they contend with medical illnesses, sensory deficits, or social isolation.

And he remains skeptical about the financial industry’s claims of heightened attention to its oldest customers. “I still see concerning financial transactions executed that should have received far greater scrutiny,” he said.

Training more front-line staff members and increasing emphasis on establishing trusted contacts for older customers would help, Gunther said, because “once the money leaves the account, it’s near impossible to ever retrieve it.” More states could enact laws allowing financial institutions to deny suspicious transactions or impose holds.

Several related bills with bipartisan support are working their way through Congress. The National Strategy for Combating Scams Act would require the FBI to coordinate efforts to protect seniors. A bill that restores an IRS deduction would at least provide the consolation of excusing scam victims from paying taxes on money they no longer have.

However, new weapons like artificial-intelligence voice cloning — in which the supposed grandson four states away who urgently needs $5,000 in gift cards actually sounds like the victim’s grandson — keep advocates and bankers awake at night.

In the Washington Trust branch where the Rhode Island woman didn’t lose her money, employees just days earlier had stopped a scam similar to the one that had targeted her.

But more recently, nobody spotted any danger signs when an older woman withdrew $9,000 for a kitchen renovation, until it went to a scammer instead of a contractor.

The New Old Age is produced through a partnership with The New York Times.

That’s a shame because accommodations of all kinds are available for those willing to ask for them. Many are required by law. Journalist Paula Span reports on the situation in this column, posted on KFF Health News on December 11, 2025. It also ran in the New York Times. Funding from the Silver Century Foundation helps KFF Health News produce articles (like this one) on longevity and related health and social issues. 

In her house in Ypsilanti, MI, Barbara Meade said, “there are walkers and wheelchairs and oxygen and cannulas all over the place.”

Barbara, 82, has chronic obstructive pulmonary disease, so a portable oxygen tank accompanies her everywhere. Spinal stenosis limits her mobility, necessitating the walkers and wheelchairs and considerable help from her husband, Dennis, who serves as her primary caregiver.

“I know I need hearing aids,” Barbara added. “My hearing is horrible.” She acquired a pair a few years ago but rarely uses them.

Dennis Meade, 86, is more mobile, despite arthritis pain in one knee, but contends with his own hearing problems. Similarly dissatisfied with the hearing aids he once bought, he said, “I just got to the point where I say, ‘Talk louder.’”

But if you ask either of them a question included on a recent University of Michigan survey—“Do you identify as having a disability?”—the Meades answer promptly: No, they don’t.

Disability “means you can’t do things,” Dennis said. “As long as you can work with it and it’s not affecting your life that much, you don’t consider yourself disabled.”

Their daughter Michelle Meade, a rehabilitation psychologist and the director of the Center for Disability Health and Wellness at the university, accompanies her parents to medical appointments and tends to roll her eyes at their reluctance to acknowledge needing support.

Working with other researchers on the recent national poll has shown her how often older adults feel that they are not disabled despite ample evidence to the contrary.

Many people still feel like ‘disability’ is a dirty word.

— Megan Morris, PhD

The survey looked at nearly 3,000 Americans aged 50 and older and found that only a minority—fewer than 18 percent of participants over 65—saw themselves as having a disability.

Yet their responses to the six questions that the Census Bureau’s American Community Survey uses to track disability rates told a different story.

The survey asks whether respondents have difficulty seeing or hearing, limitations in walking or climbing stairs, difficulty concentrating or remembering, trouble dressing or bathing, difficulty working or problems leaving the home.

In the university’s survey, about a third of those aged 65 to 74 reported difficulty with one or more of those functions. Among those over 75, the figure was more than 44 percent.

Moreover, when respondents were asked about several additional health conditions that would require accommodations under the Americans with Disabilities Act, including respiratory problems or speech disorders, the proportion climbed even higher. Half the 65-to-74 group reported disabilities, as did about two-thirds of those over 75.

Yet only a sliver—fewer than one in five—of older adults had ever received an accommodation from their health care providers to which they are legally entitled under the ADA.

Even among the small minority who identified as disabled, only a quarter had asked for an accommodation (though a third received one, whether they asked or not).

“It’s a familiar story,” said Megan Morris, PhD, a rehabilitation researcher at NYU Langone Health and director of the Disability Equity Collaborative. When it comes to the way people describe themselves, “many people still feel like ‘disability’ is a dirty word,” she said.

It’s almost an American value to decline to seek help, even when the law requires that it be available, Michelle Meade added. Faced with a disability, she said, “we’re supposed to toughen up and battle through it.”

In health care settings, it helps a lot if you tell providers you have a disability and ask for help. 

That may be particularly true among older Americans whose attitudes formed before the landmark ADA became law in 1990, or even before the 50-year-old Individuals with Disabilities Education Act, which guaranteed access to public education.

“It’s going to be hard for that older generation,” Morris said. “Disability was something that was locked away. Younger folks are more open to seeing disability as being part of a community.”

In the University of Michigan survey, for instance, among people over 65 who had two or more disabilities, about half identified as a person with a disability. In the younger cohort, aged 50 to 64, it was 68 percent.

Why does that matter? “It greatly assists in health care settings if you disclose a disability and know to request an accommodation and support,” said Anjali Forber-Pratt, PhD, the research director at the American Association of Health and Disability.

Such accommodations “can make a stressful situation easier,” she added. They include mammography and X-ray machines that allow patients to remain seated, scales that wheelchair users can roll onto, examination tables that rise and lower so that patients don’t have to step onto a footstool and swivel around.

Health care providers may also offer amplification devices for people with hearing loss, as well as magnifiers and large print materials for the visually impaired. Buildings themselves must be accessible. Practices can send a staff member with a wheelchair to help patients traverse long distances.

Even with a disability parking placard, “you hike in, you wait for the elevator, you hike to the office,” said Emmie Poling, 75, a retired teacher in Menlo Park, CA.

Because of arthritis and spinal stenosis, “I can’t walk with an upright posture for more than a few minutes” without pain, she said. “I basically live on Tylenol.” Yet when she makes an appointment and the scheduler asks if she will need assistance, Poling replies that she won’t.

“My personal voice says, ‘Come on, you can do it,’” she said.

Patients who identify as disabled feel less depressed and anxious than those who don’t, according to research. 

Identifying as a person with a disability provides other benefits, advocates say. It can mean avoiding isolation and “being part of a community of people who are good problem-solvers, who figure things out and work in partnership to do things better,” Meade said.

Government programs and private organizations like the National Disability Rights Network,  the Americans with Disabilities Act National Network and the National Association of Councils on Developmental Disabilities help connect people with services and supports in their communities.

Several studies have found too that patients who identify as disabled have less depression and anxiety, higher self-esteem and a greater sense of “self-efficacy” than disabled people who don’t.

For years, despite a lifetime of surgeries for congenitally dislocated hips, as well as joint replacements and cancer treatment, Glenna Mills, an artist in Oakland, CA, told herself that she was not disabled.

“I suffered a lot by denying that I couldn’t walk very far,” she recalled. Although walking caused pain in her knees, hips and shoulders, “I didn’t want people to see me as someone who couldn’t keep up,” she added.

But about 10 years ago, “I stopped worrying about that,” said Mills, 82. “I was more willing to say, ‘I can’t do that activity. I can’t walk that far.’” She bought a scooter that allowed her to take walks with her husband and dog and to spend time in museums. “I’m happier now,” she said.

More often, older Americans resist a label that could help improve their care. Even those who do request accommodations may find that enforcement of the ADA remains spotty, in part because patients don’t always report violations.

The Meades, after years of pleading from their children, have made appointments to see an audiologist about new hearing aids.

But Poling intends to struggle on without seeking or accepting assistance. “I know that point will come,” she said. “I’ll attempt to surrender as gracefully as possible, given my personality.”

Until then, she said, “the mental picture that’s acceptable to me is not wanting to look like I’m disabled.”

“KFF Health News” coverage of longevity and our aging society is supported in part by The Silver Century Foundation.

The conventional wisdom used to be that seniors would be slow to adopt new digital health technologies. Many seniors were not online. Or many struggled with various cognitive issues. Or they’re not tech savvy. Or they’re suspicious of apps and AI. I wondered how much things had changed when CMS announced the new initiative to “make health tech great again.”

A lot has changed, according to results from the first of KFF’s survey series of the public and seniors about their use of, and appetite for, digital health tech. Possibly COVID forced America’s seniors to get on a steep tech learning curve. Possibly their kids have educated them. Or maybe seniors have simply aged into tech or adapted to new technologies to survive, as they’ve had to do to deal with their cell phone company and streaming service—what choice do they have?

From this survey, we found that the vast majority of seniors are using digital health tools and are interested in making greater use of it to navigate the health care system and manage health care needs. We didn’t find a meaningful difference between “younger” and “older” seniors, although we couldn’t look at the very old with this survey sample. And most Medicare beneficiaries (81%) say it’s important for Medicare to make it easier for them to share information between their providers or make apps more available to manage chronic conditions (63%), which are goals of the CMS initiative.

About 8 in 10 Medicare beneficiaries ages 65 and older used a health care app or website in the last year, and a sizable majority said it made it easier to use the health system. Half of them use multiple apps (55%). And there was no difference in the share of those 65 years or older who used an app or website to help manage their care in the last year (77%) and 30–49-year-olds (76%).

There were, however, sizeable differences between higher and more moderate to lower income seniors in their use of digital health tech—maybe not surprising but important.  These differences may reflect sources of care, internet access, and many other factors, but they also mean that there will be real disparities in the use of digital health tools unless concerted efforts are made to level the playing field. As I attend conferences on digital health tech and AI, I hear a lot about how these tools might transform research, or diagnosis, or reduce physician burnout, or create business opportunities. I hear very little discussion of how digital health tech may actually assist patients (credit to the CMS initiative for that, whether you think it will succeed or not), and virtually no discussion of the challenges of reaching lower income populations or of integrating new digital technologies into public programs to improve access and health (except recently to determine eligibility for Medicaid work requirements). Possibly I am attending the wrong conferences.

There were also some very big holes in seniors’ use of digital health tools. Relatively modest shares of older Medicare beneficiaries have used an app or website for a video visit in the past year (just 30%). That was surprising. Even fewer have used it to help manage a chronic condition (23%), a major goal of health tech proponents. These are areas to watch and, if you are pushing this stuff, to work on.

And some Medicare beneficiaries do face real barriers to using tech: 17% have cognitive or mental impairments.

To be fair, we didn’t ask Medicare beneficiaries if they still preferred “old school” human contact to apps like MyHealth. These days, you message a care team; they message you back. That’s how you “talk to your doctor.” Many younger adults prefer urgent care centers to what now passes for “meaningful” interaction with your care “team.”

Our survey also found some significant obstacles to more rapid and widespread adoption of digital health tech by seniors, and one is especially significant: AI looms large in plans to expand digital health tech, but only 31% of Medicare beneficiaries ages 65 and older trust AI “a great deal” (8%) or “a fair amount” (23%) to access medical records and provide personalized information and advice. Public trust in AI tools to make appointments or send messages or access medical records is generally low.  And both the general public and seniors are worried about the privacy of health information controlled by government, tech companies, or insurance companies (hospitals fare better, but still half of the public overall are worried about the privacy of the health information they manage).

Digital health tech is not the solution to the more basic and most important problems facing the health system. One of my tasks when I was a kid in Boston was to shovel the snow from the driveway so my dad, an internist at what is now BI/Deaconess, could make house calls in the middle of the night. Today, many people can’t find primary care providers at all or get appointments with them. House calls, of course, are long forgotten.  Many can’t afford medical care or pay their medical bills, especially people who need a lot of care because they have a chronic illness or a major disease. But apps and other kinds of tech can play a role in making a fragmented and almost hopelessly complex system more navigable for patients. Apparently, as our survey findings suggest, a lot of Medicare beneficiaries—but not all beneficiaries equally—are ready for more digital health tech, and, as I said earlier, have become tech savvy to survive.