Financial Abuse, Financial
  Mismanagement and Dementia:
What are the Issues for Practitioners?

      Professor Linda Ros...
• Financial and asset management and
  caring for older people

• Deliberate mismanagement or
  misappropriation of older ...
Assets and ageing research program
• Series of interlinked projects
   – Financial planning for old age and retirement, es...
Financial/Asset Management

• Financial management is a significant and important part
  of preparing for and coping in ol...
Income and Wealth by Age, Australia
  250,000




  200,000




  150,000


                                              ...
Financial and asset management

• Managing an older person’s money and assets
  is a significant, under-recognised and und...
Financial and asset management
• 26% of population helped an older person with managing
  finances and assets
• 20% report...
Financial and asset management:
         Issues for practitioners

• Knowledge/expertise
• How to support carers
• How to ...
Financial abuse

•   Financial abuse: misappropriation, fraud and
    theft of assets within a relationship of trust
•   o...
Financial abuse

• Practitioners working in generic services see
  relatively few cases of abuse
• Lack of knowledge of la...
How is financial abuse identified?
• Community living
  – access to older person often mediated through
    carer
  – Frag...
How is financial abuse identified?

•    Hospitalisation
      • Belated attempt to gain EPA
      • Undue pressure to cha...
Decision making by practitioners on
          financial abuse
• How are decisions made about whether abuse is
  occurring?...
Decision making by practitioners on
          financial abuse
• Assessment of situation
  – characteristics of the alleged...
Characteristics of alleged abuse

• Pattern of incidents one-off /ongoing
• Intentionality – ignorance, opportunistic vs.
...
Characteristics of older person
– Cognitive or physical incapacity
– Attitudes and beliefs
– Extent of isolation from soci...
Characteristics of alleged abuser
• Attitudes and beliefs
   – Sense of entitlement
   – No harm to the older person
• Res...
Action factors
• Personal impact on older person
• Distress older person has regarding the situation
• Degree to which abu...
Decision to intervene

• Impact of intervention
   – Referral or intervention options
   – How amenable suspected abuser i...
Summary
• Financial management is a significant part of providing
  care for older people
• Practitioners need to
   – rec...
• Organisational responses
  – Financial management for older people
     • What assistance is there to support carers in
...
Organisational responses

• What triggers are in place to identify financial
  abuse?
• What referral mechanisms are in pl...
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Financial Abuse, Financial Mismanagement and Dementia: What ...

  1. 1. Financial Abuse, Financial Mismanagement and Dementia: What are the Issues for Practitioners? Professor Linda Rosenman The University of Queensland Australia
  2. 2. • Financial and asset management and caring for older people • Deliberate mismanagement or misappropriation of older people’s assets i.e. financial abuse
  3. 3. Assets and ageing research program • Series of interlinked projects – Financial planning for old age and retirement, especially women – Legal provisions for substitute decision making – direct care workers identifying and acting on financial mismanagement or abuse – Knowledge and understanding of substitute financial management by carers and older people • Subgroups: rural areas; indigenous – National survey of prevalence of asset management – Research with care facilities into managing residents’ financial affairs – Community demonstration project aiming to educate • older people and carers about asset management and • public and private providers on identifying cases of abuse and mismanagement
  4. 4. Financial/Asset Management • Financial management is a significant and important part of preparing for and coping in old age • Older people have a large asset base – Small asset bases particularly require prudent management • Capacity to manage their money and assets – lack of experience or preparation – lack of capacity – complexity
  5. 5. Income and Wealth by Age, Australia 250,000 200,000 150,000 Total Income $p.a. Net Wealth $ 100,000 50,000 0 15-24 25-34 35-44 45-54 55-64 65-74 75+
  6. 6. Financial and asset management • Managing an older person’s money and assets is a significant, under-recognised and under- supported task for carers – Limited preparation – Lack of understanding of substitute decision making requirements by carers – Barriers, to respect client privacy/autonomy by banks and financial institutions – complexity
  7. 7. Financial and asset management • 26% of population helped an older person with managing finances and assets • 20% reported some difficulty – Capacity to communicate (dementia a particular challenge) • inability to articulate or identify wishes • risk of accusations of theft or misappropriation of possessions or assets by older person/family – no power of attorney • range and number of financial management tasks • task complexity – multiple and large assets eg selling an asset, – negotiating tax, pension health and care payments • Lack of community based assistance especially by/from financial institutions
  8. 8. Financial and asset management: Issues for practitioners • Knowledge/expertise • How to support carers • How to identify and deal with mismanagement • Obligations, protections and risks of involvement in client financial matters • How to identify and deal with financial abuse
  9. 9. Financial abuse • Financial abuse: misappropriation, fraud and theft of assets within a relationship of trust • one of the most common forms of elder abuse • majority of workers dealing with aged do not have experience in identification, substantiation and intervention in financial abuse of older adults
  10. 10. Financial abuse • Practitioners working in generic services see relatively few cases of abuse • Lack of knowledge of law re: guardianship and establishing mental capacity of older person • Understanding volition, rights and wishes of older person and implications for older person and carer of intervention • Lack of appropriate referral and intervention services
  11. 11. How is financial abuse identified? • Community living – access to older person often mediated through carer – Fragmentation of services – no single case manager or point of contact • Lack of money or assets to pay for care or services • Neglect of physical/psychological needs regardless of assets • Evident use of older persons assets – car, home
  12. 12. How is financial abuse identified? • Hospitalisation • Belated attempt to gain EPA • Undue pressure to change will • Long term Care facility • Falsifying assets on admission • Failure to pay bills
  13. 13. Decision making by practitioners on financial abuse • How are decisions made about whether abuse is occurring? • How are decisions made about whether and how to intervene? – Difference between identifying and substantiating financial abuse and taking action
  14. 14. Decision making by practitioners on financial abuse • Assessment of situation – characteristics of the alleged abuse – characteristics of the older person – characteristics of the alleged abuser • Decision to intervene – Individual variation in threshold for taking action – Impact of intervention
  15. 15. Characteristics of alleged abuse • Pattern of incidents one-off /ongoing • Intentionality – ignorance, opportunistic vs. targeted • Visibility vs. secretiveness • Asset management arrangements – orderly and easily monitored vs. loose and chaotic
  16. 16. Characteristics of older person – Cognitive or physical incapacity – Attitudes and beliefs – Extent of isolation from social networks – Characteristics of the relationship with alleged abuser – History of any type of abusive behaviour in the relationship – Quality of relationship – Distribution of power in the relationship – Degree of reciprocity in the relationship
  17. 17. Characteristics of alleged abuser • Attitudes and beliefs – Sense of entitlement – No harm to the older person • Responses to issues being raised – Unwillingness to acknowledge problem/issue • Passive to overt resistance • Lifestyle problems – Mental health/substance abuse – Unemployment, poverty – Living beyond means, debts, gambling
  18. 18. Action factors • Personal impact on older person • Distress older person has regarding the situation • Degree to which abuse reduces care options or service provision • Degree to which abuse physically or emotionally endangers the older person • Meaning of assets lost to older person • Financial impact on older person • Extent to which person can afford to lose what is disappearing • Degree to which person is at risk of losing financial independence
  19. 19. Decision to intervene • Impact of intervention – Referral or intervention options – How amenable suspected abuser is to intervention by practitioner – Impact of intervention on long term carer/client relationship
  20. 20. Summary • Financial management is a significant part of providing care for older people • Practitioners need to – recognise it as a significant caring role – support carers in carrying out what may be an unfamiliar and complex task of care – be familiar with major characteristics of financial management and the legal requirements for acting on behalf of another person – identify financial mismanagement and financial abuse – make decisions on if and how to intervene
  21. 21. • Organisational responses – Financial management for older people • What assistance is there to support carers in financial management • What training/information is there to prepare practitioners re: legal requirements for substitute decision making and understanding financial obligations
  22. 22. Organisational responses • What triggers are in place to identify financial abuse? • What referral mechanisms are in place? • What training is there for staff in identifying and acting on financial abuse? • What protections are there for staff in identifying suspected financial abuse?

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