Exposing Financial Exploitation of Impaired Elderly Persons

doi:10.1097/00019442-200005000-00004

The American Journal of Geriatric Psychiatry

Volume 8, Issue 2, Spring 2000, Pages 104-111

https://doi.org/10.1097/00019442-200005000-00004 Get rights and content

There is a dearth of medical publications on financial exploitation of elderly persons, but a significant amount of information on this subject is contained in the literature of other disciplines. Financial abuse accounts for up to one-half of all types of elder abuse in the United States, accounting for over 500,000 victims. Psychological abuse, including deception, intimidation, and threats, always accompanies financial exploitation. Despite the devastating emotional and financial losses incurred, physicians are reluctant to recognize, diagnose, and assist impaired elderly victims of financial exploitation.

Section snippets

Perspectives

Elder abuse was first addressed in the medical literature in 1975, when the British Medical Journal published the article titled “Granny-Battering”.² In previous decades, medical practitioners believed that families provided care for their frail elderly members in a considerate and kind manner. Although this assumption was largely accurate, nurses and social workers recognized from their case experiences that some families did not protect their vulnerable elders. In fact, these caregivers noted

EPIDEMIOLOGICAL FEATURES

Community surveys report that 1%–12% of elderly persons report some form of maltreatment since they turned 65 years old.1, 13, 14, 15 A conservative estimate is 3%–4%, on the basis of the more rigorous studies.¹ This includes approximately 1.4 million victims of elder abuse in the United States. But when a financial abuse option is offered on survey questionnaires, the actual prevalence of elder abuse may be closer to the 12% figure.¹⁵ Most surveys of elder victims of abuse that have a question

CLINICAL PRESENTATIONS

Financial exploitation of elders occurs in three common situations: door-to-door scams; professional swindles; and caregiver, relative, or acquaintance abuse.11, 15, 27, 28, 29, 30 Individuals who target elderly victims in door-to-door scam operations usually represent themselves as repairmen, skilled workers, or representatives of charities. They contract for services that they do not provide, double-bill for services, or falsely present themselves as representatives of charitable

Case Reports

Case #1. An 83-year-old man suffered from hearing difficulties, arthritis, chronic urinary tract infections, cerebrovascular accident, and depression for years. His family hired an experienced caregiver, who agreed to take care of him in her home for $1,000 per month. Over a period of 18 months, the caregiver deceptively coerced his signature on checks and his car title, and, without family consent, increased her caregiving charges to $3,000 per month. When she advised the family to sell his

REPORTING REQUIREMENTS AND LEGAL ASPECTS

Our society follows the ethical principle of beneficence, which urges authorities to act in a way that will benefit those who have been mistreated or are at risk of harm.4, 20, 25, 27 On the other hand, we value the principles of individual autonomy and privacy ensuring that every citizen remains free of unreasonable intrusion into his life.⁹ Each of these sometimes competing ethical values should influence our thinking when consideration is given to identifying and protecting victims of

CONCLUSIONS

Exploitation of elderly persons can result in devastating emotional and financial losses for our impaired senior citizens, especially for affluent elderly persons who have worked hard and were financially independent. Because there are no physical wounds and because privacy and autonomy are treasured values in our society, a commitment to identifying victims and developing treatment strategies for financial exploitation of elderly persons has not yet been fully embraced by the medical

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Development and assessment of the Partner Exploitation Inventory
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Differences in mating preferences, strategies, and goals can lead to romantic relationship conflict. One method of addressing conflict is exploitation, which occurs when deception, manipulation, coercion, or force is used to obtain a resource that the exploited is reluctant to provide. Here we create and provide initial assessment of the Partner Exploitation Inventory, which measures the use of tactics to exploit a romantic partner. Participants (n=172) used an act nomination procedure to generate 62 exploitative acts that may be used against a romantic partner. Next, using a new group of participants (n=516), we grouped the acts into three components that represent different forms of partner exploitation: Harm-Inducing, Ego-Boosting, and Emotional Manipulation. Men reported greater use of Ego-Boosting and Harm-Inducing exploitation, and women reported greater use of Emotional Manipulation exploitation. Evidence for the validity of the Partner Exploitation Inventory was also found through positive associations with questionnaires measuring similar constructs. This study expands our knowledge of men's use of exploitation strategies and is the first study to directly investigate women's use of exploitation strategies. We also created a tool that can be used to examine exploitation in the future.
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Financial capacity is an important instrumental activity of daily life that comprises those abilities needed for an individual independently to manage financial affairs in a manner consistent with personal self-interest and values. In this chapter, we examine the topic of financial capacity and decision-making in older adults in our aging society. Specifically, we discuss the crucial phenomenon of cognitive aging and diminished financial capacity, the impact on financial skills of cognitive disorders such as mild cognitive impairment (MCI) and Alzheimer’s disease (AD), and early warning signs of diminished financial capacity. We present a useful clinical conceptual model of financial capacity, describe different approaches to assessing financial capacity, and then discuss empirical studies of financial capacity in older adults with a focus on patients with MCI and AD. This chapter concludes with sections addressing exciting new neuroimaging investigations of financial decision-making and capacity, the importance of psychiatric and other non-cognitive contributions to financial capacity in aging, and directions for future research.
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Citation Excerpt :
Older age (late 70s and older), living alone, home ownership, lack of financial knowledge, and/or cognitive deficits (that become apparent when problems appear in mismanaging finances) are all associated with increased risk for being exploited financially.5 Female gender, social network size, severity of the physical and/or emotional disability or illness, and ethnicity (especially African Americans) have also been implicated in increasing an older adult’s vulnerability to FE.5,12,16–18,20,21 Understanding of FE in minority groups is limited with FE of African American Elder (AAE) studies having the largest but limited number.
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Citation Excerpt :
In Polish circumstances, financial exploitation of older people also had high prevalence. The data show a higher risk of material exploitation of older people, especially the impaired seniors (Tueth, 2000). This is especially evident in circumstances when perpetrators are economically dependent on their older aged victims.
Violence against older people remains a taboo topic in Poland, and is still an under-recognized phenomenon. The aim of this study was to examine the risk of different types of domestic violence in older people in relation to their health-related quality of life as measured by chronic conditions, functional limitations, psychological well-being, depressive symptoms and feelings of social isolation. A cross-sectional study using a standardized questionnaire in a simple random sample of 518 older citizens of Krakow was carried out. A multidimensional logistic regression of data showed that such factors as poor assessment of psychological health, number of chronic conditions, suffering from emotional and social loneliness and lack of social support in everyday life significantly increased the risk of being a victim of domestic violence in older citizens of Krakow.
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Special ArticleExposing Financial Exploitation of Impaired Elderly Persons

Section snippets

Perspectives

EPIDEMIOLOGICAL FEATURES

CLINICAL PRESENTATIONS

Case Reports

REPORTING REQUIREMENTS AND LEGAL ASPECTS

CONCLUSIONS

Abuse and neglect of elderly persons

N Engl J Med

Granny-battering (letter)

BMJ

Maltreatment of elderly persons

Psychiatr Serv

Reporting elder mistreatment

J Gerontol Nurs

An Examination of a Hidden Problem. Report by the Select Committee on Aging, U.S. House of Representatives. Comm Pub 97-277

Diagnostic and Treatment Guidelines on Elder Abuse and Neglect

Position statement on elder abuse, neglect, and exploitation

Am J Psychiatry

The ethics of mandatory elder abuse reporting statutes

Adv Nurs Sci

Privacy beliefs and the violent family: extending the ethical arguments for physician intervention

JAMA

The Illinois plan for a statewide elder abuse program

Introducing a framework for defining financial abuse of the elderly

Journal of Elder Abuse and Neglect

What can nurses do about financial exploitation of elders?

J Gerontol Nurs

The investigation and outcome of reported cases of elder abuse: the Forsyth county aging study

Gerontologist

Fiduciary abuse of the elderly: a prosecutor's perspective

Journal of Elder Abuse and Neglect

Questions and Answers. NARCDA 190

Special Article
Exposing Financial Exploitation of Impaired Elderly Persons