Financial decision-making abilities and financial exploitation in older African Americans: Preliminary validity evidence for the Lichtenberg Financial Decision Rating Scale (LFDRS)

ABSTRACT

This study examines preliminary evidence for the Lichtenberg Financial Decision Rating Scale (LFDRS), a new person-centered approach to assessing capacity to make financial decisions, and its relationship to self-reported cases of financial exploitation in 69 older African Americans. More than one third of individuals reporting financial exploitation also had questionable decisional abilities. Overall, decisional ability score and current decision total were significantly associated with cognitive screening test and financial ability scores, demonstrating good criterion validity. Study findings suggest that impaired decisional abilities may render older adults more vulnerable to financial exploitation, and that the LFDRS is a valid tool.     

Item response theory analysis of the Lichtenberg Financial Decision Screening Scale

The focus of these analyses was to examine the psychometric properties of the Lichtenberg Financial Decision Screening Scale (LFDSS). The purpose of the screen was to evaluate the decisional abilities and vulnerability to exploitation of older adults. Adults aged 60 and over were interviewed by social, legal, financial, or health services professionals who underwent in-person training on the administration and scoring of the scale. Professionals provided a rating of the decision-making abilities of the older adult. The analytic sample included 213 individuals with an average age of 76.9 (SD = 10.1). The majority (57%) were female. Data were analyzed using item response theory (IRT) methodology. The results supported the unidimensionality of the item set. Several IRT models were tested. Ten ordinal and binary items evidenced a slightly higher reliability estimate (0.85) than other versions and better coverage in terms of the range of reliable measurement across the continuum of financial incapacity.     

The Lichtenberg Financial Decision Screening Scale (LFDSS): A new tool for assessing financial decision making and preventing financial exploitation

ABSTRACT

One of the challenges in preventing the financial exploitation of older adults is that neither criminal justice nor noncriminal justice professionals are equipped to detect capacity deficits. Because decision-making capacity is a cornerstone assessment in cases of financial exploitation, effective instruments for measuring this capacity are essential. We introduce a new screening scale for financial decision making that can be administered to older adults. To explore the scale’s implementation and assess construct validity, we conducted a pilot study of 29 older adults seen by APS (Adult Protective Services) workers and 79 seen by other professionals. Case examples are included.     

Decisional conflict among Chinese family caregivers regarding nursing home placement of older adults with dementia

Purpose: To describe factors influencing decisional conflict among Chinese family caregivers regarding nursing home placement of older adults with dementia. Design and Methods: Individual interviews were used to collect data with 30 Chinese family caregivers of older adults with dementia in Taiwan. Data were analyzed using thematic analysis. Results: Factors influencing caregivers' decisional conflict included the Chinese value of filial piety, limited financial resources and information, placement willingness of the older adult, family disagreement, distrust of nursing home care quality, and limited nursing home availability. Factors influencing caregivers' decisional conflict post placement included disappointment with nursing home care quality and self-blame for the placement decision. Implications: Findings resulting from this study indicate that Chinese family caregivers experience decisional conflict during the nursing home decision making process as well as after the placement decision. It is important to provide appropriate decision support beginning before admission and across the trajectory of the older person's nursing home stay in order to decrease decisional conflict and facilitate a more positive decision making process for caregivers, family members, and older adults with dementia.     

Neuropsychological Profiles of Victims of Financial Elder Exploitation at the Los Angeles County Elder Abuse Forensic Center

The current article examines neuropsychological correlates of financial elder exploitation in a sample of older adults who have been documented victims of financial elder exploitation. The purpose of this exploratory study was twofold. First, a subsample of the referrals at the Los Angeles County Elder Abuse Forensic Center (LACEAFC) was compared to community dwelling adults in terms of the specific cognitive domains linked to financial capacity including memory, calculation, and executive functioning. Next, the correlation between presence of neuropsychological data and the likelihood of filing a case with the LA County’s District Attorney office was examined. Twenty-seven LACEAFC cases and 32 controls were assessed. Overall, the forensic center group performed worse than a community-based age-matched control group on the MMSE, calculation, and executive functioning (ps < .01). The presence of neuropsychological data was significantly correlated to an increased likelihood of a case being filed.     

Financial Exploitation of Older Adults in Rural Settings: A Family Perspective

Federal agencies responsible for funding protective services to older adults are increasingly concerned with the growing incidence of financial exploitation in rural areas. The Wall Street Journal recently has reported an increasing trend of unemployed adult children migrating from urban centers to smaller rural towns and countrysides to live with their parents since 2008. This current study explores the attitudes of family caregivers regarding management of financial matters for their elderly care recipients. The major findings of the study include that adult children often (1) overestimate their parents' ability to manage their finances; (2) prefer to manage their parents' finances informally, as opposed to using legal options like power of attorney; and (3) tend to think of their parents' assets as “almost theirs.” The study concludes with recommendations on the critical need for information to help families make important decisions about helping elderly parents with their finances. This information would not only promote the use of safeguards against abuse, but could potentially provide caregivers with greater confidence and protection.     

The Social Vulnerability Scale for Older Adults: An Exploratory and Confirmatory Factor Analytic Study

The Social Vulnerability Scale (SVS), a 22-item informant report of vulnerability to exploitation and, in particular, financial exploitation of older adults, was administered to 266 respondents who assessed the social vulnerability of a significant other aged 50 years or over, either a person with dementia or other neurological condition (n?=?116), or a healthy adult (n?=?150). Exploratory factor analysis in the combined sample revealed a 15-item two-factor solution labeled gullibility and credulity. Stability in factor structure was established in an independent sample (n?=?123) using confirmatory factor analysis, and sound reliability (internal consistency) and validity (known-groups) were demonstrated. The SVS15 is a potentially useful instrument for assessing older adults' vulnerability to exploitation.     

Hong Kong Chinese aging adults voice financial care expectations in changing family and sociocultural contexts: implications for policy and services

Despite being one of the world’s wealthiest cities, approximately one-third of Hong Kong older adults live below the poverty line. Innovatively using the Photovoice research method, this study invited 36 Hong Kong Chinese aging adults to photograph images and voice their concerns and expectations regarding financial care. Insufficient government support, diminishing family support, insecurity and fear regarding future finances, and strong desire for self-sufficiency through early preparation and bridge employment were recurring themes observed in the participants’ photographs and narratives. The shifting of the participants’ financial care expectations from informal to formal sources in changing family and sociocultural contexts indicated that older people are in urgent need of policy reform from a needs-based to rights-based approach to foster empowerment and fulfill older people’s rights of financial security, dignity and participation. Improving the retirement protection system should go hand in hand with encouraging family support and caregiving and creating age-friendly working environment for older residents. The findings of this study may have crucial policy implications for Hong Kong and other aging societies, especially those that share similar filial piety values and have seemingly ungenerous welfare systems.     

Conceptual Model and Map of Financial Exploitation of Older Adults

This article describes the processes and outcomes of three-dimensional concept mapping to conceptualize financial exploitation of older adults. Statements were generated from a literature review and by local and national panels consisting of 16 experts in the field of financial exploitation. These statements were sorted and rated using Concept Systems software, which grouped the statements into clusters and depicted them as a map. Statements were grouped into six clusters, and ranked by the experts as follows in descending severity: (a) theft and scams, (b) financial victimization, (c) financial entitlement, (d) coercion, (e) signs of possible financial exploitation, and (f) money management difficulties. The hierarchical model can be used to identify elder financial exploitation and differentiate it from related but distinct areas of victimization. The severity hierarchy may be used to develop measures that will enable more precise screening for triage of clients into appropriate interventions.     

Cognitive,social, and neural determinants of diminished decision-making and financial exploitation risk in aging and dementia: A review and new model

ABSTRACT

In this article we will briefly review how changes in brain and in cognitive and social functioning, across the spectrum from normal to pathological aging, can lead to decision-making impairments that increase abuse risk in many life domains (e.g., health care, social engagement, financial management). The review will specifically focus on emerging research identifying neural, cognitive, and social markers of declining financial decision-making capacity in older adults. We will highlight how these findings are opening avenues for early detection and new interventions to reduce exploitation risk.     

Assessing Knowledge of Elder Financial Abuse: A First Step in Enhancing Prosecutions

Financial exploitation by a family member is the most common form of elder mistreatment; yet, it is a difficult crime to detect and prosecute. Psychologists have traditionally assisted prosecutors by assessing decisional capacity and opining in court whether an alleged victim was able to consent to the contested transactions. This article proposes and evaluates a novel form of psychological expertise in financial abuse trials—social framework testimony to reeducate jurors who are misinformed about aspects of this largely hidden crime. Findings suggest that, as in cases of child and spousal abuse, social framework testimony on the general dispositional and situational factors inherent in elder financial abuse may enhance prosecutions.     

Intergenerational Remote Exergaming with Family and Friends for Health and Leisure

Global guidelines for physical activity are not being met by most of the world’s youths, adults, and older adults. Family and friends who engage in physical activity across generations derive emotional, social, cognitive, and physical benefits from their interaction. Youths depend on adult assistance to travel long distances, adults are encumbered with obligations to work, and older adults often live more than 200 miles from their extended families. Intergenerational physical activity is difficult because generations are distant and lead busy lifestyles. Remotely played exergames can connect family and friends for intergenerational physical activity. Internet exergaming can help to make physical activity convenient and enjoyable as well as eliminate the effect of distance on playing with family and friends.     

Cognitive abilities,self-efficacy,and financial behavior

This paper investigates the effect of cognitive abilities on financial behavior among older adults. Using the U.S. Health and Retirement Study, I find that cognitive abilities significantly affect financial behavior through two channels: ability and self-efficacy. People with higher cognition scores achieve better financial outcomes. This positive association is especially strong in tasks having high demand of cognitive abilities, which confirms the ability channel of the cognitive ability effect. In addition, there is evidence for the self-efficacy channel as a secondary source of cognitive influence. Lower cognitive abilities decrease people’s sense of self-efficacy, which, in turn, significantly decreases financial management efficiency. The findings have important policy implications, specifically that more effort is needed to assist the growing older population through the cognitive aging process and that noncognitive skills, as a secondary source of influence, also warrant attention.     

Financial Exploitation of Older Persons

Abstract

Financial exploitation is a recognized social problem of unknown, though likely increasing, magnitude. It can occur through numerous methods, including the misuse of powers of attorney and guardianship, illegal transfers of property, and outright fraud and theft. Financial crimes against older persons are difficult to address because they often go unreported. This paper provides a summary of findings from a study of financial exploitation of older persons. We review what is known about the nature and scope of financial exploitation of older persons and describe barriers to addressing the problem. We also identify gaps in knowledge, discuss current methods for addressing financial exploitation, and provide recommendations and suggested policy approaches for prevention and remediation.     

Grandparenting and support from adult children: Does children’s international migration make a difference for Chinese older adults?

ABSTRACT

Guided by social exchange theory, this study investigates the association between grandparenting and support from adult children, and the role of children’s international migration in moderating such association. Data were derived from a 2012 survey of older adults in Beijing, China (478 adult children nested in 300 older parents). The results of independent cluster logistic and linear regressions showed that regardless of children’s migration status, grandparenting was significantly associated with a greater likelihood of receiving household help and personal care, but not with emotional or financial support from children. Children’s migration status moderated the associations between grandparenting and receiving support from children. Theoretical implications for research and practical implications for services and policies are discussed.     

Lessons from Erikson

Abstract

The purpose of this paper is to examine issues related to autonomy across the life span and to draw comparisons between a young child's search for autonomy and an older adult's efforts to maintain autonomy. The paper includes an introduction of the challenges for young children and older adults as related to autonomy. A definition of autonomy and an explanation of Erik Erikson's stages of psychosocial development are included. Each of Erikson's stages is reviewed with consideration given to traits, characteristics, and needs of the young child and older adult. Similarities and differences between young children and older adults in their search for autonomy are examined. The paper concludes with implications for caregivers regarding their practices with young children and older adults.     

Assessing Capacity Within a Context of Abuse or Neglect

In 2000, with the implementation of Part III of the Adult Guardianship Act: Support and Assistance for Abused and Neglected Adults, British Columbia formally recognized the need to examine issues of decisional capacity of older adults within a context of abuse or neglect. Interestingly, however, although the test of capacity was clearly laid out under this piece of legislation, the potential influence that living in a situation of abuse or neglect may have on how the person makes decisions is not explicitly addressed. Similarly, this is a missing link throughout the literature discussing decisional capacity in older adults. This gap exists despite the fact that determining the “protection” needs of someone who is being abused and/or neglected often hinges directly on that person's decisional capacity. The purpose of this article is to examine the unique aspects associated with assessing and determining capacity for older adults who are living in a situation of abuse or neglect. The specific objectives are to: (a) examine how living in a situation of abuse or neglect may influence the determination of capacity and (b) explore the implications of conducting an assessment within a potentially abusive context. The legal notion of undue influence and the psychological concept of relational connection are introduced as potentially important for considering decision making within this context.     

When Parenting Pays Off: Influences of Parental Financial Socialization on Children’s Outcomes in Emerging Adulthood

This study examined the influences of parental financial socialization during adolescence on emerging adults’ financial outcomes using Family Financial Socialization Theory. It utilized two waves of data from 307 triads—consisting of parents and emerging adults—from a large city in the Pacific Northwest of the United States. Time one was reported in 2012 by fathers and mothers when their 13 to 17-year-old children were adolescents and time two in 2017 by their emerging adult children 5 years later. Results of path analyses revealed that responsible parental financial behavior at Time 1 predicted greater financial satisfaction and lower financial independence for their emerging-adult children at Time 2. In addition, parental financial distress at Time 1 predicted lower financial satisfaction, higher financial distress, and higher financial independence for their children at Time 2. Implications for practitioners, educators, and parents are discussed.

     

Cross-validation of the screening scale in an adult protective services sample

Adult Protective Services (APS) professionals are often called on to assess decision-making capacity when investigating financial exploitation. Previous research found that in consecutive APS cases, a decision-making screening scale (LFDSS) also detected financial exploitation. The purpose of this study was to apply the clinical cutoff scores derived from the previous study to a new sample of APS cases. Using a sample of 105 participants, from APS workers across 5 counties this study investigated the clinical utility of the LFDSS to detect financial exploitation based on ratings by APS professionals using the scale. Results demonstrate that the LFDSS has excellent internal consistency and clinical utility properties. This paper provides support for use of the LFDSS as a reliable and valid instrument. Instructions for use of the LFDSS are included in the article, along with information about online support tools.     

Longitudinal Prevalence and Correlates of Elder Mistreatment Among Older Adults Receiving Home Visiting Nursing

The objectives of this study were to identify elder mistreatment (EM) prevalence among a cohort of older adults receiving visiting nurse care in their homes, determine EM subtypes, and identify factors associated with EM. EM data were collected by nurses during monthly home visits for up to 24 months. It took the nurses a mean of 10.5 visits to discern EM. Fifty-four (7.4%) of 724 patients were identified as mistreated, of which 33 had enough information to subtype the EM. Of these 33, 27 were victims of neglect, 16 of psychological abuse, and 10 of financial exploitation, and 17 suffered more than one type. Among the entire sample, 11 variables were positively correlated with EM presence. Nurses visiting older adults in their homes should be aware that their patients are, as a group, vulnerable to EM, and that the factors identified here may be specific markers of greater risk.