Geriatric and developmentally disabled individuals with psychiatric conditions are easily vulnerable to financial abuse. Stories vary from a 60-year-old with mild mental retardation being financially exploited for jewelry and appliances by his counselor to a housemate forging an 86-yearold woman's checks. Elders are the fastest growing age group who become dependent on others for services as their functional level diminishes, placing them at increased risk of exploitation. This commentary reviews what is known about financial abuse in elders so nurses can be more adept in assessing, educating, and intervening
WHATIS FINANCIAL ABUSE?
The term financial abuse includes the theft or misuse of an elder's money or property (Sengstock & Barrett, 1993). The range of activities includes cashing and pocketing a relafive's Social Security check to resurfacing a driveway twice in a week and collecting the payment twice from the unsuspecting demented person.
Financial abuse has had increased exposure in the past 20 years, however, it is not a new phenomenon. Property ownership by the aged (over age 50 before industrialization and over age 65 in the last five decades) was a source of tension between the elder parent and their offspring as it curtailed the younger generation's prosperity (Stearns, 1986).
Industrialization reduced familial tension as offspring could acquire wealth at a younger age. Recent attention to elder abuse may result from new and stringent federal, state, and local regulations, (e.g., the Omnibus Budget Reconciliation Act of 1987 and Adult Protective Services) and not necessarily an increase in prevalence (Stearns, 1986).
Rates of financial abuse range from 1.1% to 12% (Kurrle, Sadler, & Cameron, 1992; Shiferaw et al., 1994; Tatara & Blumerman, 1996). Varying rates have been attributed to differing definitions and assessments of financial abuse. Often elders voluntarily give money to others, diminishing chances of prosecution. Third parties are the most likely to report abuse and adult children are most often implicated at rates of 36.7% of all elder abuse in 1994 (Tatara & Blumerman, 1996).
Societal, cultural, economic, political, and psychological factors influence financial abuse. The rates of abuse by family members has been associated with the increased emotional and financial stress as elders live beyond their productive years (Steinmetz, 1980). An added stressor is the increase in women working outside the home which decreases the availability of traditional care providers (All, 1994). Geographic distance between relatives has influenced elders becoming more vulnerable targets to abuse due to isolation and lack of community support.
With changing residential settings, decreased social support and community networking, elders are targets for various scams. Most inner-city senior apartment dwellings prohibit solicitation and provide security to protect residents. Notices have appeared in local papers and on the news warning elders to be wary of individuals posing as household contractors or as investment agents. Lonely elders fall victim to the attention and companionship the perpetrator provides.
WHO IS AT RISK?
Elders at risk are those who are frail, female, over age 75, physically dependent on a caregiver, cognitively impaired, and socially isolated (Lachs & Pillemer, 1995; Shiferaw et al., 1994).
WHAT CAN NURSES DO?
Nurses in the community and in clinics are likely to encounter elders at risk and can be key players in reducing the prevalence of financial abuse. Nurses can assess the level of social support available, provision of care, and financial issues and make appropriate referrals. Nursing interventions should target elders at senior centers and outpatient clinics regarding financial abuse facts to help empower them to avoid exploitation. Elders' views on companionship should also be explored. Getting families more actively involved in the elder's life or a referral to a volunteer companion program are ways of improving socialization without attaching a cost.
Other interventions to minimize exploitation include direct deposit of social security checks or monthly pensions, increased networking with neighborhood groups and members, and reporting of fraudulent companies to the Better Business Bureau. Referrals of suspected abuse can be made to Adult Protective Services, police units, and the local aging service networks available. Nurses working with the elderly should familiarize themselves with the local, state, and federal regulations protecting the rights of elders and serve as advocates for continued legislation.
As we approach the 21st century, more elders will be living in their homes, dependent on others for care. Nurses on the front line working with elders have the opportunity to be effective change agents. Nurses can educate elders, the community, and other health care workers about financial exploitation and potentially decrease the occurrence. The National Center on Elder Abuse is online (http: / / interinc.com / NCE A) or available by phone (202) 682-2470 for further information on elder abuse.
- All, AC. (1994). A literature review: Assessment and intervention in elder abuse. Journal of Gerontological Nursing, 20, 25-32.
- Kurrle, S., Sadler, P., & Cameron, I. (1992). Patterns of elder abuse. Medical Journal of Australia, 157, 673-676.
- Lachs, M.S. & Pillemer, K. (1995). Current concepts; Abuse and neglect of elderly persons. New England Journal of Medicine, 332, 437-443.
- Sengstock, B., & Barrett, S. (1993). Abuse and neglect of the elderly in the family settings. In JC Campbell & J. Humphreys (Eds.), Nursing care of survivors of family violence (pp. 173-208). Baltimore: CV. Mosby.
- Shiferaw, B., Mittelmark, M, Wolford, J., Anderson, R., Walls, P. & Rohrer, B. (1994). The investigation and outcome of reported cases of elder abuse: The Forsyth County Aging Study. The Gerontologist, 24, 123-125.
- Stearns, P. (1986). Old age family conflict: The perspective of the past. In K.A. Pillemer & R.S. Wolf (Eds.), Elder abuse: Conflict in the family (pp. 3-24). Dover, MA: Auburn House.
- Steinmetz, S. (1980). Statement cited in Elder abuse: The hidden problem. A briefing by the Select Committee on Aging (pp. 7-10). (Comm. Pub. No. 96-220). Washington, DC: U.S. Government Printing Office.
- Tatara, T. & Blumerman, M.A. (1996). National Center on Elder Abuse. Elder Abuse Information Series #2: Elder Abuse in Domestic Settings.