Financial Abuse

Financial abuse has been chosen as the subject of this study because it is often said to be one of the most prevalent forms of abuse, and yet has been one of the least studied. Researching the role of health, social care and banking professionals in detection and intervention of financial abuse of older people has been commissioned so that evidence based policies can be developed to support the decisions these professionals have to make in these situations.

Investigator(s)

• Mary Gilhooly, Brunel University
• Priscilla Harries, Brunel University
• Ken Gilhooly, University of Hertfordshire
• Catherine Hennessy, University of Plymouth
• David Stanley, University of Northumbria
• Tony Gilbert, University of Plymouth
• Bridget Penhale, University of Sheffield

Team

• Action on Elder Abuse
• British Association of Social Workers
• Help the Aged
• HSBC
• North Tyneside Council
• Relatives and Residents Association
• Peninsula Care Sector Group
• Peninsula Primary Care Research Network

Contact details

Mary Gilhooly

Background

• With substantial and increasing numbers of frail and cognitively impaired older people being cared for in the community, there are growing challenges associated with money handling.

• Financial abuse of people with dementia or declining cognitive and physical functioning is of growing concern.

• It is equally important to protect professionals and carers from unfair allegations of financial abuse, as it is to safeguard the assets of vulnerable older people.

• Although financial elder abuse is much discussed, it is poorly understood and has rarely been researched using rigorous methodologies.

• As a consequence current policies on detection and intervention are not based on a sound evidence base.

• To enable frail and cognitively impaired older people to live happily in the community, without fear of financial exploitation, requires the reassurance of effective mechanisms to be in place for detecting and intervening in cases of financial abuse.

Aims/objectives

The aim of this project is to look at how professionals in the health, social care and banking sectors recognize and make decisions when they suspect financial abuse of an older person. The aim is also to contribute to the financial elder abuse literature and decision making literature. A practical application of such research is to support the development of evidence-based guidelines for professionals when making decisions in cases of suspected financial abuse of older adults.

Design

The methods and research questions for the three phases of this study are as follows:

Phase I

In-depth interviews will be conducted with health and social care professionals and staff in banking and financial services that deal with financial assets. 'Critical incident methodology' will be used to determine the cues and patterns that raise suspicions of financial elder abuse and trigger intervention. The following questions will guide collection and analysis of data:

1. What are the cues or patterns that are perceived as triggering suspicions of financial abuse?
2. What 'rules of thumb' are used or have been devised to deal with these matters?
3. What kinds of decisions are made or have to be made?
4. What are the features that make decisions difficult, typical, rare, or unusual?

Phase II The factors identified from Phase I will be incorporated into case study examples, which will then be presented to participants to decide if they suspect financial abuse of an older person, and if so, how they might intervene. The following questions will guide collection and analysis:

1. Which case features explain the greatest variance in decision-making?
2. Which characteristics of the decision-maker help explain decision-making? Is the decision-maker's age of special relevance in decision making?

Phase III

Examination of policy documents and guidelines in order make comparisons between recommended practice and what actually happens in practice.

1. Are there commonalities in policies and guidelines as to what cues or patterns should raise suspicions of financial elder abuse and what should then happen in terms of intervention?
2. To what extent do current policies and guidelines on detecting and intervening in cases of suspected financial elder abuse match what actually happens in situations of real world decision making?

The disciplines brought together include psychology, social work, social policy, business, sociology, accountancy, and banking. Older people will be involved at all stages of the project.

Policy implications

The following recommendations were made by the Health Select Committee Inquiry into Elder Abuse (2004) regarding financial abuse.

• Recommendation 18, ‘We recommend that the prevention, detection and remedying of financial abuse should be included as specific areas of policy development by adult protection committees’.

• Recommendation 20, ‘We further recommend that the regulatory bodies of health and social care increase their surveillance of financial systems including the use of powers of attorney and, in care homes, the use of resident’s personal allowances’.

• Drawing on these observations the outcomes of the project will have important implications for policy, particularly in relation to the insights it will provide into the process of decision making by professionals in health and social care, banking and asset management. It is noted by the project that financial abuse of older people is an area that creates much discussion but there is a paucity of good research in this area. The key policy this project aims to influence is ‘No Secrets’: Guidance on developing and implementing multi-agency policy and procedures to protect vulnerable adults from abuse (2000) and related policy / legislation: Protection of Vulnerable Adults (2004), Safeguarding Vulnerable Groups (2006) and Mental Capacity Act (2007). In addition, there are implications for policy related to the Financial Services Act (2000) and the protection of consumers of financial services and the implementation of Trust, Assurance and Safety (2007) which relates to the future regulation of health professions.

• The evidence and outcomes of the project will be available to inform both policy and guidance at a national level, as well as to underpin decision making by professionals with regard to best practice. In particular, at a local level, its implications will be highly relevant to the work of the multi-agency partnership Safeguarding Adults Boards which are the responsibility of each local authority. In addition, the project anticipates that evidence about decision making will convert into best practice guidance monitored through the governance arrangements in relevant commissioner and provider organisations across health, social care and the banking and financial sectors. Furthermore, this best practice guidance would be used in investigations of suspected abuse and acted on by police and regulatory bodies for professionals.

• By informing policy and practice through Safeguarding Adults Boards, health and social care organisations, the financial industry and Professional Regulatory Bodies, practice will come to reflect the guidance provided by such organisations. In addition, the teaching of practitioners and student practitioners on programmes in universities and other educational institutions will take account of this guidance, further reinforcing practice. The project anticipates that evidence relating to professional decision making will contribute to an increase in intervention, confirmation, and sanctions in cases of financial abuse and to an overall reduction in the occurrence of financial abuse contributing to a climate of prevention rather than protection.