Financial abuse of older people: A case study

Abstract

This article presents a case study to illustrate the complexities of financial abuse of older people by their family members. It provides insights into why older people and social care professionals may not detect or define family member’s behaviour as abuse or feel discomfort in talking about it. The authors argue case studies can lead to new understandings about financial abuse that move beyond operational definitions to theoretical explanations that consider practices and outcomes of ageism and gender relations.

Keywords

Case study elder abuse family members financial abuse older people

Introduction

This article aims to contribute to the theoretical development of financial abuse of older people by family members through the presentation of a case study. It is argued that case studies can lead to new understandings about financial abuse that move beyond operational definitions to theoretical explanations. The growing focus on population ageing parallels an increased focus on the abuse of older people. As people age they often become increasingly dependent on their family members and older people’s finances and other assets can become an area of contention within families (WHO/INPEA, 2002; Wilson et al., 2009). Financial abuse is usually not reported by older people and in many cases is not even detected because of discomfort or denial, and yet it potentially has devastating effects (WHO/INPEA, 2002). Similarly, social care professionals often doubt their ability to identify it (Bagshaw et al., in press; McLaughlin and Lavery, 1999). This article examines, through a case study, the complexities of financial abuse to provide insights into why older people and human service workers may not detect such abuse or find discomfort in talking about it.

Understanding financial abuse of older people

Operational definitions

Financial or material abuse is the ‘illegal or improper exploitation and/or use of funds or resources’ (WHO/INPEA, 2002: 3). National prevalence studies of elder mistreatment have operationalized definitions of financial abuse to include acts like stealing or forcing older persons to give money/property/possessions and fraud activities; and have found it to be often the most common form of mistreatment of older people. To measure one year prevalence, Acierno et al. (2010) found from 5777 community-residing adults aged 60 years and older residing in the United States that 5.2 percent had experienced financial abuse by a family member, the most frequent form of abuse reported. In the UK Biggs et al. (2009) reported on 2111 people aged 66 and older living in private households and found 0.6 percent experienced financial abuse by a family member, close friend or care worker, the second most frequent to neglect. Similarly, Naughton et al. (2012) reported from 2021 community-dwelling people aged 65 years and older within a 12-month period in Ireland that 1.3 percent had experienced financial abuse; the most frequent type of mistreatment reported. In comparison, Lowenstein et al. (2009) reported financial abuse to be higher from a sample of community urban dwellers aged 65 and older (392 males, 650 females) in Israel. They found during the 12 months preceding the interview, the most prevalent form being verbal abuse followed by financial exploitation (6.4%) and it was mostly inflicted by adult children. Finally, although a national prevalence study has not been conducted, several Australian researchers have found or inferred that the most common form of reported or suspected abuse is financial abuse, and have concluded that the people most likely to commit this abuse are the older person’s adult daughter or son (Cripps, 2001; Livermore et al., 2001). In building an understanding of financial abuse, the national prevalence studies have shown that financial abuse is often the most common form of abuse of older people and this abuse is likely to be perpetrated by a family member.

Contested definitions

Moving beyond the terrain of prevalence studies, understanding financial abuse is a contested area because it requires a cultural context in order to provide meaning about the circumstances in which this form of abuse may occur. For example, in some traditional societies older widows are subjected to abandonment and ‘property grabbing’ or evacuation from their home (WHO/INPEA, 2002), which can be considered a form of financial abuse. In more developed countries, however, financial abuse is more likely to be identified as forgery, stealing, forced changes to a will, transferring money or property to another person, or withholding funds from the older person and the failure of others to repay loans. It also includes the misappropriation of enduring powers when a trusted person (usually a family member) is legally appointed with enduring powers to manage the financial affairs of the older person whose frailty is increasing and can no longer manage their own affairs (Dixon et al., 2010; Smith, 1999).

‘Elder abuse’ generally has been acknowledged in the literature as being contentious because of particular stances or positions on key issues surrounding intent and consequences and acts of omission and commission. It is not ‘objectively self-evident’; rather the social construction of the problem may depend on the influence of a number of stakeholders or parties (Brammer and Biggs, 1998: 285). Wilber and Reynolds (1996) argue that financial abuse of older people tends to be the result of a relationship gone wrong, or a betrayal of trust, rather than outright theft and so victims may be unwilling to report the abuse, particularly when the abuser is a family member, friend and/or confidante. Similarly, Hugman (1995) argues that situations of family care-giving introduce another complicating factor in defining and understanding financial abuse because of the often subtle nature of financial abuse.

Social care professionals also experience difficulties in identifying financial abuse, which is evidenced in studies that have examined social workers’ or other social care professionals’ awareness of financial abuse. McLaughlin and Lavery (1999) surveyed 40 staff from eight professional groups from Northern Ireland, including social workers, about their awareness of elder abuse. They found that no respondent gave a single definition of ‘elder abuse’ but instead defined abuse by typology; physical and psychological abuse was the most cited categories (80%). Only one-third cited financial abuse. Only 25 percent believed they were competent in identifying elder abuse and the majority of respondents (90%) indicated that they would require more training in elder abuse. More recently, Davies et al. (2011), aimed to identify the case features or ‘cues’ that raised suspicions of elder financial abuse amongst 23 social workers (19) and their managers (13) across England. They found three cues were used including the person who raised concern, that is, the ‘identifier’, the mental capacity of the client, and the nature of the financial anomalies. What these studies show is that professionals generally understanding concepts of ‘abuse’, ‘neglect’ and ‘trust’ (Dixon et al., 2010) but they will have different understandings and ways of identifying different forms of abuse or neglect.

Risk factors

Recent studies of financial abuse have also pointed to factors that suggest vulnerability to financial mistreatment. Gender has been explored as a risk factor, with studies showing that most abused people are older women, particularly when examining physical and sexual abuse (Biggs et al., 2009; Rabiner et al., 2004; WHO/INPEA, 2002). However, in relation to financial abuse, Naughton et al. (2012) found that women were more likely to experience this form of mistreatment than men, whereas, Biggs et al. (2009) found the prevalence of financial abuse was similar for both sexes and Acierno et al. (2010) found that gender was not a significant independent predicator of abuse. However, both of these studies acknowledged few conclusions could be drawn regarding gender due to small sample sizes and recommended further exploration of gender as a risk factor. Similarly, Lowenstein et al. (2009) found no significant statistical differences in financial abuse of older people according to gender, but when comparing the statistics for men and women, women were more exposed to other forms of violence (physical, sexual, emotional, neglect). By comparison, Ockleford et al. (2003) sampled a group of 149 women (50 Irish, 50 Italian, 49 British) asking about physical, psychological and financial abuse and found the figure of abuse higher than those arising from the larger national prevalence studies. Just less than 20 percent of the sample of women older than 59 years had experienced some form of financial, psychological and physical abuse. Of those mistreated, 24 percent reported abuse ongoing over years and 39 percent reported distressing effects persisting for years.

When identifying potential risk factors, studies have also shown that previous abuse may predict elder abuse. For example, Naughton et al. (2012) found one-third of participants indicated that mistreatment had started before the age of 65 years. This study showed a trend towards higher levels of mistreatment experienced by older people living in intergenerational or extended family households. Similarly, Acierno et al. (2010) also found that experience of previous traumatic events, including domestic violence, increased the risk for emotional, sexual and financial abuse. An Australian study by Bagshaw et al. (in press) surveyed 214 service providers (including social workers) about their knowledge and understandings of financial abuse of older people, and 113 older people and family members (43% being older people) views and experiences of financial abuse. They found the three highest risk factors of financial abuse included a family member having a strong sense of entitlement to an older person’s property or possessions, an older person having diminished capacity, and an older person being dependent on a family member for care. In subtle ways these studies point to power and exchange dynamics and the extent of control each person in the family has over others, hence it can be argued that power and control are factors that need further consideration when developing theoretical understandings of financial abuse (Rabiner et al., 2004).

Theoretical explanations

Identifying prevalence, levels of professional awareness, and risk factors for financial abuse of older people provides unique insights into financial abuse, but as Lowenstein (2009) argues, the next stage required is that of theoretical development. She states that theoretical under-development reduces the ability to discover unifying themes and their relationship to local idiosyncrasies and argues that theoretical knowledge needs to be grounded in data from the study of elder abuse itself. Similarly, Davies et al. (2011) argues for the importance of moving towards a deeper analysis of ‘real-world cases’ to help professionals answer the implicit question of whether or not the older client is experiencing financial abuse. It is for these reasons that a case study of financial abuse of an older person is presented in this article. A case study can show the unique circumstances and idiosyncrasies in a particular context but at the same time can be used to expand knowledge about financial abuse generated in previous studies, such as risk factors (Stake, 1995). As Stake (1995) encourages, we have selected one case study to maximize what we can learn about financial abuse, that is, to show its complexities, which aids theoretical development in understanding why older people themselves and social care professionals struggle to identify it. Case studies are likely to lead to new understandings and assertions, which support theoretical development because they render the local into something workable (Wendt and Boylan, 2008).

Case study: Examining financial abuse

The case study analysed in this article is drawn from an Australian national research project that focused on the prevention of financial abuse of older people. All methods associated with the study were approved by the Human Research Ethics Committee of the University of South Australia. In June 2010, the researchers conducted a voluntary, anonymous, South Australian based phone-in with 14 older people or their family members. Participants were recruited through aged care service providers and community service announcements in the media. Table 1 provides an overview of the participants.

Table 1.

Participants.

Participant	Victim	Perpetrator of financial abuse
Older woman	Themselves	Daughter
Older woman	Themselves	Daughter
Son	Father	Daughter
Son	Mother	Daughter
Son	Mother and Father	Son
Daughter	Mother	Son
Sister	Sister	Daughter
Son	Mother	Daughter
Daughter	Mother	Daughter
Niece	Uncle	Niece
Sister	Mother	Daughter
Daughter	Mother and Father	Daughter
Step Daughter-in-law	Step Mother-in-law	Daughter
Friend	Woman	Daughter and two sons

Semi-structured interview guides were used during the phone-in. This allowed the researchers to gain basic demographic data and ask open-ended questions associated with the following themes: concerns with family relationships, the older person’s financial and property arrangements and potential for or actual abuse/exploitation of these by a family member, history of family violence, the type and nature of assistance given to the older person with regard to their property and finances and their degree of satisfaction, and any other information. Older people and relatives of older people were invited to participate in the phone-in and the interview guides were adjusted according to who was being interviewed. Interviews went for approximately 1.5 hours and were undertaken by social workers who had expertise in working with older people and/or in the field of violence and abuse. The telephone interviews were not audio-recorded as Stake (1995: 64) argues, recording the interview is not necessary because exact words of the respondent is not the priority. Instead, the interviewers took comprehensive notes to continually seek clarification (Stake, 1995). Written notes allowed the interviewer to concentrate on the key ideas and episodes spoken about during the data collection phase. In addition, within a few hours of the interview, the interviewer prepared a written piece to reconstruct the account and prepare the story (Stake, 1995). Before each interview, participants were reassured of confidentiality, safety was confirmed, and telephone counselling services were offered.

To analyse data generated from the phone interviews the information from each caller was collated into a case study so the nature, context and complexity of financial abuse could be examined. Stake (1995: 71) argues that there is no particular moment when data analysis begins because analysis is a matter of giving meaning to first impressions as well as to final compilations, hence analysis and interpretations occurred during the interview on an ongoing basis. It is not the intent of this article to make generalized findings in relation to issues of financial abuse as this is not the purpose of case studies (Rubin and Babbie, 2008); instead we present one case study to inform, sophisticate, and increase theoretical understandings of financial abuse. The case study allows the reader to engage with the complexities, nuances and idiosyncrasies of financial abuse, that is, readers are invited to move away from operational definitions to an elegant intricacy of understanding (Stake, 1995). Case studies are lengthy and so we cannot provide full renditions of the 15 cases we collected for the project. For this article we have provided one case study that has been edited to protect the identity of the family. All identifying material has been removed and the participants given pseudonyms.

A case study: An example of financial abuse

Susan is a woman in the 65 to 69 year age group who lives in Adelaide and called about both her parents who are non-indigenous Australians over 85 years of age and living in a nursing home in a rural area. They have two daughters and a son who are now all in their 60s. This elderly couple mainly rely on the staff of the nursing home, their oldest daughter Wendy – Susan’s sister who visits them weekly – and their son Frank who briefly visits them every second day. Frank and Wendy live near their parents and provide them with practical support; however, Wendy can only visit once a week as she lives two hours drive away. Susan can only visit her parents occasionally as she lives too far away. She relies on a disability pension and now finds it hard to travel. She offers them emotional support by phone.

Susan said that her elderly parents support each other emotionally but her father constantly puts her mother down verbally. He criticizes and bosses her, sometimes loudly, which upsets the other residents in the nursing home. His behaviour is becoming worse as her parents age although she said that her father has always been a patriarch and has dominated all of them and at times verbally abused her mother and the children when they were growing up. He was very strict and critical of the children in their earlier years.

Frank lives closest to the parents and when he visits, he does not stay for long. Her elderly parents are both somewhat intimidated by him and his wife has never liked them. However, they give in to whatever he wants because he runs practical errands for them.

Susan stated that her brother has intimidated both parents since their father retired from farming and bullied his father into giving all of the farming properties to him before they died, threatening not to continue to farm them unless they did. He is also resentful that the parents have left him out of their will, although there is comparatively little money left. He barely speaks to his sisters and at times is aggressive on the phone when speaking with them. Both parents are upset by his attitude; in particular, the mother is very distressed as she feels that her daughters have been treated unfairly and she cannot do anything about it. The brother has also taken the livestock and farm machinery without paying anything and has sold other assets that were superfluous to his needs without permission from the parents. He assumes that because he has shared the farming with his father since leaving school he has a right to the properties and related assets. He has two unmarried daughters who have no intention of becoming farmers and Susan thinks that he intends to sell the properties as soon as the parents die.

Even though the parents have assigned powers of attorney and guardianship to the two daughters, they rely heavily on Frank who lives closest to the nursing home. Susan feels that her brother is resentful and has been grabbing as much of their remaining assets as he can since finding out that he has been left out of their will. Her main concern is about the attitude of her brother in relation to the property and other assets and the pressure this has placed and still places, on their parents.

Susan has been frightened by her brother’s aggression on the phone on two occasions. Both parents have also told Susan that, prior to going into the nursing home, they had been frightened of their son’s verbal abuse on a number of occasions and gave in to his demands for fear of losing his practical support.

Susan’s elderly mother has discussed her concerns about her brother with her but the father is ‘too proud’ to acknowledge or discuss the situation with anyone. Her mother has also complained to Susan about her father’s ‘put downs’ and his occasional loss of temper with her. There has been very little that Susan could do other than to make sure that her parents got assistance to complete the forms to assign Enduring Powers of Attorney and Guardianship to the daughters, specifying what they wanted to happen if and when they lose capacity.

Discussion

In forming understandings of financial abuse through reading Susan’s story, operational definitions of financial abuse can be extracted. Susan provides examples of improper exploitation and/or use of funds or resources such as being bullied into giving farm property or taking livestock and machinery without permission. However, the complexity of financial abuse starts to emerge from the case study when issues surrounding intent and consequences, acts of omission and commission, and the relation of abuse to informal care are examined. Susan reported that her brother has been selling farming assets without permission and had threatened their parents on numerous occasions to gain property and assets. Susan’s concern about not gaining permission raises questions surrounding intent and acts of commission when trying to identify the case as ‘financial abuse’. Particular stances or interpretations can be made depending on whether Frank is seen as intending to abuse or not and where harm is caused as a result of his actions. Similarly, Frank’s perceived caring role (visiting every second day, running errands) may determine ‘legitimate’ private transactions or abusive interactions that require intervention in this case. These points of difference are often debated when determining or naming financial abuse (Brammer and Biggs, 1998; Hugman, 1995; Wilber and Reynolds, 1996).

Particular risk factors for vulnerability to financial mistreatment can also be extracted from Susan’s story adding yet another layer of complexity to identifying financial abuse. In this case the risk factors for vulnerability to financial abuse from the son included the older parents’ dependency on the son for care (in particular, running practical errands), the son’s sense of entitlement to the parents’ properties and other assets (Bagshaw et al., in press; Naughton et al., 2012). Together, dependency and a sense of entitlement can act as fertile ground for financial abuse because there is an expectation of trust, particularly amongst family members. However, trust becomes complex when it is embedded in cultural norms and expectations that can be ‘notoriously subjective, particularly in family settings’ (Brammer and Biggs, 1998: 296). For example, research has found that values of self-reliance, privacy, pride and traditional family values that promote patriarchal inheritance are common in farming families in rural Australia (Wendt, 2009). The older parents trust the son to care for them and to continue the operation of the farm, and simultaneously the son trusts the parents to foster space for the patriarchal inheritance to which he believes he is entitled. It can be very difficult for older people to acknowledge or say they do not trust their children; Susan’s story highlights the complexity of trust in the context of particular cultural values, such as when she said her father was ‘too proud’ to discuss the abuse with anyone. Wilber and Reynolds (1996) state financial abuse of older people is difficult to detect because of the private nature of many financial transactions within families. This is particularly relevant in the management and inheritance of farm assets, asset sharing, succession and intergenerational transfer of assets. Susan’s story shows the multiple interests involved in intergenerational family farms and shared income, which are all issues that raise particular challenges and conflicts for family members. The risk of financial abuse is exacerbated when assets are complex and competing stakeholders are invested (Tilse et al., 2006).

This case study shows Susan talking about her brother’s sense of entitlement to the property and other assets, resulting in the two daughters inheriting comparatively little, in spite of their mother’s concerns. A case study cannot predict gender as a risk factor; however, it does provide a context to examine gender relations. This case study represents the perspective of a daughter, who may be influenced by family dynamics. The son (Frank) was identified as the perpetrator of financial abuse by Susan who provided accounts of him exerting power and control over the parents and his verbally aggressive behaviour toward them and her. Susan’s story provides a glimpse of the father’s abuse of his wife and the children in the past and so the distinction between prior family violence and the current abuse of these older people is blurred and can be seen as a continuum. Susan’s story reveals gender inequality in relation to inheritance of the parents’ assets arising from the father’s patriarchal attitudes and so gender provides a lens through which dynamics of power and control can be examined. Examining the dynamics of power and control as well as the intergenerational aspects of abuse has the potential to illuminate some of the complexities embedded in identifying financial abuse because it exposes fear and intimidation in family relationships as well as how abuse can be perpetuated across generations.

Conclusions

Research that has operationalized financial abuse, determined its prevalence and identified particular risk factors that make older people vulnerable to financial mistreatment has provided a strong platform upon which to better understand the occurrence and manifestations of financial elder abuse. However, the case study presented in this article shows that the phenomenon of financial abuse of older people by family members is often more complex and multidimensional than prevalence and risk factor studies, alone, may demonstrate. Financial abuse is embedded in social and cultural arenas with competing influences from family members, which makes the problem of financial elder abuse complex and context-specific. This contributes to the difficulties older people may have in naming it and social care professionals defining it, and determining when and how it is occurring.

Lowenstein (2009) argues that raising awareness of the complexities of financial abuse is a fundamental prevention strategy and an important step in bringing about a change in attitudes and behaviour amongst social care professionals and older people and their family members; but that awareness and knowledge should be developed from the local or individual level, which can then inform organizational, national and international stages. A case study provides this opportunity because the story allows for naturalistic generalization, that is, the reader has the opportunity for vicarious experience. This experience assists readers to arrive at a high-quality understanding of financial abuse (Stake, 1995) that moves beyond individual acts or dysfunction, while allowing for a more nuanced analysis of its processes and effects. As demonstrated herein, the detail of the case study enables consideration of the practices and outcomes of ageism and gender relations, which serve to shape and influence the power relations in families, communities and societies. The case study demonstrates the continuities between financial elder abuse and other forms of social oppression, such as ageism and sexism and how they can become key mechanisms in the perpetuation of abuse.

The development of theoretical explanations of financial elder abuse that consider the impact of ageism and sexism in the lives of older people and their families have the potential to enhance the judgement and decision making of social care professionals (Davies et al., 2011; McLaughlin and Lavery, 1999) because these frameworks can guide and inform practice. For example, ageism can restrict older people’s ability to exercise control over their own lives (Wilson et al., 2009), including access to and utility of their own financial resources (Langan and Means, 1996). Similarly, even though previous prevalence studies have not been able to draw definitive conclusions about gender differences in the victims and perpetrators of financial elder abuse, older women are still the primary victims of physical and sexual abuse perpetrated against them by men; and studies have found interconnections among different forms of abuse (Bagshaw et al., 2009; Walsh et al., 2007). The gendered aspects of elder abuse are particularly evident in those cases where domestic violence has persisted into old age and where it is difficult to distinguish between elder mistreatment and domestic violence in older women (Fisher and Zink, 2007).

Analysis of particular cases of financial elder abuse have the potential to illuminate the ways that age, gender and the misuse of power and control are exercised in the lives of older people, which in turn provide insights into the complexity of financial abuse and explanations for why it is so difficult for social care professionals to identify it as well as why older people may be apprehensive in talking about it.

Footnotes

Funding

This project was funded by the Australian Research Council and the South Australian Government, through the Department for Communities and Social Inclusion and the Office for Ageing (Department for Health and Aging). As ARC-Linkage partners, the following South Australian organisations also contributed in-kind support for the project - Office of the Public Advocate (SA), Relationships Australia (SA), Alzheimer’s Australia (SA), Guardianship Board (SA), and the Aged Rights Advocacy Service.

Author biographies

Sarah Wendt is Associate Head of School: Research/Senior Lecturer, School of Psychology, Social Work and Social Policy, University of South Australia, Australia.

Dale Bagshaw is Adjunct Associate Professor, School of Psychology, Social Work and Social Policy, University of South Australia, Australia.

Lana Zannettino is Senior Lecturer, School of Nursing and Midwifery, Flinders University, Australia.

Valerie Adams is a Research Associate at the Hawke Research Institute, University of South Australia, Australia.

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