Providing Assistance for Older Adult Financial Exploitation Victims: Implications for Clinical Gerontologists

Perceived Financial Vulnerability, Wealth, and Wealth Change: The Health and Retirement Study

OBJECTIVES

The 6-item Perceived Financial Vulnerability (PFV) scale assesses awareness and psychological vulnerability regarding finances. Prior findings using the Health and Retirement Study (HRS) identified significant associations of PFV with wealth, demographics, and health status. This study examines the relationship between wealth, changes in wealth, and PFV.

METHODS

Data from HRS respondents were analyzed (N = 1,056). Total assets at baseline (2016) and changes in total assets over two waves (2016 to 2018) were stratified into deciles and used as primary predictors of PFV in 2018. Multiple linear regression models examined the influence of demographics, wealth change (linearly and curvilinearly), and baseline wealth on PFV.

RESULTS

Wealth change and baseline wealth were associated with PFV. When controlled for baseline wealth, wealth loss linearly predicted increased PFV.

CONCLUSIONS

These findings support the utility of the PFV. Findings underscore the importance of integrating multifaceted financial and demographic information when conceptualizing subjective financial welfare.

CLINICAL IMPLICATIONS

Financial wellbeing is crucial in older clients and should be assessed over time. The 6-item PFV effectively evaluates contextual aspects of financial decision-making across socioeconomic statuses, making it valuable for clinical assessments.

Successful Aging Through Financial Empowerment (SAFE): Financial Coaching with Older Adult Victims of Financial Exploitation

Financial exploitation (FE) of older adults is a growing public health problem. Current estimates of financial exploitation show between 5% and 11% of older adults are victimized each year. This study examined an empowerment-centered financial coaching intervention. Program records and participant baseline and follow-up assessment data were used to detail program dynamics and investigate participant outcomes. Most SAFE participants were very satisfied or satisfied (91%) with the services they received. Participants also reported significantly less stress at the six-month follow-up. These findings demonstrate that empowerment-centered financial coaching interventions can successfully address FE in older adult populations.

Trust and betrayal in older adult financial exploitation

OBJECTIVES

Although the knowledge base regarding the financial exploitation of older adults is expanding, work to understand the subpopulations of older adult financial exploitation victims and their experiences is greatly needed. This study uses betrayal trauma theory (BTT) as the foundation for conceptualizing the harm that arises from elder family financial exploitation.

METHODS

The study uses a cross-sectional design to investigate group differences among a total sample of 95 community-dwelling older adults, 32 of the participants (33.7%) were older adult victims of family financial exploitation and the remaining 63 (66.3%) were victims of financial exploitation perpetrated by strangers.

RESULTS

The group of older adults who were victims of elder family financial exploitation had significantly lower functional ability scores, higher stress and financial exploitation vulnerability scores and lost more money on average than those victimized by strangers.

CONCLUSION

The present study provides support that BTT provides a valuable framework for understanding why older adult family financial exploitation victims are more vulnerable than victims of exploitation committed by strangers. Attention to this subgroup of financially exploited older adults will provide improved understanding of the unique challenges these victims face and inform prevention and intervention services.

The association between experiences of being defrauded and depressive symptoms of middle-aged and elderly people: a cross-sectional study in China

OBJECTIVES

This study assessed the correlation between middle-aged and elderly fraud victimhood's experiences of being defrauded (EOBD) and depressive symptoms.

STUDY DESIGN

This was a prospective study.

METHODS

Data from China Health and Retirement Longitudinal Study 2018 (N = 15,322, mean age = 60.80 years) were used. Logistic regression models were used to identify the association between EOBD and depressive symptoms. Independent analyses were used to examine the association between different types of the fraud and depressive symptoms.

RESULTS

Among the middle-aged and elderly people, 9.37% of them have EOBD, and it was significantly associated with depressive symptoms. Among those with EOBD, fundraising fraud (3.72%) and fraudulent pyramid scheme and sales fraud (22.4%) were significantly associated with depressive symptoms, whereas telecommunication fraud (73.88%) had a limited role in inducing depressive symptoms in victimhood.

CONCLUSION

This study suggested that the government should make further efforts to prevent fraud, pay more attention to the mental health of the middle-aged and elderly victimhood, and provide timely psychological assistance to reduce the secondary harm caused by fraud.

Self-reported fraud victimization and objectively measured blood pressure: Sex differences in post-fraud cardiovascular health

BACKGROUND

Over 5 million older Americans are victims of financial exploitation, schemes, and/or scams per year. Such victimization is associated with increased hospitalizations, admittance to skilled nursing facilities, and lower 5-year all-cause mortality survival rates. Despite this, associations with medical comorbidities like elevated blood pressure (BP) have not been examined.

METHODS

We investigated the association of self-reported fraud victimization (presence/absence) with objectively measured BP metrics leveraging cross-sectional and longitudinal data from over 1200 non-demented adults (75% female; age ~81 years) from the Rush Memory and Aging Project. We first examined cross-sectional associations between baseline fraud victimization and BP, then used longitudinal data to test the hypothesis that fraud victimization is associated with increases in BP after incident fraud. During up to 11 years of annual observation, participants were queried for fraud victimization and underwent serial BP measurements to calculate per visit averages of systolic and diastolic BP, mean arterial pressure (MAP), and pulse pressure.

RESULTS

Cross-sectional analyses established that fraud victimization at baseline was associated with higher BP values. Next, using longitudinal changepoint analyses, we showed that fraud victimization was associated with elevations in BP among men but not women. Specifically, men who reported incident fraud exhibited increases in all BP metrics post-fraud.

CONCLUSION

Results suggest an important link between fraud victimization and BP, particularly among men. Older men showed significant elevations in BP after incident fraud that, compounded over time, may portend other adverse health outcomes.

Relationship Between Socioeconomic Conditions and Financial Fraud Victimization Among Older Adults in China: Do Financial Literacy and Financial Attitudes Matter?

Using data from the 2015 wave of the China Household Finance Survey (N ≈ 12,100), this study used structural equation modeling to examine the relationship between socioeconomic conditions (i.e., educational attainments, hukou status, and household financial assets per capita) and financial fraud victimization among Chinese older adults and the mediating roles of financial literacy and financial attitudes (i.e., interest in financial matters and risk tolerance). We found that although neither educational attainment nor hukou status was directly related to financial fraud victimization, household financial assets per capita was postively associated with the risk of financial fraud victimization. In addition, higher educational attainment, urban hukou, and more financial assets per capita were associated with more risk of financial fraud victimization through higher levels of financial literacy and higher interest in financial matters. Implications for preventing and protecting Chinese older adults from financial fraud victimization are discussed.

Spotlight on the Challenges of Depression following Retirement and Opportunities for Interventions

As a major life transition characterized by changes in social, behavioral, and psychological domains, retirement is associated with numerous risk factors that can contribute to the development of depression in later life. Understanding how these risk factors intersect with overall health and functioning can inform opportunities for mental health promotion during this transition. The objective of this review is to summarize the literature on risk and protective factors for depression during retirement transitions, discuss challenges related to appropriate management of depression in later life, and describe opportunities for prevention and intervention for depression relating to retirement transitions, both within and beyond the health care system. Key implications from this review are that 1) the relationship between depression and retirement is multifaceted; 2) while depression is a common health condition among older adults, this syndrome should not be considered a normative part of aging or of retirement specifically; 3) the existing mental health specialty workforce is insufficient to meet the depression management needs of the aging population, and 4) therefore, there is a need for interprofessional and multidisciplinary intervention efforts for preventing and managing depression among older adults. In sum, both healthcare providers, public health practitioners, and community organizations have meaningful opportunities for promoting the mental health of older adults during such major life transitions.

The Relationship Between Financial Decision-Making and Financial Exploitation in Older Black Adults

Objectives: This study examined the relationship between contextual measure of financial decision-making and the financial exploitation experiences of older Blacks, and the convergent validity of mental health measures of contextual decision-making items. Methods: This cross-sectional study of 104 older Black adults included 52 cases of confirmed financial exploitation. Participants were matched on age and gender. Bivariate and multivariate analyses were performed to examine these relationships. Results: The contextual measure of financial decision-making was significantly associated with financial exploitation, above and beyond the relationship of demographic measures. Further, there was strong evidence for convergent validity between the contextual measure and mental health measures. Discussion: Results underscore the significant relationship of the contextual factors involved in financial decision-making and financial exploitation. This study provides a conceptually driven approach to understanding the experiences of older Black adult victims of financial exploitation.

Anxiety and Depressive Symptoms are Associated with Perceived Financial Exploitation in Israeli Older Adults

OBJECTIVES

There are no studies that have investigated mental health correlates of financial exploitation (FE) in Israel. Israel has diverse cultural traditions that emphasize strong family ties and social embeddedness, factors which may impact FE correlates. This study aimed to examine mental health correlates of perceived FE in Israel.

METHODS

Israeli older adults (N = 137; mean age = 67.86, SD = 6.86, 51.5% female) were surveyed for history of FE, demographic measures, and depressive (CES-D) and anxiety symptoms (GAD-7).

RESULTS

Twenty-one participants self-reported a FE history (perceived FE group), and 115 denied a history (non-FE group). After controlling for age, sex, and education, the perceived FE group reported significantly more anxiety (F(1, 108) = 7.16, p = .009) and depressive symptoms (F(1, 103) = 13.90, p < .001) than the non-FE group. A greater frequency of perceived FE participants surpassed clinical cutoffs of anxiety and depression.

CONCLUSIONS

Perceived FE was associated with anxiety and depressive symptoms, and in some cases at clinically significant levels. Future studies aimed at understanding mechanisms of these relationships are needed.

CLINICAL IMPLICATIONS

Findings support the need for clinical evaluations for those who have experienced FE in order to provide mental health services when appropriate.

Financial Stressors and Resources Associated With Financial Exploitation

Background and Objectives

The prevalence of older adult financial exploitation (FE) is increasing. Population-based survey estimates of FE in the older adult population range from 5% to 11%. Given the growing prevalence of FE victimization in older adult populations, understanding the population's vulnerability to FE has increased in importance. This study investigates a conceptual framework in an attempt to understand how financial stressors and resources are associated with substantiated FE in a sample consisting largely of Black older adults.

Research Design and Methods

The study uses a cross-sectional design to investigate group differences among a total sample of 142 community-dwelling older adult participants, 62 of whom sought services to address FE and 80 with no history of FE.

Results

The group of older adults who sought services to address FE was more likely to be unmarried and had fewer years of education. Measures of financial literacy and perceived financial vulnerability had protective and risk effects, respectively.

Discussion and Implications

The present study found that sociodemographic and financial stress and resource measures have significant relationships with FE. These findings support the conceptual framework describing their relationship. This new conceptual framework provides a guiding factor in better understanding vulnerability to FE in older adults. The study also adds to the paucity of research completed on FE with Black older adults.

OUP accepted manuscript

Background and Objectives

Adult Protective Services (APS) are the frontline agencies investigating elder mistreatment and providing/coordinating postinvestigation services. Yet, their effectiveness in reducing different types of mistreatment in relation to services is unknown. This study aimed to address the knowledge gap by identifying services provided by mistreatment type, and examining the associations of services with mistreatment reduction.

Research Design and Methods

A pretest–post-test design was implemented using the Identification, Services, and Outcomes (ISO) Matrix to assess mistreatment levels during case investigation and at case closure after services were provided. San Francisco and Napa APS participated in a 6-month data collection.

Results

The 4 most prevalent types of mistreatment were examined: emotional, physical, financial abuse, and neglect by others. On average, level of mistreatment decreased across mistreatment types after APS intervention. Care/case management, mental health, and other services were most common, while specific services differed depending on type of mistreatment. Care/case management services were associated with physical and emotional abuse reduction, legal services further correlated with emotional abuse reduction; financial planning services were associated with financial abuse reduction; care/case management and other services were associated with neglect reduction.

Discussion and Implications

This is the first study to address APS services by mistreatment type and the outcomes of services. Adoption of the ISO Matrix by APS programs opens the possibility of research and practice collaboration in APS outcomes research using a standardized approach.

The Impact of Financial Coaching on Older Adult Victims of Financial Exploitation: A Quasi-Experimental Research Study

The financial exploitation (FE) of older adults affects not only victims' finances, but also their health. This preliminary study investigated the impacts of a financial coaching program on the financial, neurocognitive, physical, and emotional health of older adult victims of FE. Twenty older adults residing in a large urban area who had experienced FE were compared at baseline and follow-up with a group of 20 older adult of the same area who were making important financial decisions, but had not experienced FE and did not receive the intervention. At baseline, both groups were similar on demographic variables, but participants who had experienced FE had more health problems, poorer memory and executive functioning, less social support, and greater stress than the comparison group. Six months after financial coaching ended, program participants had significantly less anxiety. Overall, older adult victims of FE showed no significant declines and, in fact, showed some improvement.

Examining the Validity of the Financial Exploitation Vulnerability Scale

Objectives: Objectives: Lichtenberg, Campbell, Hall, and Gross used a contextual framework for financial decision-making to create and provide evidence for a new scale to assess risk for financial exploitation, the Financial Exploitation Vulnerability Scale (FEVS). This study examined the criterion validity of self-reported memory complaints and living alone on FEVS risk scores.Methods: Participants were the first 258 individuals reporting as 60 years or older and who completed the FEVS on the https://olderadultnestegg.com website between December 2020 and February 2021. Correlations, multiple regression, analysis of variance, and chi-square analyses were conducted to compare groups based on risk scores.Results: FEVS risk scores were significantly correlated with years of education, self-reported memory complaints, and living alone; 18% of unique variance was accounted for by these measures in a regression analysis. The ANOVA indicated that while there was an interaction effect for memory complaints by living alone, the majority of variance accounted for was attributed to the self-reported memory complaints measure. Conclusions: Older adults with memory complaints are in need of perceived financial vulnerability assessment.Clinical Implications: The Financial Exploitation Vulnerability Scale is a valuable self-report tool that clinical gerontologists can use in their intake assessments and follow-ups.

A Short Form of the Financial Exploitation Vulnerability Scale

OBJECTIVES

The purpose of the present study was to develop a short form of the Financial Exploitation Vulnerability Scale (FEVS) with good psychometric properties to detect contextual risk exploitation.

METHODS

The sample included community volunteers who were 60 years and older, as well as elders who were referred to the SAFE program after being the victim of a financial scam or identity theft. All participants completed the FEVS as part of a larger test battery. Factors analysis was used to explore the underlying structure of the FEVS and eliminate items. ROC analysis and logistic regression were used to evaluate the clinical utility of the Financial Exploitation Vulnerability Scale - Short Form (FEVS-SF) to detect exploitation.

RESULTS

The resulting FEVS-SF was unidimensional, contained nine items, and had comparable internal consistency to the full FEVS. Sensitivity and specificity were good at a cut score of five or greater. FEVS-SF was a better predictor of exploitation than demographic factors and several measures of cognitive functioning.

CONCLUSIONS

The FEVS-SF can detect the experience of financial exploitation among older adults better than other known risk factors, and equally as well as a measure of executive functioning.

CLINICAL IMPLICATIONS

This tool serves a need in many professional settings (e.g., doctor's offices and Adult Protective Services) for a brief, standardized assessment measure of financial exploitation risk. This measure also provides actionable information for professionals to follow up with the standard of care for their clients.

Elder Abuse Vulnerability and Risk Factors: Is Financial Abuse Different From Other Subtypes?

Elder abuse (EA) affects one in six older adults, and financial EA, a common subtype, severely impacts victims and society. Understanding victim vulnerability and perpetrator risk factors is essential to EA prevention and management. The limited existing evidence about these factors in relation to EA types suggests that financial EA is different. In a cross-sectional quantitative analysis of secondary data (N = 1,238), we investigated EA vulnerability and risk factors, and victim-perpetrator family relationship, with respect to different EA types (financial only, financial co-occurring with other types, and nonfinancial abuse). Financial abuse-only cases had the lowest prevalence of vulnerability and risk factors. Most of these factors, and a familial relationship, were significantly more common in cases involving other EA types. Findings indicate that financial abuse, occurring in isolation, is distinct from other EA types. Risk assessment and future research should consider financial abuse separately to other EA forms.

Context Matters: Financial, Psychological, and Relationship Insecurity Around Personal Finance Is Associated With Financial Exploitation

BACKGROUND AND OBJECTIVES

Context can influence or overwhelm the intellectual and cognitive aspects of financial decision making but has only recently received increased attention. The construct validity of conceptual subscales from a financial decision-making scale was examined in the context of their relationship to financial exploitation.

RESEARCH DESIGN AND METHODS

Two hundred forty-two community-based participants were recruited into the study. The final sample contained 242 participants. Measures included demographic variables, conceptually derived contextual items, and neurocognitive measures. Seventeen of the 34 contextual items investigated differentiated financially exploited and nonexploited older adults. Combining these 17 contextual items led to the creation of a new scale: the Financial Exploitation Vulnerability Scale (FEVS). Correlational analyses and area under the curve analyses were used to examine the relationship between this new scale of contextual items and other measures and to determine how clinically meaningful the scale was in the current sample.

RESULTS

Contextual items were powerful discriminators between those who were exploited and those who were not. The new scale of contextual items (the FEVS) demonstrated good internal consistency (Cronbach's alpha = 0.82) and a strong area under the curve (receiver operating characteristic = 0.80), thereby indicating good clinical significance and evidence for construct validity.

DISCUSSION AND IMPLICATIONS

We examined the conceptually derived subscales of financial awareness, psychological vulnerability, and relationship strain and how these relate to financial exploitation. Our major finding is that contextual items differentiated between exploited and nonexploited adults, which demonstrate the importance of measuring context in financial decision making and exploitation. A new scale for measuring contextual items was introduced.