Financial Exploitation of Older Adults: A Population-Based Prevalence Study

A Capsule Commentary to this article was published on 26 August 2014

ABSTRACT

BACKGROUND

Financial exploitation is the most common and least studied form of elder abuse. Previous research estimating the prevalence of financial exploitation of older adults (FEOA) is limited by a broader emphasis on traditional forms of elder mistreatment (e.g., physical, sexual, emotional abuse/neglect).

OBJECTIVES

1) estimate the one-year period prevalence and lifetime prevalence of FEOA; 2) describe major FEOA types; and 3) identify factors associated with FEOA.

DESIGN

Prevalence study with a random, stratified probability sample.

PARTICIPANTS

Four thousand, one hundred and fifty-six community-dwelling, cognitively intact adults age ≥ 60 years.

SETTING

New York State.

MAIN MEASURES

Comprehensive tool developed for this study measured five FEOA domains: 1) stolen or misappropriated money/property; 2) coercion resulting in surrendering rights/property; 3) impersonation to obtain property/services; 4) inadequate contributions toward household expenses, but respondent still had enough money for necessities and 5) respondent was destitute and did not receive necessary assistance from family/friends.

KEY RESULTS

One-year period FEOA prevalence was 2.7 % (95 % CI, 2.29–3.29) and lifetime prevalence was 4.7 % (95 % CI, 4.05–5.34). Greater relative risk (RR) of one-year period prevalence was associated with African American/black race (RR, 3.80; 95 % CI, 1.11–13.04), poverty (RR, 1.72; 95 % CI, 1.09–2.71), increasing number of non-spousal household members (RR, 1.16; 95 % CI, 1.06–1.27), and ≥ 1 instrumental activity of daily living (IADL) impairments (RR, 1.69; 95 % CI, 1.12–2.53). Greater RR of lifetime prevalence was associated with African American/black race (RR, 2.61; 95 % CI, 1.37–4.98), poverty (RR, 1.47; 95 % CI, 1.04–2.09), increasing number of non-spousal household members (RR, 1.16; 95 % CI, 1.12–1.21), and having ≥1 IADL (RR, 1.45; 95 % CI, 1.11–1.90) or ≥1 ADL (RR, 1.52; 95 % CI, 1.06–2.18) impairment. Living with a spouse/partner was associated with a significantly lower RR of lifetime prevalence (RR, 0.39; 95 % CI, 0.26–0.59)

CONCLUSIONS

Financial exploitation of older adults is a common and serious problem. Elders from groups traditionally considered to be economically, medically, and sociodemographically vulnerable are more likely to self-report financial exploitation.

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Contributors

We wish to thank the Cornell Survey Research Institute and the many older adults who participated in the study. Drs. Peterson and Lachs had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Funders

  1. a.

    This work was supported by funding from the New York State William B. Hoyt Memorial Children and Family Trust Fund, administered under the New York State Office of Children and Family Services. The funding agency had no role in the design and conduct of the study, in the collection, analysis, and interpretation of data, or in the preparation, review, or approval of the manuscript.

  2. b.

    Dr. Peterson is the recipient of a Paul B. Beeson Award from the National Institute on Aging, the American Federation for Aging Research, The John A. Hartford Foundation and The Atlantic Philanthropies under award K23AG042869. Dr. Peterson also received research support to complete this analysis from the Department of Medicine, Weill Cornell Medical College, NY, NY.

  3. c.

    Dr. Lachs is the recipient of a Mid-Career Mentoring Award in Patient Oriented Research from the National Institute on Aging K24 AG022399. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Prior presentations

  1. a.

    Portions of this work were presented at the Department of Medicine Grand Rounds, Weill Cornell Medical College, 16 September 2013.

  2. b.

    We previously released a report of frequency counts of the quantitative data only, which can be found at: http://ocfs.ny.gov/main/reports/Under%20the%20Radar%2005%2012%2011%20final%20report.pdf.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Authors

Corresponding author

Correspondence to Janey C. Peterson EdD, MS, RN.

Appendices

Appendix 1: American Association for Public Opinion Research Formulas (13)

$$ \mathrm{Response}\kern0.5em \mathrm{Rate}:\mathrm{I}/\left(\left(\mathrm{I}+\mathrm{P}\right)+\left(\mathrm{R}+\mathrm{NC}+\mathrm{O}\right)+\mathrm{e}\left(\mathrm{UH}+\mathrm{UO}\right)\right) $$
$$ \mathrm{Cooperation}\kern0.5em \mathrm{Rate}:\mathrm{I}/\left(\left(\mathrm{I}+\mathrm{P}\right)\left.+\mathrm{R}\right)\right) $$

I:

Complete Interviews

P:

Partial Interviews

R:

Refusal and break off

NC:

Non Contact

O:

Other

e:

is the estimated proportion of cases of unknown eligibility that are eligible, according to AAPOR Eligibility Estimates.

UH:

Unknown Household

UO:

Unknown Other

Appendix 2: Description of Financial Exploitation Items

FEOA was assessed with five items. Respondents were asked if, since turning age 60, someone they lived with or spent a lot of time with had done the following: stolen anything or used things that belonged to them without permission (e.g., money, bank ATM or credit cards, checks, personal property or documents) (FEOA1); forced, convinced or misled them to give away something that belonged to them or to give away legal rights to something that belonged to them (e.g., money, bank account, credit card, deed to a house, personal property, or documents such as a will or power of attorney) (FEOA2); pretended to be them to obtain goods or money (FEOA3); inadequate contributions toward household expenses (e.g., rent, groceries), but respondent still had enough money for necessities (FEOA4); respondent was destitute and did not receive necessary assistance from family/friends (e.g., went on welfare, could not pay rent) (FEOA5).

For each affirmed FEOA item, respondents were asked: 1) how the perpetrator was related (i.e., spouse/partner, adult child, son/daughter-in-law, grandchild, other relative, neighbor, friend, other non-relative, or paid aid/attendant; 2) how many times the incident happened in the last year (i.e., never, once, two to ten times, more than ten times); 3) how serious a problem it was if the incident item happened (i.e., not serious at all, somewhat serious, very serious); and 3) to describe the incident using their own words. Responses were transcribed verbatim.

Each narrative was adjudicated to ensure that it was consistent with financial exploitation (i.e., improper use of funds, property or resources by another individual, including but not limited to, fraud, false pretense, embezzlement, conspiracy, forgery, falsifying records, coerced property transfers, or denial of access to assets). Therefore, we excluded civil disputes, divorce-related matters, and narratives that were inconsistent with financial mistreatment (as defined above) and did not consider them as outcomes.

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Peterson, J.C., Burnes, D.P., Caccamise, P.L. et al. Financial Exploitation of Older Adults: A Population-Based Prevalence Study. J GEN INTERN MED 29, 1615–1623 (2014). https://doi.org/10.1007/s11606-014-2946-2

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KEY WORDS

  • financial exploitation
  • elder financial abuse
  • elder abuse
  • elder mistreatment
  • economic abuse