Connect
MJA
MJA

Financial capacity in older adults: a growing concern for clinicians

Paul A Gardiner, Gerard J Byrne, Leander K Mitchell and Nancy A Pachana
Med J Aust 2015; 202 (2): 82-85. || doi: 10.5694/mja14.00201

Summary

  • Older people with cognitive impairment and/or dementia may be particularly vulnerable to diminished financial decision-making capacity.
  • Financial capacity refers to the ability to satisfactorily manage one's financial affairs in a manner consistent with personal self-interest and values.
  • Impairment of financial capacity makes the older individual vulnerable to financial exploitation, may negatively affect their family's financial situation and places strain on relationships within the family.
  • Clinicians are often on the front line of responding to queries regarding decision-making capacity, and clinical evaluation options are often not well understood.
  • Assessment of financial capacity should include formal objective assessment in addition to a clinical interview and gathering contextual data.
  • Development of a flexible, empirically supported and clinically relevant assessment approach that spans all dimensions of financial capacity yet is simple enough to be used by non-specialist clinicians is needed.

Please login with your free MJA account to view this article in full

  • Paul A Gardiner
  • Gerard J Byrne
  • Leander K Mitchell
  • Nancy A Pachana

  • University of Queensland, Brisbane, QLD.

Correspondence: n.pachana@uq.edu.au

Acknowledgements: 

This project was funded by a National Health and Medical Research Council dementia grant (511119).

Competing interests:

No relevant disclosures.

  • 1. Marson DC, Hebert T. Financial capacity. In: Cutler BL, editor. Encyclopedia of psychology and the law, vol 1. Thousand Oaks, Ca: Sage Publications, 2008: 313-316.
  • 2. Pinsker DM, Pachana NA, Wilson J, et al. Financial capacity in older adults: a review of clinical assessment approaches and considerations. Clin Gerontol 2010; 33: 332-346.
  • 3. Marson DC. Clinical and ethical aspects of financial capacity in dementia: a commentary. Am J Geriatr Psychiatry 2013; 21: 382-390.
  • 4. Griffith HR, Belue K, Sicola A, et al. Impaired financial abilities in mild cognitive impairment: a direct assessment approach. Neurology 2003; 60: 449-457.
  • 5. Martin RC, Griffith HR, Belue K, et al. Declining financial capacity in patients with mild Alzheimer's disease: a one-year longitudinal study. Am J Geriatr Psychiatry 2008; 16: 209-219.
  • 6. Fogarty B. Guardianship and administration laws across Australia. Intellectual Disability Rights Service, 2009. Revised by Morris M, 2012. http://www.idrs.org.au/pdf/Guardianship_and_administration_laws_across_Australia_by_Ben_Fogarty.pdf (accessed May 2014).
  • 7. Kurrle S, Naughtin G. An overview of elder abuse and neglect in Australia. J Elder Abuse Negl 2008; 20: 108-125.
  • 8. Boldy D, Horner B, Crouchley K, Davey M. Addressing elder abuse: Western Australian case study. Australas J Ageing 2005; 24: 3-8.
  • 9. Carcach C, Graycar A, Muscat G. The victimisation of older Australians. Trends and issues in crime and criminal justice series. Canberra: Australian Institute of Criminology, 2001.
  • 10. Kelly S, Harding A. Funding the retirement of baby boomers. Agenda 2004; 11: 99-112.
  • 11. Widera E, Steenpass V, Marson D, Sudore R. Finances in the older patient with cognitive impairment: “He didn't want me to take over”. JAMA 2011; 305: 698-706.
  • 12. Marson DC, Martin RC, Wadley V, et al. Clinical interview assessment of financial capacity in older adults with mild cognitive impairment and Alzheimer's disease. J Am Geriatr Soc 2009; 57: 806-814.
  • 13. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189-198.
  • 14. Marson DC, Chatterjee A, Ingram KK, Harrell LE. Toward a neurologic model of competency: cognitive predictors of capacity to consent in Alzheimer's disease using three different legal standards. Neurology 1996; 46: 666-672.
  • 15. Sullivan K. Neuropsychological assessment of mental capacity. Neuropsychol Rev 2004; 14: 131-142.
  • 16. Tilse C, Setterlund D, Wilson J, et al. Minding the money: a growing responsibility for informal carers. Ageing Soc 2005; 25: 215-227.
  • 17. Setterlund D, Wilson J, Tilse C, Robbinson G. Financial abuse within families: views from family members and professionals. Symposium on assets, ageing and abuse. 8th Australian Institute of Family Studies Conference; 2003 Feb 12-14; Melbourne, Australia.
  • 18. Moye J. Assessment of competency and decision making capacity. In: Lichtenberg PA, editor. Handbook of assessment in clinical gerontology. New York: Wiley, 1999: 488-528.
  • 19. Marson DC, McInturff B, Hawkins L, et al. Consistency of physician judgments of capacity to consent in mild Alzheimer's disease. J Am Geriatr Soc 1997; 45: 453-457.
  • 20. Marson DC, Schmitt FA, Ingram KK, Harrell LE. Determining the competency of Alzheimer patients to consent to treatment and research. Alzheimer Dis Assoc Disord 1994; 8 Suppl 4: 5-18.
  • 21. Neuroscience Research Australia. Addenbrooke's Cognitive Examination-III (ACE-III). http://www.neura.edu.au/frontier/research/test-downloads (accessed Nov 2013).
  • 22. Jorm AF. A short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): development and cross-validation. Psychol Med 1994; 24: 145-153.
  • 23. Kershaw MM, Webber LS. Assessment of financial competence. Psychiatry, Psychol Law 2008; 15: 40-55.
  • 24. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982-1983; 17: 37-49.
  • 25. Pachana NA, Byrne GJ, Siddle H, et al. Development and validation of the Geriatric Anxiety Inventory. Int Psychogeriatr 2007; 19: 103-114.
  • 26. Mathuranath PS, George A, Cherian PJ, et al. Instrumental activities of daily living scale for dementia screening in elderly people. Int Psychogeriatr 2005; 17: 461-474.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.