Detecting and Preventing Financial Abuse of Older Adults

1. Detecting and Preventing Financial Abuse of Older AdultsDr Deborah CairnsProf Mary Gilhooly, Dr Priscilla Harries, Mrs Miranda Davies, Ms Elizabeth Notley 20th July 2010

2. Grant Holders Prof Mary Gilhooly Brunel University Dr Priscilla Harries Brunel University Prof Ken Gilhooly Hertfordshire University Prof Catherine Hennessy Plymouth University Dr Tony Gilbert Plymouth University Prof David Stanley Northumbria University Ms Bridget Penhale University of Sheffield Older Peoples Reference Group Teresa Lefort nda Financial Elder Abuse Project

3. Project Partners Action on Elder Abuse Gary Fitzgerald British Association of Social Workers Ms Ruth Cartwright Help the Aged Mary Cox HSBC Neil Shadbolt North Tyneside Council Alison Tombs Relatives and Residents Association Dr Gillian Dalley Peninsula Care Sector Group Ms Gill Fairhurst Peninsula Primary Care Research Network Prof John Campbell nda Financial Elder Abuse Project

4. Content Overview of the study Progress to date Questions?

5. Background Definition ‘Financial or material abuse, including theft, fraud, exploitation, pressure in connection with wills, property or inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits’ (DH & Home Office, 2000, Pg. 9) Prevalence A Department of Health and Comic Relief study reported financial abuse as the second most common type of elder abuse, after neglect (O’Keefe et al., 2007)

6. Aim What is the aim of this study? The aim is to investigate how different professional groups make decisions when they suspect financial elder abuse is taking place.

7. Research design PHASE I Semi-structured interviews PHASE II Experiments on Suspected Financial Abuse Decision Making PHASE III Policy analysis Detecting Financial Elder Abuse Figure represents the NDA financial abuse grant phases of study (Gilhooly et al., 2008).

8. Phase I – Semi-structured interviews

9. Phase I methodology • Data collection • Semi-structured interviews applying the Critical Incident Technique (Flanagan, 1954) to learn about cases of financial elder abuse.

10. Phase I research Questions Q1. What are the cues that are perceived as raising suspicions of financial elder abuse? Q2. What are the types of decisions that have to be made when financial abuse is suspected?

11. Q1. What are the cues that are perceived as raising suspicions of financial elder abuse?

12. Cues that raised suspicion of financial elder abuse

13. Cues that raised suspicion of financial elder abuse

14. Cues that raised suspicion of financial elder abuse

15. Cues that raised suspicion of financial elder abuse

16. Cues that raised suspicion of financial elder abuse

17. Cues that raised suspicion of financial elder abuse

18. Cues that raised suspicion of financial elder abuse

19. Cues that raised suspicion of financial elder abuse

20. Cues that raised suspicion of financial elder abuse

21. Cues that raised suspicion of financial elder abuse

22. Cues that raised suspicion of financial elder abuse

23. Q2. What are the types of decisions that have to be made when financial abuse is suspected?

24. Overall summary of decision findings

25. Overall summary of decision findings

26. Overall summary of decision findings

27. Overall summary of decision findings

28. Overall summary of decision findings

29. Overall summary of decision findings

30. Overall summary of decision findings

31. Overall summary of decision findings

32. Phase II – Case scenariosOnline Task

33. Phase II methodology • Data Collection • Case scenarios created from Phase I analysis presented to • participants on website • Same set of scenarios viewed by health and social care professionals • Separate set of scenarios for banking professionals

34. Phase II research Questions Which cues from Phase I are most influential in the decision making process in relation to the detection of financial elder abuse and the likelihood of intervention? 2. Which characteristics of the decision-maker help explain decision-making?

35. Phase II research Questions Which cues from Phase I are most influential in the decision making process in relation to the detection of financial elder abuse and the likelihood of intervention?

36. Phase II research Questions Which cues from Phase I are most influential in the decision making process in relation to the detection of financial elder abuse and the likelihood of intervention? Cues from Phase I varied in case scenarios

37. Example of a case scenario for health & social care professionals This scenario is about a 66 year old male. Another professional tells you that recently a change to this older person’s will has been made, leaving all possessions to the cleaner.This older person has major physical health problems and is extremely confused and forgetful.

38. Cue 1 This scenario is about a 66 year old male. Another professional tells you that recently a change to this older person’s will has been made, leaving all possessions to the cleaner.This older person has major physical health problems and is extremely confused and forgetful.

39. Cue 1 Cue 2 This scenario is about a 66 year old male. Another professional tells you that recently a change to this older person’s will has been made, leaving all possessions to the cleaner.This older person has major physical health problems and is extremely confused and forgetful.

40. Cue 1 Cue 2 This scenario is about a 66 year old male. Another professional tells you that recently a change to this older person’s will has been made, leaving all possessions to the cleaner.This older person has major physical health problems and is extremely confused and forgetful. Cue 3

41. Cue 1 Cue 2 This scenario is about a 66 year old male. Another professional tells you that recently a change to this older person’s will has been made, leaving all possessions to the cleaner.This older person has major physical health problems and is extremely confused and forgetful. Cue 4 Cue 3

42. Cue 5 Cue 1 Cue 2 This scenario is about a 66 year old male. Another professional tells you that recently a change to this older person’s will has been made, leaving all possessions to the cleaner.This older person has major physical health problems and is extremely confused and forgetful. Cue 4 Cue 3

43. Cue 5 Cue 1 Cue 6 Cue 2 This scenario is about a 66 year old male.Another professional tells you that recently a change to this older person’s will has been made, leaving all possessions to the cleaner.This older person has major physical health problems and is extremely confused and forgetful. Cue 4 Cue 3

44. Example of case scenario on Web

45. Example of case scenario on Web Analyses from Q1 Analyses from Q2

46. Phase II research Questions 2. Which characteristics of the decision-maker help explain decision-making?

47. Phase II research Questions 2. Which characteristics of the decision-maker help explain decision-making? Gender Age Ethnicity Employer Years in current role / profession

48. What next? • Phase II completion • Phase III completion • Potential training for health, social care and banking professionals • Guideline development for health, social care and banking professionals

49. The need for Guidelines and Training “It would be helpful if there was a list of things to look out for and identify what financial abuse is. How to spot the signs" (Cashier) "Physically, yes the system helps you to monitor the culprits but the financial one is difficult to detect. Unless somebody gives you some information about what to look for you have no idea” (Social Worker) "I’ve not been trained to pick up on signs of financial abuse, so I don’t go into a situation looking for it - I go in to treat the patient. I suppose we need to be better informed as to what to look for and how to deal with abuse in order for us to be more confident to come forward and say that we suspect it" (General Practitioner)

50. Thank You