Skip to main content Accessibility help
×
Home
Hostname: page-component-768dbb666b-x9ds4 Total loading time: 0.287 Render date: 2023-02-03T11:28:53.849Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true

Managing older people's money: assisted and substitute decision making in residential aged-care

Published online by Cambridge University Press:  17 September 2010

CHERYL TILSE*
Affiliation:
School of Social Work and Human Services, University of Queensland, Brisbane, Australia.
JILL WILSON
Affiliation:
School of Social Work and Human Services, University of Queensland, Brisbane, Australia.
LINDA ROSENMAN
Affiliation:
Deputy Vice Chancellor (Research), Victoria University, Melbourne, Australia.
DAVID MORRISON
Affiliation:
School of Law, University of Queensland, Brisbane, Australia.
ANNE-LOUISE MCCAWLEY
Affiliation:
School of Social Work and Human Services, University of Queensland, Brisbane, Australia.
*
Address for correspondence: Cheryl Tilse, School of Social Work and Human Services, University of Queensland, St. Lucia, Queensland 4072, Australia. E-mail: c.tilse@uq.edu.au

Abstract

Current approaches to the assessment of cognitive capacity in many jurisdictions seek to balance older people's empowerment with their protection. These approaches incorporate a presumption of capacity, a decision-specific rather than global assessment of that capacity, and an obligation to provide the support needed for adults to make or communicate their own decisions. The implication is that older people are assisted to make decisions where possible, rather than using substitute decision makers. For older people, decision making about financial matters is a contentious domain because of competing interests in their assets and concerns about risk, misuse and abuse. In residential-care settings, older people risk being characterised as dependent and vulnerable, especially in relation to decisions about financial assets. This paper reports an Australian study of the factors that facilitate and constrain residents' involvement in financial decision making in residential settings. Case studies of four aged-care facilities explored how staff interpreted the legislative and policy requirements for assisted and substitute decision making, and the factors that facilitated and constrained residents' inclusion in decisions about their finances. The observed practices reveal considerable variation in the ways that current legislation is understood and implemented, that there are limited resources for this area of practice, and that policies and practices prioritise managing risk and protecting assets rather than promoting assisted decision making.

Type
Articles
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Australian Government Department of Health and Ageing 1997. Charter of Residents' Rights and Responsibilities. Department of Health and Ageing, Canberra. Available online at http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-publicat-resicharter.htm [Accessed 15 April 2009].Google Scholar
Australian Institute of Health and Welfare (AIHW) 2007. Australia's Welfare. AIHW, Canberra. Available online at http://www.aihw.gov.au/publications/aus/aw07/aw07.pdf [Accessed 15 April 2009].Google Scholar
Bennett, H. and Hallen, P. 2006. Guardianship and financial management legislation: what doctors in aged care need to know. Internal Medicine Journal, 35, 8, 540–1.Google Scholar
Dwyer, S. 2005. Older people and permanent care: whose decision? British Journal of Social Work, 35, 7, 1081–92.CrossRefGoogle Scholar
Ganzini, L., Volicer, L., Nelson, W. and Derse, A. 2003. Pitfalls in the assessment of decision making capacity. Psychosomatics, 44, 3, 237–43.CrossRefGoogle ScholarPubMed
Grisso, T. (ed.)2003. Evaluating Competencies. Second edition, Plenum, New York.Google Scholar
Johns, R. 2007. Who decides now? Protecting and empowering vulnerable adults who lose capacity to make decisions for themselves. British Journal of Social Work, 37, 3, 557–64.CrossRefGoogle Scholar
Knapp, M. and Prince, M. 2007. Dementia UK: Summary of Key Findings. Alzheimer's Society, London. Available online at http://alzheimers.org.uk/site/scripts/download_info.php?fileID=2 [Accessed 9 May 2010].Google Scholar
Langan, J. and Means, R. 1996. Financial management and elderly people with dementia in the UK: as much a question of confusion as abuse? Ageing & Society, 16, 3, 287314.CrossRefGoogle Scholar
Letts, P. 2009. Capacity and financial abuse in adults. In Pritchard, J. (ed.), Good Practice in the Law and Safeguarding Adults. Jessica Kingsley, London, 122–58.Google Scholar
Mackay, K. 2009. Scottish legislative framework for supporting and protecting adults. In Pritchard, J. (ed.), Good Practice in the Law and Safeguarding Adults. Jessica Kingsley, London, 3352.Google Scholar
Manthorpe, J., Rapaport, J. and Stanley, N. 2008. Expertise and experience: people with experiences of using services and carers' views of the Mental Capacity Act 2005. British Journal of Social Work, 16, 1, 117.Google Scholar
McCawley, A., Tilse, C., Wilson, J., Setterlund, D. and Rosenman, R. 2006. Access to assets, older people with impaired capacity and financial abuse. Journal of Adult Protection, 8, 1, 2032.CrossRefGoogle Scholar
Means, R. and Langan, J. 1996. Money ‘handling’, financial abuse and elderly people with dementia: implications for welfare professionals. Health and Social Care in the Community, 4, 6, 353–8.CrossRefGoogle Scholar
Moye, J. 2003. Guardianship and conservatorship. In Grisso, T. (ed.), Evaluating Competencies. Second edition, Plenum, New York, 309–90.Google Scholar
Moye, J. and Marson, D. C. 2007. Assessment of decision-making capacity in older adults: an emerging area of practice and research. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 62, 1, 3–11.CrossRefGoogle ScholarPubMed
Ontario Ministry of the Attorney General (MAG), Capacity Assessment Office 2005. Guidelines for Conducting Assessment of Capacity. MAG, Toronto. Available online at http://www.attorneygeneral.jus.gov.on.ca/english/family/pgt/capacity/2005-05/guide-0505.pdf [Accessed 15 April 2009].Google Scholar
Queensland Government 2000. Guardianship and Administration Act 2000. Chapter 2, Section 5, Queensland Government, Brisbane. Available online at http://www.legislation.qld.gov.au/LEGISLTN/CURRENT/G/GuardAdminA00.pdf [Accessed 15 April 2009].Google Scholar
Queensland Government, Department of Justice and Attorney General (DJAG) 2010. Enduring Power of Attorney. DJAG, Brisbane. Available online at http://www.justice.qld.gov.au/justice-services/guardianship/enduring-power-of-attorney/enduring-power-of-attorney [Accessed 9 April 2010].Google Scholar
Scourfield, P. 2007. Helping older people in residential care remain full citizens. British Journal of Social Work, 37, 7, 1135–52.CrossRefGoogle Scholar
Tilse, C., Setterlund, D., Wilson, J. and Rosenman, L. 2005. Minding the money: a growing responsibility for informal carers. Ageing & Society, 25, 2, 215–27.CrossRefGoogle Scholar
Tilse, C., Wilson, J., Setterlund, D. and Rosenman, L. 2007 a. The new caring: financial asset management and older people. Annals of the New York Academy of Science, 1114, 355–61.CrossRefGoogle ScholarPubMed
Tilse, C., Wilson, J., Setterlund, D. and Rosenman, L. 2007 b. Managing the financial assets of older people: balancing independence and protection. British Journal of Social Work, 37, 3, 565–72.CrossRefGoogle Scholar
Tilse, C., Wilson, J. and Setterlund, D. 2009. Personhood, financial decision making and dementia: an Australian perspective. In O'Connor, D. and Purves, B. (eds), Decision Making, Personhood and Dementia: Exploring the Interface. Jessica Kingsley, London, 133–44.Google Scholar
United Kingdom Department of Constitutional Affairs. 2007. The Mental Capacity Act 2005 Code of Practice. Department of Constitutional Affairs, London. Available online at http://www.dca.gov.uk/legal-policy/mental-capacity/mca-cp.pdf [Accessed 15 April 2009].Google Scholar
Wilbur, K. 2001. Decision-making, dementia and the law: cross national perspectives. Aging and Mental Health, 5, 4, 309–11.CrossRefGoogle Scholar
Wilson, J., Tilse, C., Setterlund, D. and Rosenman, L. 2009. Older people and their assets: a range of roles and issues for social workers. Australian Social Work, 62, 2, 155–67.CrossRefGoogle Scholar
9
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Managing older people's money: assisted and substitute decision making in residential aged-care
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Managing older people's money: assisted and substitute decision making in residential aged-care
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Managing older people's money: assisted and substitute decision making in residential aged-care
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *