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By Heather Campbell
This post is part 2 of 2. My earlier piece looked at Diogenes syndrome and the civil law, namely residential tenancies (eviction), involuntary commitment and capacity assessments.
Diogenes syndrome by proxy was first described in 1994.1 The authors called it “a clear example of elder abuse,” although they said it may be unintentional.
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By Heather Campbell
Diogenes syndrome is a behavioural disorder characterized by extreme self-neglect, domestic squalor, hoarding, social withdrawal, refusal of help, and a lack of concern about one’s living condition 1. It is mostly found in older adults, but it can occur across all ages and socioeconomic backgrounds. Affected individuals are usually of average or above-average intelligence, and they sometimes have other mental illnesses, such as schizophrenia or frontotemporal dementia.2
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The following resource is part of the Family Violence Initiative, funded by the RCMP. Find similar tools by searching for the FVIF tag or consult the list of available resources.
November, Financial Literacy Month, is an opportunity to take an in-depth look at the impact financial literacy has on older adults and their support networks. Financial literacy affects more than the financial well-being of individuals and communities as financial decisions and repercussions, informed or not, have widespread influences on our physical health, our mental well-being, and our social systems. One of CNPEA’s current projects is part of the Family Violence Initiative, and one of CNPEA’s goals for this project is to raise awareness about the intersection of elder abuse in a family context. This post will take a look at the way financial abuse affects elders and manifests within the family structure.
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Older adults often develop health related issues as they age, In that situation, they may need care and support from family. In some families, this leads to conflict over finances or care issues. This conflict may occur between the older adult and the adult children or between the adult children. Sometimes these conflicts can become so extreme that family relationships are damaged. In a worst-case scenario, a family member may take advantage of the situation to gain access to the elderly parents' money. This is heartbreaking for all concerned.
Family members can apply financial literacy skills to prevent these conflicts or to resolve them once they have arisen. The term “financial literacy” refers to the ability to understand financial decisions and to manage money. This term is often applied to basic financial management skills such as forming a budget and paying bills on time. However, the concept is much broader. The term ‘financial literacy’ refers to the skills and knowledge that allow an individual to make informed and effective decisions with all of their financial resources. This includes good financial planning for the future. Take, for example, the situation of Mrs. Brown.
Mrs. Brown is 85 years old. She has three adult children: Martha, John and Suzie. Mrs. Brown has always been ‘healthy as a horse’. However, she recently had a stroke. The damage from her stroke limits her ability to carry out tasks such as shopping and meal preparation. As well, she is sometimes confused about financial decisions. She now struggles to pay her monthly bills. Her three children are in conflict about what to do. Martha and John believe that Mrs. Brown should move into a care home. Mrs. Brown wants to continue to live at home and Suzie supports this decision. This dispute escalates into an unpleasant and ongoing conflict between siblings. After a few months of conflict, Mrs. Brown has a second stroke. She is no longer able to get out of bed and, whenever her children try to ask her for an opinion she says, “whatever you think dear”. The disagreement between the children about what to do continues to escalate. Unfortunately, Mrs. Brown did not appoint any of her children as power of attorney or her legal representative for health decisions so it is not clear who has legal authority to make a decision. The adult children cannot agree about where Mrs. Brown should live or who should pay for her care. The three adult children continue to argue and no resolution is in sight.
One of the reasons for this dispute is because it is not clear who has the authority to make decisions. Mrs. Brown did not grant any of her children the authority to make decisions pursuant to a Power of Attorney or a Representation Agreement. Nor did she communicate her wishes to her family members in advance of her stroke. All three of her children have good intentions and want to do what is best for her, but they do not agree about what this is.
This conflict could have been avoided if Mrs. Brown had made her wishes clear prior to her stroke, while she had full mental capacity. However, there still is an option available. This option is family mediation. A mediator is a neutral third party who is trained to help resolve disputes. In this situation, the mediator would meet with Mrs. Brown and the three adult children to find out what the issues are. Then the mediator would help Mrs. Brown and the three adult children to create a plan for the future. This plan could include where Mrs. Brown would live, how to pay for this accommodation and other care details.
Elder mediation is a very promising approach. Elders can use their financial literacy skills and can proactively make plans for future management of their finances in the event of health issues. Financial planning includes choosing trusted family members or friend to manage money and to make health care situation should the older adult no longer be able to do so. Financial planning is an important aspect of financial literacy.
In situations where the older adult’s health has deteriorated, where there is no care plan in place and where family members cannot agree on how to proceed, mediation is an option. With the help of a mediator, Mrs. Brown will be able to explain her wishes regarding her finances and future care. With the assistance of the mediator, Mrs. Brown and her three adult children will be able to create a financial plan for the future.
Financial planning should include a consideration of how to proceed when an unexpected health issue arises. The optimum approach is to create a plan in advance. In situations such as the one described in the Mrs. Brown scenario, where health issues are already present and there is a family conflict over how to proceed, a mediator can help older adults and their families create and implement a financial plan. Being aware of these issues is an important aspect of financial literacy and helps protect the future well-being of older adults.
About the author
Joan Braun, LLB, MSW, RSW is a registered social worker and a lawyer. Joan has been working as a mediator in private practice since 2004 and her current area of specialty is resolving disputes between older adults and their families. In addition to work as a mediation practitioner, Joan has studied academically in the field. She has two graduate degrees, one in law and one in social work. She has published two peer-reviewed papers published and has authored other materials. Joan has more than 8 years experience in senior management in the social justice sector, including 5.5 years as executive director of the BC Centre for Elder Advocacy and Support (BCCEAS) and Centre for Public Legal Education Alberta (CPLEA), organizations with a focus on older adult issues. At BC CEAS Joan oversaw the establishment of the first legal aid clinic for older adults in Western Canada, and a diverse range of other programs for older adults who had experienced abuse. In the summer of 2015 Joan left a management position to return to private practice as a mediator and lawyer. She is also studying towards a PhD in law. She is the current Canadian Bar Association representative to BC's Committee to Reduce Elder Abuse and is on the Board of CNPEA.
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As we enter Financial Literacy Month (FLM) 2016, I want to draw attention to a topic I believe warrants closer attention in Canada’s financial literacy strategy. Financial literacy strategies in Canada currently pursue three specific goals in order to improve the financial literacy and financial health of Canadians of all ages. This strategy includes a focus on teaching Canadians to 1) manage debt wisely; 2) save for the future and, 3) understand their rights and responsibilities. I certainly strongly support the current focus on improving financial health using these steps. However, recent research is increasingly suggesting that a lack of financial literacy doesn’t just have consequences for our financial health. A lack of financial literacy can also have serious consequences for our emotional, psychological, and functional/physical health in a number of ways, particularly with respect to the health consequences associated with financial mistreatment and abuse. While people of all ages can experience financial mistreatment and fraud, and the resulting negative health outcomes, the research suggests the health consequences are particularly damaging for older adults.
