Adult Protective Services (APS)
Adult Protective Services (APS) is a social services program provided by state governments to serve older adults and adults with disabilities who live in the community. APS workers investigate cases of abuse, neglect or exploitation, working closely with a wide variety of allied professionals such as physicians, nurses, paramedics, firefighters and law enforcement officers. Every state has their own distinct APS system. Programs vary from state to state in respect to populations served, services provided and scope of the program.
Screening tests for cognitive impairment generally include asking patients to perform a series of tasks that assess at least one cognitive domain (memory, attention, language, and visuospatial or executive functioning). The most commonly used screening tool for dementia is the Mini Mental State Exam or MMSE and the MoCA (Montreal Cognitive Assessment). Both are a brief list of questions and instructions with easy-to-follow scoring. In depth cognitive assessment is usually performed by a psychologist with expertise in neuropsychology and consists of testing across several domains including attention, language, visual-spatial skills, memory and executive functioning. This in-depth testing is more reliable and assesses cognitive domains more accurately than do screening tests.
A decrease in mental function causing a person to have trouble remembering, learning new things, concentrating, or making everyday decisions. Cognitive impairment ranges from mild to severe. With mild cognitive impairment (MCI), people begin to notice diminished cognitive function, but can still perform everyday activities. Persons with severe levels of impairment may be unable to understand the meaning or importance of words or tasks, have difficulty talking or writing, and be unable to care for themselves.
confirmatory factor analyses
Confirmatory factor analysis is a statistical procedure to test how well the variables that are measured represent the number of constructs. For example, how is the question, “How fearful are you that someone will take your financial freedom?” related to the person’s psychological vulnerability. Confirmatory factor analysis tests the validity of an assessment tool and can confirm or reject the measurements used. The Older Adult Nest Egg assessments use Confirmatory Factor Analysis and Item Response Theory for question selection and validation of results.
A person appointed by a judge to protect and manage the financial affairs of another person due to physical or mental limitations. The conservator is required to make regular accountings that must be approved by the court. The conservator can be removed by court order if no longer needed, if petitioned by the person being protected or their relatives, or for failure to perform duties.
Factors considered when analyzing a particular behavior or decision, often unique to a particular individual or their circumstance. The Financial Vulnerability Assessment measures the contextual factors of financial awareness, psychological vulnerability, and susceptibility to undue influence or exploitation, along with decision-making abilities (intellectual factors) to determine a person’s vulnerability. Contextual factors can often overwhelm intellectual factors to impair financial decision-making.
A group of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities. Alzheimer's disease is one of many types of dementia, but accounts for 60 to 80 percent of cases. Vascular dementia, which occurs after a stroke, is the second most common dementia. Other conditions can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies. A person must be significantly impaired in at least two of the following areas to be diagnosed with dementia: memory, communication and language, ability to focus and pay attention, reasoning and judgment, visual perception.
The ability of an individual to manage his or her own money and financial affairs and make relevant decisions while keeping in mind possible financial and legal consequences of those acts.
financial decision-making abilities and scoring
The assessments on the Older Adult Nest Egg website measure, among other things, the ability to make a financial decision. They determine whether the decision is an informed one and does not rate the quality of that decision. For example, the decisional ability score does not depend on whether a person picked a stock that went up or down in value. Instead, it examines the thought process surrounding the decision. Can the decision maker communicate: their choice; their rationale behind making that choice; an understanding of the choice they made; and an appreciation of the potential consequences of that choice?
The decisional ability score tabulates the responses of the older adult along with the judgment of the interviewer, to determine the integrity of the person’s decisional abilities and their degree of vulnerability to financial exploitation.
Financial exploitation occurs when a person misuses or takes the assets of a vulnerable adult for his or her own personal benefit. This frequently occurs without the explicit knowledge or consent of the exploited adult, depriving them of vital financial resources for their personal needs. Assets can be taken through deception, false pretenses, coercion, harassment, duress and threats.
Financial vulnerability reflects the degree to which a person is capable of being injured financially when an adverse event happens. A person’s financial vulnerability is a dynamic or changing state. Two distinct types of markers: psychological and behavioral, can indicate how vulnerable a person is. Psychological markers include fear, anxiety, and lack of financial knowledge. Behavioral markers include low or unpredictable income, high levels of debt, and no financial safety net.
Wrongful or criminal deception intended to result in financial or personal gain. The legal definition of fraud requires: 1) a false statement of a material fact; 2) knowledge on the part of the defendant that the statement is untrue; 3) intent on the part of the defendant to deceive the alleged victim; 4) justifiable reliance by the alleged victim on the statement; and 5) injury to the alleged victim as a result.
financial situational awareness
Financial situation awareness is knowing enough about your money, assets, debts and financial accounts to understand how information, events, and your own actions will impact goals now and in the near future. Financial situation awareness is critical for informed financial decision-making that takes into account a broad range of interactive influences.
a person legally appointed to look after and be responsible for someone unable to manage their own affairs. Guardians are regulated by federal and state statutes, must act in the best interest of their ward, and can be compensated from the ward’s assets for their efforts. The courts can also appoint a temporary guardian, and limit the authority of the guardian when appropriate. In some jurisdictions, "custodian" or "conservator" is used instead of "guardian."
The deliberate use of a person’s identifying information, like their name, Social Security number, or credit card number, without their permission, to commit fraud or other crimes. The person whose identity has been stolen can suffer adverse consequences, including being held financially responsible for the perpetrator's actions. About 18 million people in the United States experience identity theft each year.
intellectual & contextual factors:
As explained under “Financial Decision-Making Abilities and Scoring,” a person must communicate several factors to confirm their decisional abilities: choice, rationale, understanding and appreciation. These are termed Intellectual Factors. Another group of factors, called Contextual Factors (the context of the decision), involves a person’s underlying traits. These are: awareness of the financial situation, psychological vulnerability and susceptibility to influence. Low awareness paired with high vulnerability and susceptibility can significantly impair the Intellectual Factors. Scoring for Older Adult Nest Egg assessments weighs both factor types carefully for the most accurate result.
item response theory
A widely used method to analyze responses to tests or questionnaires with the goal of improving measurement accuracy and reliability. Item Response Theory confirms that the test is actually measuring what it is intended to measure. The Older Adult Nest Egg assessments use Item Response Theory and Confirmatory Factor Analysis for question selection and validation of results.
A technique used by therapists to diminish client indecision and uncertainty and help them find motivation to make positive decisions and reach goals. The therapist does not supply the motivation, but is an empathetic guide to lead the client to self-efficacy, optimism, motivation and achievement of goals. Therapists also point out discrepancies between the clients’ goals and behavior, but avoid direct confrontations and arguments.
A non-authoritative approach that allows clients to be active participants in working through problems and issues. The interviewer acts as a compassionate facilitator, listening without judgment and acknowledging the client’s experience without directing the conversation. A person-centered approach can be especially effective when working with persons making financial decisions while experiencing cognitive decline or dementia. The interviewer is careful to not overestimate the person’s deficits, to elicit the person’s reasons for the financial decision or transaction; to convey a deep respect for the person’s choices and preferences; and to recognize that there is more to personhood than cognition.
power of attorney (POA):
A legal document that allows a person to appoint another person or organization (such as a law firm) to manage their affairs if they are unable to do so. There are several types of POAs. A general POA, for instance, includes the handling of financial and business transactions, buying life insurance, settling claims, operating business interests, making gifts, and employing professional help. A health care POA grants authority to make medical decisions if the person is unconscious, mentally incompetent, or otherwise unable to make decisions on his or her own. A person can also designate the amount of time the POA will be in effect.
To receive a Risk Score for any client interview, the client answers MUST be entered online at the Older Adult Nest Egg website. The score is calculated based on miss-matches between the client’s response and the interviewer’s assessment of the situation. The Risk Score is presented on a color-gradient scale of green to red, 0-14; the higher the number, the higher the risk. For example, clients at high risk (a score of 10) demonstrate a degree of impairment in their capacity to make the financial decision with awareness, integrity and autonomy. The cause of this impairment could be a temporary issue or the beginnings of a more serious deficit. In this case, the score analysis would recommend that the financial decision be postponed and the client evaluated more fully.
A dishonest scheme or fraud created to fool a person into handing over money or other assets to another person or company. Modern scams often involve the internet and include emails claiming the recipient has won the lottery or owes back taxes and must send an amount of money or further contact information to claim the prize or pay off the tax debt. Scams can be sophisticated and are constantly evolving, making them difficult to detect at any age.
Limited to a single financial transaction (or decision), such as buying a car, creating a will, or re-financing a house. The Older Adult Nest Egg assessments confine discussion to a single transaction or decision for clarity and simplicity and to better assess deficiencies in financial decision-making.
A trustee is responsible for using the assets in a trust according to the provisions detailed in the trust itself, often regardless of their own or the beneficiary’s wishes. Trustees have fiduciary responsibility and liability to uphold the terms of the trust and can find themselves liable to claimants, prospective beneficiaries, and third parties.
A trustee is legally and morally bound to manage the trust property in a responsible and productive manner. Trustees are generally held to a "prudent person" standard in meeting their fiduciary responsibilities, though investment, legal and other professionals can be held to a higher standard commensurate with their expertise. Trustees can be paid for their time only if the trust specifically provides for payment
Involves one person (often in a position of trust and power) taking advantage of another person to make them unable to freely exercise their independent will. Techniques used to exert undue influence include insinuations, flattery, trickery and deception. Proving undue influence can be difficult. Proof requires a victim who is susceptible, an opportunity for undue influence to occur, evidence that undue influence was attempted, and a record of an unusual or suspicious transaction. Mere suspicion is insufficient, as the law permits loved ones and confidants to advise those in need without fear of litigation.
Institute of Gerontology
At Wayne State University
87 East Ferry St.,
Pauline Knapp Building
Detroit, MI 48202