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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 ,
JILL WILSON ,
LINDA ROSENMAN ,
DAVID MORRISON  and
ANNE-LOUISE MCCAWLEY
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: [email protected]
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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.

Keywords

capacitysubstitute decision makingfinancial managementresidential care
Type
Articles
Information
Ageing & Society , Volume 31 , Issue 1 , January 2011 , pp. 93 - 109
Copyright
Copyright © Cambridge University Press 2010

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