Abstract
Dementia progresses slowly, where an exact demarcation of when someone loses their ability to manage their finances is hard to determine. Delirium, which may occur independently or with co-occurring dementia, typically has a waxing and waning of cognitive ability. Therefore, when someone is delirious, there may be lucid intervals where one may argue that the individual has capacity, but moments later, the person’s consciousness may deteriorate. Evaluating monetary decision-making capacity can prove useful as it can be used to gauge whether one is at significant risk for financial exploitation. This chapter will focus on the relationship between financial decision-making and aging. How cognitive impairment may influence financial and testamentary capacity is included. A review of scales that can be used in the setting of financial capacity evaluations is also provided to help guide evaluators. Furthermore, in the setting of assessing an older individual’s capacity to manage financial decisions, this chapter provides a discussion on the importance of including an evaluation to assess an older individual’s ability to thwart undue influence.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kennedy KM. Testamentary capacity: a practical guide to assessment of ability to make a valid will. J Forensic Leg Med. 2012;19(4):191–5.
Caboral-Stevens M, Medetsky M. The construct of financial capacity in older adults. J Gerontol Nurs. 2014;40(8):30–7.
Jackson S, Hafemeister T. APS investigation across four types of elder maltreatment. J Adult Prot. 2012;14(2):82–92.
Vogel A, Stokholm J, Gade A, Andersen BB, Hejl AM, Waldemar G. Awareness of deficits in mild cognitive impairment and Alzheimer’s disease: do MCI patients have impaired insight? Dement Geriatr Cogn Disord. 2004;17(3):181–7.
Zamboni G, Drazich E, McCulloch E, Filippini N, Mackay CE, Jenkinson M, et al. Neuroanatomy of impaired self-awareness in Alzheimer’s disease and mild cognitive impairment. Cortex. 2013;49(3):668–78.
Appelbaum PS. Clinical practice. Assessment of patients’ competence to consent to treatment. N Engl J Med. 2007;357(18):1834–40.
Vloeberghs R, Opmeer EM, De Deyn PP, Engelborghs S, De Roeck EE. Apathy, depression and cognitive functioning in patients with MCI and dementia. Tijdschr Gerontol Geriatr. 2018;49(3):95–102.
Bayard S, Jacus JP, Raffard S, Gely-Nargeot MC. Apathy and emotion-based decision-making in amnesic mild cognitive impairment and Alzheimer’s disease. Behav Neurol. 2014;2014:231469.
de Mendonca A, Ribeiro F, Guerreiro M, Garcia C. Frontotemporal mild cognitive impairment. J Alzheimers Dis. 2004;6(1):1–9.
Stoeckel LE, Stewart CC, Griffith HR, Triebel K, Okonkwo OC, den Hollander JA, et al. MRI volume of the medial frontal cortex predicts financial capacity in patients with mild Alzheimer’s disease. Brain Imaging Behav. 2013;7(3):282–92.
Yuan P, Raz N. Prefrontal cortex and executive functions in healthy adults: a meta-analysis of structural neuroimaging studies. Neurosci Biobehav Rev. 2014;42:180–92.
Tracy VL, Basso MR, Marson DC, Combs DR, Whiteside DM. Capacity for financial decision making in multiple sclerosis. J Clin Exp Neuropsychol. 2017;39(1):46–57.
Shulman KI, Hull IM, DeKoven S, Amodeo S, Mainland BJ, Herrmann N. Cognitive fluctuations and the lucid interval in dementia: implications for testamentary capacity. J Am Acad Psychiatry Law. 2015;43(3):287–92.
Rosenbloom MH, Schmahmann JD, Price BH. The functional neuroanatomy of decision-making. J Neuropsychiatry Clin Neurosci. 2012;24(3):266–77.
Spreng RN, Cassidy BN, Darboh BS, DuPre E, Lockrow AW, Setton R, et al. Financial exploitation is associated with structural and functional brain differences in healthy older adults. J Gerontol A Biol Sci Med Sci. 2017;72(10):1365–8.
Samanez-Larkin GR, Knutson B. Decision making in the ageing brain: changes in affective and motivational circuits. Nat Rev Neurosci. 2015;16(5):278–89.
Andrews-Hanna JR, Smallwood J, Spreng RN. The default network and self-generated thought: component processes, dynamic control, and clinical relevance. Ann N Y Acad Sci. 2014;1316:29–52.
Weller JA, Levin IP, Shiv B, Bechara A. The effects of insula damage on decision-making for risky gains and losses. Soc Neurosci. 2009;4(4):347–58.
Griffith HR, Belue K, Sicola A, Krzywanski S, Zamrini E, Harrell L, et al. Impaired financial abilities in mild cognitive impairment: a direct assessment approach. Neurology. 2003;60(3):449–57.
Marson DC, Sawrie SM, Snyder S, McInturff B, Stalvey T, Boothe A, et al. Assessing financial capacity in patients with Alzheimer disease: a conceptual model and prototype instrument. Arch Neurol. 2000;57(6):877–84.
Gerstenecker A, Eakin A, Triebel K, Martin R, Swenson-Dravis D, Petersen RC, et al. Age and education corrected older adult normative data for a short form version of the Financial Capacity Instrument. Psychol Assess. 2016;28(6):737–49.
Swanson C, Marson D, McPherson T, Gerstenecker A, Logovinsky V. The financial capacity instrument - short form is a novel, performance-based measure that may help differentiate mild cognitive impairment and mild dementia due to Alzheimer’s disease populations in clinical trials. Alzheimers Dement. 2017;13(7):264–5.
Lichtenberg PAPA, Ficker LP, Rahman-Filipiak AM, Tatro RB, Farrell CM, Speir JJM, et al. The Lichtenberg Financial Decision Screening Scale (LFDSS): a new tool for assessing financial decision making and preventing financial exploitation. J Elder Abuse Negl. 2016;28(3):134–51.
Marson D. Conceptual models and guidelines for clinical assessment of financial capacity. Arch Clin Neuropsychol. 2016;31(6):541–53.
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–86.
Marson DC, Martin RC, Wadley V, Griffith HR, Snyder S, Goode PS, et al. Clinical interview assessment of financial capacity in older adults with mild cognitive impairment and Alzheimer’s disease. J Am Geriatr Soc. 2009;57(5):806–14.
Niccolai LM, Triebel KL, Gerstenecker A, McPherson TO, Cutter GR, Martin RC, et al. Neurocognitive predictors of declining financial capacity in persons with mild cognitive impairment. Clin Gerontol. 2017;40(1):14–23.
Widera E, Steenpass V, Marson D, Sudore R. Finances in the older patient with cognitive impairment: “He didn’t want me to take over”. JAMA. 2011;305(7):698–706.
Lichtenberg PA. Financial exploitation, financial capacity, and Alzheimer’s disease. Am Psychol. 2016;71(4):312–20.
Lepping P. Overestimating patients’ capacity. Br J Psychiatry. 2011;199(5):355–6.
Conflicts of Interest or Disclosures
The authors of this book chapter have nothing to disclose and have no conflicts of interest to report.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Glass, O.M., Tune, L., Hermida, A.P. (2019). The Capacity to Manage Finances. In: Balasubramaniam, M., Gupta, A., Tampi, R. (eds) Psychiatric Ethics in Late-Life Patients. Springer, Cham. https://doi.org/10.1007/978-3-030-15172-0_4
Download citation
DOI: https://doi.org/10.1007/978-3-030-15172-0_4
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-15171-3
Online ISBN: 978-3-030-15172-0
eBook Packages: MedicineMedicine (R0)