Current Australian aged care policies and broad notions of ageing well promote ideas of independence and choice in older age in all areas of life including involvement in decision making about financial assets. However, older people who enter residential care are likely to be presented with a range of challenges relating to their continued involvement in managing their money. Such challenges include concerns about conserving assets to manage costs of care, the complexity of current systems of residential care fees and charges, the need for assistance to manage assets related to illness and/or disability that precipitated entry into residential care, and ‘...potentially attitudes...’ that presume residents will be unwilling or unable to be involved in managing their financial assets.
Care staff in Aged Care Facilities (ACFs) are also presented with a range of challenges around supporting resident involvement in the management of their assets. Since the introduction of the current policies and their associated standards in 1997, the population of residents has changed. An increasing proportion of residents now have high care needs and/or have dementia. This changed population of residents, together with ACF resourcing and staffing issues noted in recent government reviews, suggest there will be tensions in implementing these policies in the current environment. Little is known about how these tensions are managed in the area of resident involvement in managing their financial assets.
Although there is a growing knowledge base around older people and asset management practices and financial abuse, limited attention has been paid to the experiences and preferences of older people in residential aged care in relation to involvement in managing their assets. This thesis seeks to address this gap in understanding. The study explores the perspectives and experiences of 18 residents in four ACFs in the ongoing management of their assets. It seeks to identify the fit between the perspectives of residents, current practices in ACFs and current policy and standards. The thesis is part of a larger ARC Linkage project exploring the management of assets in AFCs.
Senior managers in each facility were interviewed to provide a contextual understanding of current policies, resources and practices within the four facilities in relation to residents’ financial assets. Semi-structured interviews were then completed with the high care and low care residents who had agreed to take part in the study. The transcripts from the interviews were analysed using thematic analysis. The analysis highlights the importance of the processes of admission in, including or excluding residents, the differences between residents on their preferred level of involvement, the roles played by family members, the importance of the fit between preferences and resources available, and the barriers and opportunities for residents to remain involved in managing their assets. Most of the eighteen participants were concerned about their assets irrespective of whether their assets were large or small. There was some variation among participants in whether they self managed or received assistance either by choice or through a lack of alternatives. Satisfaction was strongly linked to the fit between participants’ preferences about what they wanted to happen, whether that was to self-manage or receive assistance, and the opportunities available.
In residential care, older people manage their assets within a commonly held context where they are at risk of being stereotyped as incapable and no longer able to manage their own financial affairs. The findings from this study challenge assumptions that residents in ACFs are no longer interested in managing their assets. Facilities, staff and families provided some opportunities for these residents to be involved to some extent in asset management. Barriers to involvement were also identified in the processes of admission which often excluded residents, the limited support available to some residents who lacked appropriate support from family or friends, presumptions that families, rather than residents, were the primary asset managers, and concentrated on concerns to managing risk rather than support independence of the older person in this area of practice.
Although care has to be taken in drawing conclusions from a small purposive sample, the research provides important insights into the experiences of some residents and the issues for practice that arise. Recommendations for practice include the importance of identifying the issue of asset management as a valued part of some residents’ lives, challenging assumptions about families and substitute decision makers being the preferred managers, ensuring that in the process of admission residents are not excluded, where possible, from decisions and adopting a stronger facilitative role for those residents with limited or no social supports, who wish to retain involvement in asset management. Partnerships between ACFs and families could also be strengthened. The Aged Care Standards promote the rights for older people in aged care facilities to have independence and choice in asset management, if that is what they prefer. There was little evidence from this study to indicate that ACFs have adopted particular strategies to maximise residents’ independence in this area.