Financial Exploitation of Older Adults in the United States: A Systematic Scoping Review

Background/Objectives: The present study is a systematic scoping review to determine the extent and nature of the peer-reviewed research literature concerning financial exploitation of older adults in the United States (U.S.). The rising population of older adults in the U.S. means financial exploitation is a major challenge that will grow in the future. Recent estimates suggest that between 2.2% and 6.6% of older adults already lose approximately $109 million of personal wealth every year.

Methods: The scoping review was structured by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMAP). All years of five academic databases - the Web of Science (1900-2018), ERIC (1966-2018), PyscINFO (1800-2018), Social Services Abstracts (1979-2018), and PubMed (1966-2018) were searched using variations on the phrase “elder financial exploitation”. Google Scholar (1950-2018) was used to supplement the search of the academic databases and improve the overall accuracy of the scoping review. A two-stage process with explicit inclusion and exclusion criteria was employed. At the first stage, only peer-reviewed research articles and conference proceedings were included. Other types of documents, such as dissertations and theses were excluded. During the second stage, titles and abstracts were screened to exclude duplicates, editorials, and studies using samples from other countries.

Results: Forty-six peer-reviewed papers - 24 from the five academic databases and 22 from Google Scholar – were included and categorized into ten subject areas: (1) profiles of older adults who experienced financial exploitation, (2) measuring financial exploitation, (3) profiles of perpetrators, (4) impacts of financial exploitation, (5) prevalence estimates, (6) racial, ethnic, and cultural differences, (7) conceptual models and frameworks, (8) stakeholders’ perceptions, (9) legal and non-legal programs and services, and (10) evaluations of legal services.

Describing older adults who experienced financial exploitation by examining demographic and cognitive functioning factors was the most fertile area of research. Studies that included data about race, ethnicity, culture and/or gender were not uniform in their findings nor definitive enough in methodology to fully answer important questions about possible disparities. Testing of conceptual/theoretical models and measurement instruments appeared limited. The review also suggests that the older adults who are financially exploited experience a range of untreated consequences that include negative changes to a variety of factors associated with quality of life (e.g. finances, health, social relationships, independence, and psychological stress). Certain important topical areas received some, but inadequate attention such as profiling perpetrators’ methods and identifying prevalence rates.

Conclusions/Implications: The scoping review found a limited number of peer-reviewed papers (n=46) focused on financial exploitation of older adults. The papers were spread across a large number of subject areas (n=10), yet critical gaps remained in the literature. Two important gaps were: (1) The lack of rigorous evaluations of legal and non-legal services from a client-centered perspective; and (2) research about how the use of technology is changing the landscape of financial exploitation. Future studies in these two areas could help develop knowledge leading to evidence-based services that address the increasingly complex challenges of financial exploitation faced by older adults.