A Mixed-Methods Study of Affective, Cognitive, and Behavioral Responses Among Financially Exploited Older Adults

Background: Nearly one in 20 older adults in the US are financially exploited (Peterson et al., 2014). Financial exploitation, characterized by the improper use of one’s assets by trusted persons (Hall et al., 2016), is particularly distressing, both financially and psychologically, for older people (Acierno et al., 2010). It is multidimensional and often leads to adverse outcomes, including depression, anxiety, stress, and trauma (Weissberger et al., 2019; Lavery et al., 2020). As the victims of financial exploitation are difficult to locate and have complex experiences, we employed a mixed-methods approach to explore the affective, cognitive, and behavioral actions/responses of older adults to such experiences. We also compared the experiences of older adults who received free legal support (clients) with those who did not (non-clients).

Methods: A total of 39 financial exploitation victims (clients n=22, non-clients n=17, aged 65 and over) were recruited via multiple strategies, including emails, letters, calls, flyers in prominent places such as buses, libraries, and through Adult Protective Services. Both quantitative (survey and standardized measurements) and qualitative (narrative) data were collected through individual interviews. Self-reported demographics, the Kessler Psychological Distress Scale, Perceived Financial Stress Scale, and a semi-structured interview guide were used. Due to the sample size, statistical analyses of quantitative data were limited to descriptive and bivariate analyses. Chi-square tests with Monte Carlo simulation allowed for the comparison of quantitative data between groups and further verified by Fisher’s exact test. Qualitative data was analyzed using two different processes. Clients’ narratives were analyzed using a three-step inductive process. Non-clients narratives were analyzed using protocol coding methods available from clients’ narrative analyses. Final codes were iteratively refined, vetted by an independent reviewer.

Results: Thirty-nine percent of the participants (Mean=74 years) reported being severely financially stressed and over one-third reported having a severe mental disorder. Significant associations were found between financial stress and psychological distress (χ²=6.302, p<.05), with higher rates in the non-client group. Qualitative results were grouped into three themes: affective, cognitive, and behavioral actions/responses. Affective findings included feelings of anxiety, fear, and distrust. Examples of cognitive processes included frustration with navigating the aid system, seeking knowledge about the crime, and a sense of personal responsibility. The behavioral theme included borrowing money and seeking help and support. There were between-group differences, where non-clients reported a greater need for knowledge about crime and legal aid services (43%) than clients (7%). Clients reported improved emotional and coping mechanisms (20% versus 13%) and desire for access to comprehensive support (19% versus 2%).

Implications: Findings show the complex nature of financial exploitation among older adults, emphasizing the need for developing a better understanding of this phenomenon. Our analyses suggest that combining psychological support with affordable legal assistance can offer whole-person care, addressing both the emotional and practical needs of victims as they recover and heal from exploitation. Additionally, greater awareness and education within communities and among service providers are crucial for early detection and prevention efforts related to financial exploitation of older adults.