Dementia, Help with Financial Management, and Financial Well-Being

ABSTRACT

This paper uses the National Health and Aging Trends Study to determine whether older individuals with dementia receive help from their informal caregivers in managing their finances and how this assistance – or the lack of it – is correlated with financial well-being. The study finds that the vast majority of those with dementia do receive help managing their finances. Those with dementia who receive help are indistinguishable from those without dementia in terms of experiencing financial difficulties. However, the minority without help are over twice as likely to experience severe financial hardship, even controlling for other factors.

KEYWORDS:

• Dementia
• representative payee
• caregiving
• financial well-being

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. NHATS uses the AD8 Dementia Screening interview, an 8 item instrument to measure memory, temporal orientation, judgment, and function (M=3.053; SD=2.828). The cognitive tests evaluates the sample person’s memory, orientation, and executive function (Mean=.272; SD=.635). Sample persons were labeled as having “Probable dementia” if they reported an actual diagnosis, met AD8 criteria if there was no reported diagnosis, or scored less than 1.5 standard deviations below the mean in at least two domains of the cognitive test. “Possible dementia” was assigned if the respondent scored less than 1.5 standard deviations below the mean in one domain of cognitive functioning. All others were given the class of “No dementia.” For subsequent rounds of interviews, sample persons who had indicated a diagnosis were not re-asked if a doctor had told them they have dementia or Alzheimer’s disease, instead, it was coded as “previously recorded” in future rounds. Similarly, AD8 questions were not asked if in a prior round AD8 scores indicate dementia or Alzheimer’s disease. NHATS tested the sensitivity of its dementia categories against the Aging, Demographics, and Memory Study (ADAMS). In the Kasper et al. (2013) study, dementia was defined narrowly as an assignment of probable dementia, and broadly defined as an assignment of probable or possible dementia. The narrow definition showed low sensitivity and the broad definition showed high sensitivity against the ADAMS dementia diagnosis. The longitudinal approach taken in this study uses both assignments of possible and probable dementia to assign a dementia classification.

2. Activities for Daily Living include bathing/showering, dressing, going to the toilet, basic mobility inside and outside, and eating. Instrumental Activities for Daily Living include shopping for groceries, cooking hot meals, laundry, and managing finances.

Additional information

Funding

This work was supported by the Social Security Administration [4 RRC08098402-08-00];Social Security Administration [4 RRC08098402-08-00];Social Security Administration [4 RRC08098402-08-00].