Int J Aging. 2024;2:e17.
doi: 10.34172/ija.2024.e17
Original Article
Analysis of Underlying Factors in Financial Neglect and Abuse in Older Adults: A Qualitative Content Analysis
Maryam Rabiey Faradonbeh 1
, Somayeh Mohammadi 2
, Mostafa Roshanzadeh 1, *
, Mina Shirvani 1, 3
, Mohammad Hossein Khalilzadeh Naghneh 4 
Author information:
1Nursing Department, Borujen Faculty of Medical Sciences, Shahrekord University of Medical Sciences, Shahrekord, Iran
2Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
3Department of Health in Disasters and Emergencies, School of Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4Department of Medical Emergency, Saveh University of Medical Sciences, Saveh, Iran
Abstract
Objectives:
To analyze underlying factors in financial neglect and abuse to enhance understanding and inform interventions that can protect the financial well-being of older adults.
Design:
A qualitative content analysis approach.
Setting(s):
Borujen, Shahrekord, Iran.
Participants:
A sample of 15 older adults (8 females and 7 males) aged 60 and above was selected through a purposeful sampling method from healthcare centres in Borujen, based on specific inclusion criteria.
Outcome measures:
Data were collected through semi-structured, in-depth individual face-to-face interviews.
Results:
The findings displayed one overarching category, which is lost property, along with four subcategories, including forced reluctance to pursue the recovery of lent money, deprivation of financial independence, distress due to an inability to recover lent money, and children’s financial evasions in repaying the lent money. Collectively, these factors contributed to older adults perceiving their property as lost.
Conclusions:
Addressing the burden imposed by financial neglect and abuse necessitates coordinated efforts from authorities, ensuring that policymakers and planners in the fields of health and aging implement concrete measures to raise awareness among families, older adults, and service providers regarding elder abuse. Ultimately, these efforts should aim to improve the quality of life for older adults.
Keywords: Content analysis, Older adults, Financial abuse, Financial neglect, Lost property
Copyright and License Information
© 2024 The Author(s).
This is an open access article distributed under the terms of the Creative Commons Attribution License (
http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Funding Statement
Funding for this study was provided by the Research Council of Shahrekord University of Medical Sciences.
Please cite this article as follows: Rabiey Faradonbeh M, Mohammadi S, Roshanzadeh M, Shirvani M, Khalilzadeh Naghneh MH. Analysis of underlying factors in financial neglect and abuse in older adults: a qualitative content analysis. Int J Aging. 2024;2: e17. doi: 10.34172/ija.2024.e17
Introduction
The phenomenon of population aging and its associated challenges represent one of the most significant issues facing Iran and the global community, creating numerous difficulties for older adults, their families, and service providers.1 Among these challenges, elder abuse stands out as one of the most serious and harmful forms of domestic violence.2,3 Elder abuse refers to a single or repeated act, or the failure to take appropriate action, within a relationship where trust is expected. Such actions result in harm and dissatisfaction among older adults,4 encompassing various forms of abuse and neglect.5,6 The World Health Organization (WHO) reports that one out of every six community-dwelling older adults has experienced elder abuse in the last year.4 The overall prevalence of elder abuse is estimated to be 56.4%, with the highest cross-sectional prevalence recorded in Tehran at 87.8% and the lowest in Shahrekord at 17.1%.7 Abdi et al also calculated the total prevalence of elder abuse to be 48.3%, identifying care neglect as the most prevalent form at 38.4%, while rejection represented the least common form at 11%.8
Several factors contribute to the emergence of elder abuse.9-11 Changes in social conditions such as urbanization and the transformation of family roles, along with the transition from traditional to modern life and shifts in values between older and younger generations, alongside the industrialization of societies in recent years have resulted in families increasingly neglecting their responsibilities toward older adults.9,12 Consequently, older adults are at greater risk of abuse by family members.12,13 Economic factors, including rising inflation and financial hardships, have also been linked to the occurrence of financial abuse.11 Additionally, the financial dependence of older adults on family members, inadequate personal income, and diminishing financial support from children have created a foundation for financial neglect.14 This mistreatment can manifest in different ways, including neglect in meeting the basic needs of the elderly and financial exploitation14,15 such as withholding financial resources despite the older adults’ needs, refusing to pay for essential equipment, and failing to ensure the necessary comfort for older adults.16
Elder abuse has a wide range of negative consequences for older adults.17 It can lead to frustration, disability, reduced self-confidence, and a decline in physical and mental performance. More importantly, it increases the care burden on hospital and maintenance systems, reduces the quality of life, and contributes to higher mortality rates.18
Numerous studies have examined elder abuse. Hsieh et al identified the most distressing aspects of elder abuse from the victims’ perspective, highlighting three key areas: feelings of loss, threats or negative consequences, and a mismatch between client needs and system responses.19 The results of the Whangmahaporn study in 2019 showed that elder abuse can be categorized into four distinct types: neglect, financial abuse, verbal abuse, and physical abuse. The study also indicated that the occurrence of elder abuse is associated with individual factors of both older adults and their abusers, including sons, daughters, sons-in-law, and grandchildren.20 In 2021, Alikarami et al explored the lived experiences of older adult women, identifying the categories such as feelings of abandonment, rejection, loneliness, concerns about decrepitude and burden, and fear of dying alone.21 Similarly, Adib et al investigated the barriers to seeking help for elder abuse in Iran, identifying three major factors: personal attitude toward abuse, inefficiencies in support systems, and dependency on others.22
The review of the aforementioned studies revealed that abuse and neglect in older adults have primarily been examined within physical and psychological dimensions. Given the existing knowledge gap in older adults’ experiences of financial neglect and abuse, using the personal experiences of this demographic, who are often the most affected by elder abuse, can provide valuable insights into the various dimensions of this phenomenon.
Methods
The present qualitative study aimed to analyze the underlying factors contributing to financial neglect and abuse in older adults. It was conducted in 2022 at Shahrekord University of Medical Sciences. Given that the study focused on the experiences of older adults regarding financial neglect and abuse and considering the scarcity of research on this phenomenon, conventional content analysis was employed.
Sampling was conducted using a purposeful approach in accordance with the established exclusion criteria. Fifteen older adults, aged 60 and above, seeking services at healthcare centres in Borujen, were selected and interviewed based on the inclusion criteria, which included the ability and willingness to articulate their experiences. The exclusion criteria comprised unwillingness to be interviewed, fear of disclosing personal information, or fatigue during the study. To achieve maximum variation in sampling, participants were selected to ensure diversity in age, sex, occupation, education level, marital status, and the number of children.
In-depth, semi-structured, and face-to-face interviews were conducted individually to collect data. The timing and location of the interviews were determined based on the preferences and comfort of the participants. Initially, the researchers introduced themselves and explained the purpose of the study, followed by interviews using pre-designed questions. The primary interview questions were posed in an open format (e.g., “Could you describe any experiences of financial abuse by family members? What factors do you believe contributed to your financial neglect and abuse?”). Subsequent questions were tailored based on participants’ responses, and exploratory questions were employed to clarify their statements. The duration of each interview varied depending on the interview process and the participants’ ability and willingness to engage. After each interview, participants were asked for permission to conduct follow-up interviews, either in person or by phone. All interviews were conducted in Persian, recorded using a tape recorder, and accompanied by handwritten notes. Data collection continued until saturation was achieved, at which point no new themes or categories emerged. All interviews were conducted and analyzed by the researcher under the supervision of the research team. Data analysis followed Granheim and Lundman’s approach, adhering to the following steps:
-
Transcribing the interviews verbatim and reviewing them multiple times to gain a comprehensive understanding of the transcripts.
-
Segmenting the text into meaning units, which were subsequently condensed.
-
Abstracting the condensed meaning units and assigning them codes.
-
Grouping the codes into subcategories and categories based on their similarities and differences.
-
Identifying overarching themes that reflect the latent content of the text.23
Initially, the interviews were transcribed verbatim by the researcher and carefully reviewed to capture a comprehensive understanding of the text. The semantic units within the interview transcripts were identified, followed by the initial coding process. The resulting codes were divided into subcategories and categories based on their similarities or differences, finally leading to the derivation of themes representing the latent content of the text.
In adherence to ethical principles, autonomy, independence, and confidentiality were strictly maintained throughout the study. Before conducting the interviews, the participants were provided with necessary information about the purpose and method of the study, and written consent was obtained for audio recording during the interviews. Participants were free to enter and withdraw from the study at any time. Furthermore, confidentiality was emphasized in all stages of the research process.
To ensure the study’s rigor, Guba and Lincoln’s criteria were followed.24 After coding, the interview text was returned to the participants to confirm the researcher’s interpretation aligned with their understanding. The researcher’s continuous engagement with the collected data during analysis and coding reflected immersion in the process. The coding and data analysis were monitored by experts from the research team who had sufficient experience in qualitative research and education. To enhance credibility, the researcher thoroughly documented all stages of the research, including collection, analysis, and formation of subcategories and categories, allowing for future scrutiny by others.
Results
Interviews with the participants were conducted over three months. In total, fifteen individual face-to-face interviews were conducted with 15 participants, with an average duration of approximately 30 minutes each. The demographic characteristics of the participants are presented in Table 1.
Table 1.
Demographic Characteristics of the Participants
Rank
|
Age
|
Sex
|
Occupation
|
Education Level
|
Marital Status
|
Number of Children
|
1 |
63 |
Female |
Housewife |
Illiterate |
Widowed |
6 |
2 |
66 |
Male |
Retired |
Elementary |
Married |
6 |
3 |
62 |
Female |
Housewife |
Illiterate |
Married |
5 |
4 |
81 |
Male |
Retired |
Associate Degree |
Married |
5 |
5 |
70 |
Female |
Housewife |
Diploma |
Widowed |
4 |
6 |
74 |
Male |
Retired |
Diploma |
Married |
5 |
7 |
75 |
Female |
Retired |
Diploma |
Widowed |
4 |
8 |
68 |
Male |
Retired |
Bachelor Degree |
Married |
4 |
9 |
72 |
Male |
Retired |
Diploma |
Married |
3 |
10 |
67 |
Female |
Retired |
Associate Degree |
Married |
5 |
11 |
76 |
Female |
Housewife |
Elementary |
Widowed |
4 |
12 |
69 |
Female |
Retired |
Bachelor Degree |
Married |
6 |
13 |
81 |
Male |
Retired |
Illiterate |
Widowed |
4 |
14 |
71 |
Male |
Retired |
Elementary |
Married |
3 |
15 |
68 |
Female |
Retired |
Bachelor Degree |
Married |
4 |
The findings of this study identified one main category, lost property, along with four subcategories: forced reluctance to recover the lent money, deprivation of financial independence from older adults, distress experienced by older adults due to inability to recover loans, and children’s financial shortcuts to avoid repayment. These categories and subcategories are detailed in Table 2.
Table 2.
Category, Subcategories, and Examples of Primary Codes Underlying Factors in Financial Neglect and Abuse in Older Adults
Category
|
Subcategories
|
Some Primary Codes
|
Lost property |
Forced reluctance to pursue recovery of lent money |
Refusal to recover the lent money due to fear of familial blame |
Avoidance of purchasing essential items due to apprehension about potential pressure or criticism from others |
Reluctance to reclaim lent money due to concerns over potential negative remarks. |
Avoiding burdening others due to their conditions |
Reluctance to insist on debt recovery for financial independence |
Prioritizing children’s needs over parents’ needs |
Deprivation of financial independence |
Imposing decisions on older adults without considering their personal autonomy |
The inability of older adults to meet personal needs due to financial dependence |
Completing tasks and fulfilling needs out of obligation rather than genuine interest or motivation |
Treating older adults’ assets and rights as one’s own |
Distress experienced due to inability to recover lent money |
Assuming older adults’ kindness and help as obligations and duties |
Expecting older adults to fulfill relatives’ needs |
Annoying reminders of any assistance provided to older adults |
Creating feelings of shame and embarrassment in older adults due to their needs and disabilities |
Mocking the beliefs, needs, and thoughts of older adults |
Trivializing the needs of older adults |
Disregarding and neglecting older adults’ needs |
Children’s evasions to repay lent money |
Postponing tasks related to older adults’ needs |
Conflict arising from returning money to older adults |
Using children’s marriages as an excuse for not returning the lent money |
Manipulating the emotions of older adults to encourage donation of assets |
Failing to fulfill promises made to older adults with ill intent |
Others’ concerns about repayment of the debt |
Lost Property
According to the results, older adults described the ultimate consequence of financial neglect and abuse as the loss of their property. They identified several contributing factors, including circumstances that compel them to give up their money, deprivation of their financial independence by relatives, distress from not recovering loans from others, and the financial shortcuts taken by their children to avoid repayment. These elements foster conditions for elder abuse, leading older adults to feel that their property is effectively lost, as outlined in Table 2.
Forced Reluctance to Pursue the Recovery of Lent Money
Older adults expressed that they often refrain from reclaiming money or property lent to their children or relatives for various reasons, including a desire not to burden others, a wish to maintain their peace, fear of criticism and pressure from family members, and a sense of financial independence. Consequently, they perceive their money as lost in such situations.
A 63-year-old woman stated:
“When I mentioned reclaiming the device I lent to my child, he became angry. I chose not to pursue it to avoid conflict.”
A 66-year-old man said:
“My children often borrow money from me but hesitate to repay it. I usually let it go to avoid arguments and conflicts.”
Deprivation of Financial Independence From Older Adults
Older adults reported that relatives often assign tasks to them without regard for their decisions, treating their rights and personal assets as their own. This behavior undermines their financial independence, leading to the completion of tasks out of obligation rather than genuine desire or motivation. Consequently, despite possessing property, older adults may find themselves lacking true ownership or the right to utilize it.
A 68-year-old man remarked:
“Frequently, my children take my card and withdraw whatever they want, not considering it as borrowed money but rather as if it belongs to them.”
A 76-year-old woman stated:
“Sometimes my children say, ‘You do not need to buy any stuff, just give me the money instead...”
Distress Experienced Due Inability to Recover Lent Money
Participants reported that interactions with relatives often lead to feelings of annoyance and resentment, as their personal needs are frequently trivialized and ignored. They added that the help they provide to their relatives is viewed as an obligation, with relatives expecting them to prioritize their needs while criticizing their efforts. This behavior induces feelings of shame and embarrassment while also mocking the older adults’ needs, beliefs, and way of thinking.
An 81-year-old male said:
“My children act as if it is my duty to put their needs first. They act like my wishes do not matter, and what they want is always more important, making me frustrated and annoyed.”
A 75-year-old woman said:
“Sometimes they give me something without even considering what I want, just to inconvenience me, or they do something for their own benefit, completely disregarding my request, yet they blame me and make me feel ashamed.”
Children’s Financial Evasions to Repay Lent Money
Analysis of the older adults’ experiences revealed that their children and relatives frequently use various excuses and strategies to evade returning borrowed money, leading older adults to perceive their money as irretrievably lost.
A 67-year-old woman stated:
“There are times when I purchase something, and my children intentionally appeal to my emotions expressing admiration for the item, saying how much they wish they could afford it themselves. They do this to either persuade me to buy it for them or give it to them.”
A 74-year-old man expressed:
“When I ask my children to return my money, they tend to delay or offer excuses, claiming it does not matter whether the money is with me or with them. If they borrow something from me, they argue that it does not matter where the item is kept, assuring me they will bring it back when needed. However, in the end, they do not return it.”
Discussion
This study aimed to analyze the underlying factors contributing to financial neglect and abuse among older adults. The findings indicated that older adults perceive their property as effectively lost due to forced reluctance to recover lent money, deprivation of financial independence, distress caused by the inability to recover loans, and financial shortcuts taken by their children to avoid repayment.
One subcategory identified in this study was the forced reluctance to recover borrowed money. Rahimi et al11 noted that rising inflation and societal industrialization in recent years have contributed to the financial neglect and abuse of older adults. Economic pressures within families decrease the importance of older adults’ needs, leading to increased instances of financial abuse despite their financial independence. Similarly, Borji and Asadollahi14 observed that insufficient income has decreased children’s financial support for older adults, resulting in the deprioritization of their needs, which in turn fosters financial neglect. Bajpai et al12 linked societal industrialization and the shift toward modernity to weakened social and family ties, ultimately contributing to elder abuse. Furthermore, their study highlighted that older adults’ dependency exacerbates the risk of abuse.
Analyzing the findings from the aforementioned studies, it can be concluded that older adults perceive existing economic challenges as significant factors contributing to neglect and financial abuse. The interplay between their financial independence and their children’s limited financial resources results in older adults neglecting their own needs and refraining from insisting on debt recovery. Additionally, these financial difficulties diminish children’s ability to support their older parents, leading to the marginalization of older adults’ needs, which are often deprioritized.
Another subcategory identified in this study was the deprivation of financial independence among older adults. Hsieh et al found that factors such as undermining the dignity of older adults, eroding their credibility, diminishing their trust in relatives, and straining relationships result from financial abuse and the removal of financial management control.19 Kulakçı Altıntas and Korkmaz Aslan et al demonstrated that unstable family dynamics, unauthorized use of older adults’ assets, and the illicit appropriation of these resources contribute to financial abuse and undermine older adults’ authority over their financial matters.25 Additionally, limited access to financial resources, lack of social support, and unemployment among some elderly individuals can further exacerbate neglect and financial abuse, reducing their autonomy in managing their finances.12,26
Analyzing the results above, it can be concluded that utilizing older adults’ financial resources without their consent, making financial decisions on their behalf, and engaging in the illegal or coercive use of their assets leads to a deprivation of their financial independence. This situation undermines their ability to exercise choice and discretion in managing their own financial affairs.
Another subcategory identified in this study was the suffering experienced by older adults due to the non-recovery of loans. Wang et al noted that older adults with religious and traditional beliefs often prioritize maintaining relationships with family and friends over their own needs, seeking peace and harmony, which can inadvertently increase elder abuse.27 This dynamic, coupled with a lack of warmth in family relationships, fosters feelings of worry and fear of rejection or abandonment among older adults. Consequently, despite their concerns about loneliness, they may choose to endure isolation, suppressing their own needs to preserve familial harmony and avoid disrupting their children’s lives.12,21,25
In analyzing these results, it is observed that many older adults, despite having various physical, emotional, and financial needs, often tolerate certain deficiencies to avoid conflict and maintain peace within their families. In response to the frustrating behavior of their relatives, they tend to remain silent, suppressing their desires and refraining from sharing their thoughts and beliefs with others.
Another subcategory of this study was children’s financial shortcuts to avoid repaying debts. Older adults reported that their relatives often provided various excuses to evade repayment. Findings from Zhang indicated that children sometimes utilize older adults’ financial resources and authority without adequately explaining the benefits to them. Additionally, for various reasons, they may refuse to repay the borrowed money.28 In some cases, financial constraints faced by caregivers of older adults also contribute to their reluctance to repay debts.1,29,30
Analyzing the results of these studies reveals that economic difficulties and familial pressures frequently lead to financial abuse. Children often prioritize their own needs over those of older adults, operating under the assumption that the older adults do not need as much financial support. Consequently, they may borrow funds for various reasons and subsequently refuse to repay them, citing excuses related to the older adults’ perceived lack of necessity, which can lead to misunderstandings and conflicts.
The present study aimed to elucidate the experiences of older adults regarding neglect and financial abuse. The findings suggested that forced refusal to recover borrowed money, deprivation of financial independence from the older adults, suffering due to non-recovery of the loan, and children’s financial shortcuts to avoid repayment contribute to older adults perceiving their property as lost.
Conclusions
This study is one of the few that specifically investigates financial abuse and neglect, focusing on the perspectives and experiences of older adults. The implications of these findings highlight two key dimensions.
First, older adults should receive education about the underlying causes of financial abuse and strategies for mitigation or prevention. They should also be encouraged to report any instances of exploitation to the appropriate support systems. Psychological counseling may be beneficial for older adults who have experienced financial neglect or abuse, addressing the emotional and psychological repercussions.
The second dimension pertains to family members, caregivers, and children of older adults. They need to understand the nature and circumstances surrounding financial abuse as individuals may unknowingly engage in harmful behaviors. Educating family members about the needs and financial situations of older adults can help reduce the prevalence of such abusive behaviors and foster a more supportive environment.
One limitation of this study is the influence of cultural and traditional relationships within the society under investigation, which may have affected older adults’ willingness to share their experiences of abuse in detail. To address this, efforts were made at the beginning of the interviews to build trust and create a comfortable environment for participants. Another limitation is related to the qualitative nature of the study, which restricts the generalizability of its findings. Additionally, since the research was conducted in a specific location with unique geographical characteristics, further qualitative studies are recommended across different regions of the country. Conducting quantitative studies with larger sample sizes is also suggested to better understand the relationship between financial behavior and other relevant variables.
Acknowledgments
We would to thank the Deputy of Research and Technology of Shahrekord University of Medical Sciences for their assistance. We also extend our sincere gratitude to the older adults who participated in this study and to all the people who helped us throughout this research.
Author contributions
Conceptualization: Maryam Rabiey Faradonbeh, Mostafa Roshanzadeh.
Data curation: Maryam Rabiey Faradonbeh.
Formal analysis: Maryam Rabiey Faradonbeh, Mostafa Roshanzadeh.
Investigation: Somayeh Mohammadi, Mina Shirvani., Mohammad Hossein Khalilzadeh Naghneh.
Methodology: Maryam Rabiey Faradonbeh, Mostafa Roshanzadeh.
Project administration: Mostafa Roshanzadeh.
Resources: Somayeh Mohammadi, Mina Shirvani, Mohammad Hossein Khalilzadeh Naghneh.
Software: Mostafa Roshanzadeh.
Supervision: Mostafa Roshanzadeh.
Validation: Mostafa Roshanzadeh.
Visualization: Maryam Rabiey Faradonbeh, Mostafa Roshanzadeh.
Writing–original draft: Maryam Rabiey Faradonbeh.
Writing–review & editing: Mostafa Roshanzadeh.
Data availability statement
The corresponding author will provide the datasets used and/or analyzed during the current work upon reasonable request.
Ethical approval
This study is the result of an approved research project from Shahrekord University of Medical Sciences with ethics code IR.SKUMS.REC.1401.060.
Consent for publication
Not applicable.
Conflict of interests
The authors declare no conflict of interests.
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