ABSTRACT Exploitation of older people can result in devastating emotional and financial consequences. Researchers and policy makers have widely recognised the deleterious effects of exploitation on older adults, particularly cognitively impaired older people. Studies to date have provided basic information about the demographic and health characteristics that contribute to exploitation in later life, namely extreme dependence, frailty, social isolation, severe physical illness, and cognitive impairment. However, an overarching explanatory framework of vulnerability, and clinical instruments to aid with identifying those individuals at elevated risk of exploitation a priori have been lacking. Furthermore, the specific cognitive and social factors at the level of the individual which promote vulnerability to exploitation remain largely unexplored. The present research was directed towards addressing these issues. For definitional purposes, the term social vulnerability is used throughout in reference to an individual’s degree of susceptibility to exploitation. Exploitation of older people can take many forms including social and sexual exploitation, mistreatment, and deprivation of rights. Financial exploitation in particular is a relatively widespread phenomenon among older people, and may be a salient marker of social vulnerability in later life. In Chapter 1 of this dissertation, literature relevant to financial exploitation and social vulnerability more generally among older people is reviewed, and a conceptual framework for describing and explaining heightened vulnerability is presented. Central to this framework are various factors of personal competence at the level of the individual (i.e., intelligence, cognitive functioning, social intelligence, social skill, personality traits) which, in theoretical terms, contribute to, or protect against, exploitation. Chapter 2 details the development and psychometric evaluation of a standardised scale for assessing social vulnerability among older adults (termed the SVS15). Given that financial exploitation may be a pertinent marker of social vulnerability in older people, item content for the scale includes items of a financial nature. The results of two studies provided support for the reliability (internal consistency) and validity (known-groups) of the SVS15. Results of a factor analysis revealed a two-factor solution, with the emerging factors labelled gullibility and credulity. Stability in factor structure of the SVS15 was established in an independent sample using structural equation modelling. Chapters 3 and 4 of the dissertation detail the methodology employed in, and results of, a series of three studies systematically investigating the relationships between personal competence factors and social vulnerability in older people. Using multiple regression analyses, non-significant associations between basic demographic characteristics and social vulnerability were found in a nonclinical older sample, indicating that heightened vulnerability to exploitation is not readily explained by age, gender, or education. Rather, general cognitive functioning emerged as the most significant correlate of SVS15 scores in a combined clinical and nonclinical sample of older adults such that poorer cognitive functioning was associated with greater vulnerability to exploitation. Executive functioning in particular showed significant overlap with SVS15 scores after controlling for differences in memory and age. These results support the inclusion of standardised neuropsychological tests of memory and executive functioning (tests which are routinely used) when issues of social vulnerability arise. After general cognitive functioning, social measures of self-awareness and social skill were also important correlates of social vulnerability scores, indicating that social measures could also contribute useful information when assessing social vulnerability in older people. From an applied perspective, Chapter 5 of the thesis presents normative data for the SVS15, and an examination of the Tclinical utility of the scale using individual case studies of older adults diagnosed with a dementia syndrome. In Chapter 6, an amalgamation of the results from the project is presented, and the theoretical and clinical contributions of the findings are highlighted. TThe findings contribute to the extant literature in two ways: (1) through the development of aT potentially useful and psychometrically sound instrument which targets symptoms of social Tvulnerability more directly than existing neuropsychological measures and (2) by enhancing the current understanding of the cognitive and social personal competence factors associated with heightened vulnerability in later life.
| Identifer | oai:union.ndltd.org:ADTP/254130 |
| Creators | Donna Pinsker |
| Source Sets | Australiasian Digital Theses Program |
| Detected Language | English |
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