Personal Characteristics and Risk Factors Associated with Economic Trade-offs and Financial Management Difficulties in Older Adult Home Care Populations

Abstract

People are living longer and this increases the risk of encountering financial difficulties when trying to make fixed retirement incomes stretch over additional years. Increased life expectancies also increase the likelihood of encountering a health issue including cognitive or functional declines that can affect money management capabilities. There are government entitlement programs available to assist retired Canadians but these programs are under review and new policies are being considered in order to reduce fiscal pressures. At the same time, family roles and structures are changing and informal supports available to previous generations may be reduced. As well, if an older person’s money is poorly managed there will be fewer options for maintaining quality of life in the retirement years. This increases the risk of poverty for older Canadians. The goals of this research are to: understand individual risk factors including demographic, clinical and social support characteristics among Canadians age 55 and over who are experiencing poverty; to understand the predictive characteristics for moving into or exiting from poverty; and, to develop a comprehensive description of those who have great difficulty managing their finances. In order to achieve this, data from the interRAI Home Care (RAI-HC) assessment instrument were used. Three regions, Winnipeg Regional Health Authority (WRHA), Nova Scotia and Ontario, were analyzed in order to understand the characteristics of those making economic trade-offs (N=345,678). Data from the province of Ontario was used to understand predictors of poverty transitions (N=47,653) and to develop a profile of those having great difficulty managing their finances (N=321,816). In order to answer each question of interest multivariable logistic regression modeling was used. Results from the analyses found that those most at risk for making economic trade-offs were in the age 55 to 64 group, had three or more depressive symptoms and were separated or divorced. Gender was not a risk factor. Regional differences for poverty risks were also identified showing greater risks for those experiencing mental health issues in WHRA, for those with more clinical indicators in Ontario, and for younger residents (age 55 to 64) in Nova Scotia. The longitudinal analyses on poverty transitions revealed that females who had completed at least a grade eight education were more likely to exit poverty. The younger group (age 55 to 64 years) with three or more depressive symptoms and experiencing unstable health were more likely to enter poverty. Marriage and older age were protective from the risks of entering poverty. Results from the analyses of those likely to have great difficulty with financial management indicated that deficits in cognition, procedural memory and function increased the risk of being unable to manage personal finances. Gender and marital status were not associated with financial management difficulty. The development of a profile of those who are making economic trade-offs and those at risk of having difficulty with financial management provides the opportunity for early intervention. Those who have not reached the traditional retirement age of 65 have an increased risk of poverty. Understanding characteristics of those who exit poverty will help establish policies and programs that will assist older Canadians. These are important issues due to the increased number of post-employment years that Canadians are living and the national focus on fiscal restraints. The management of finances has received minimal scientific research and evidence is needed to understand when changes in capability occur and how these changes may be supported by appropriate levels of assistance and supportive devices.