The relationship between a client and their provider is one built upon trust.
When receiving care from an external party, clients are putting themselves into a vulnerable position. As well as having to trust that the provider will deliver adequate, appropriate and safe care, the client may also need to trust the provider to respect their money, property and privacy.
This is especially true for clients receiving care in the home and who require a high level of day-to-day personal care and assistance for activities of daily living.
While there are cases of caregiver theft, managing clients’ finances and property means more than simply refraining from this behaviour. As an intruder into the client’s personal space or life, you must actively ensure they feel secure and can maintain autonomy regarding their assets.
Participant Money and Property NDIS Quality Indicators
Under these standards, NDIS providers must meet the following quality indicators in order to ensure clients’ assets are secure and can be used under the client’s autonomy:
Clients’ money or property can only be used with their consent, and only for purposes specified by the client. If a provider is given access to the client’s assets, there must be processes enacted to ensure the assets are protected, managed and accounted for.
Clients should be supported to access and spend their own money as they wish.
Clients are not given financial advice or information other than what would be reasonably required under their plan.
Exploitation (also known as financial or economic abuse) involves the unauthorised, improper or illegal use of a client’s money, property or assets for personal gain or the benefit of someone other than the client (CDC 2020; RACGP 2014).
In some cases, care staff may perpetrate financial abuse against clients. Providers should be aware of the signs of financial abuse and have appropriate policies and procedures in place to manage incidents involving their staff.
Be mindful of clients who are frail, isolated or lonely, as they may be particularly vulnerable to exploitation (Nursing Home Abuse Center 2019).
Examples of exploitation include:
Misappropriation of property (deliberately misplacing or exploiting the client’s property, or using the client’s property without their permission);
Forcing the client to surrender their money or assets through coercion or deception;
Using the client’s money without their permission;
Pressuring the client into giving gifts or loans; and
Restricting the client’s access to their money.
(National Consumer Voice for Quality Long-Term Care 2018; RACGP 2014; Seniors Rights Victoria 2012)
Signs of exploitation include:
Large, unexplained bank transfers or withdrawals from the client’s account;
Care staff being overly familiar with the client (e.g. calling them their ‘best friend’);
Substandard care being received by the client;
Missing belongings; and
The client not understanding or knowing their own financial situation.
(Nursing Home Abuse Center 2019)
Providers should be particularly careful about gifts from clients, as this may blur the lines of their professional relationship and create ethical implications. For example, staff may be accused of exploitation, or clients (or their loved ones) may use gifts as an attempt to ‘buy’ a higher quality level of care from their provider (Hall & Willcox 2016).
Providers should consider enacting policies and procedures about gifts in order to minimise the risk of exploitation or boundary-crossing. It may be worth considering:
Whether staff are allowed to accept gifts at all;
The maximum value of gifts that can be accepted by staff; and
Whether all gifts and their value should be disclosed to management.
(Hall & Willcox 2016)
What can Providers do?
Providers are obligated to ensure clients’ assets are secure and investigate any allegations made towards their staff. They should:
Enact policies and procedures that address theft and misappropriation of property;
Ensure employees are screened, trained and supervised;
Investigate allegations made and take protective action;
Train staff to notice and report signs of exploitation;
Implement a whistleblowing policy;
Protect clients during and after investigations;
Report allegations to the appropriate body; and
Seek feedback from clients.
(National Consumer Voice for Quality Long-Term Care 2018; Croner-i Limited 2012)
What can Clients do?
Clients may be encouraged to take protective measures such as:
Securing valuable goods or keeping them offsite;
Maintaining an inventory list of their valuable possessions;
Keeping large amounts of cash, bank cards or chequebooks offsite;
Regularly monitoring their bank accounts for unusual activity; and
Installing security cameras in the home.
Despite this, it is important to remember that providers are responsible for ensuring staff respect clients’ money and property.
Rumours or allegations of theft or exploitation should never be disregarded, even if the client is confused or providing unreliable information (Croner-i Limited 2012).
Clients form a relationship with their care staff built upon the expectation that themselves and their assets will be safe and respected. Providers have the responsibility to maintain this trust and appropriately train their staff to ensure clients have full autonomy of their money and property and do not fall victim to exploitation.
Frank is receiving home support from a carer, Brenda. Brenda has recently broken up with her partner and is experiencing financial difficulties, so she often cries and vents to Frank. Frank feels very sorry for Brenda and offers her a large tip, which Brenda graciously accepts. Is this exploitation?
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