Centre for Applied Social Research, University of Bradford, Bradford, UK.
Health Soc Care Community. 2013 Sep;21(5):554-62. doi: 10.1111/hsc.12044. Epub 2013 May 3.
This article explores how married couples managed their finances and made financial decisions when one spouse had dementia, drawing comparisons with the approaches used prior to the illness. More specifically, the article examines the role of social factors in influencing the involvement of people with dementia in financial management and decision-making, particularly whether a gender dynamic adopted earlier in a marriage similarly influenced a gendered approach following dementia. The research formed part of a larger study of everyday decision-making by couples living with dementia which explored the role of non-cognitive factors in influencing whether people with dementia were involved in decision-making processes. Twenty-one married couples living at home took part; the recently-diagnosed were excluded. Qualitative methods -including participant observation and interviews - were used to examine the couples' fiscal management and decision-making-processes, the perceptions of people with dementia and their spouses about their current financial abilities and whether any support provided by spouse-carers influenced their partners' financial capacity. The fieldwork was undertaken in the North of England between June 2010 and May 2011. Thematic analysis of the data showed that social factors influenced the perceived capacity of people with dementia and the financial practices adopted by the couples. In particular, gender influenced whether people with dementia were involved in financial decisions. The research demonstrated that non-cognitive factors need to be taken into account when assessing and facilitating the capacity of people with dementia. In addition, as people with dementia were somewhat marginalised in decisions about designating financial authority (Lasting Power of Attorney), spouse-carers may need guidance on how to undertake advance care planning and how to support their relatives with dementia in major decision-making, particularly when there are communication difficulties.
本文探讨了已婚夫妇在一方患有痴呆症时如何管理财务并做出财务决策，并将其与患病前的做法进行了比较。更具体地说，本文考察了社会因素在影响痴呆症患者参与财务管理和决策方面的作用，特别是婚姻中早期采用的性别动态是否同样会影响痴呆症后的性别化方法。这项研究是对患有痴呆症的夫妇进行日常决策的更大规模研究的一部分，该研究探讨了非认知因素在影响痴呆症患者是否参与决策过程中的作用。共有 21 对居住在家庭中的已婚夫妇参与了研究；排除了最近确诊的夫妇。采用定性方法——包括参与观察和访谈——来研究夫妇的财务管理和决策过程、痴呆症患者及其配偶对当前财务能力的看法，以及配偶照顾者提供的任何支持是否会影响其伴侣的财务能力。实地工作于 2010 年 6 月至 2011 年 5 月在英格兰北部进行。对数据的主题分析表明，社会因素影响了痴呆症患者的感知能力和夫妇采用的财务做法。特别是，性别影响了痴呆症患者是否参与财务决策。该研究表明，在评估和促进痴呆症患者的能力时，需要考虑非认知因素。此外，由于痴呆症患者在指定财务授权（持久授权书）方面的决策中有些边缘化，配偶照顾者可能需要有关如何进行预先护理计划以及如何在重大决策中支持其患有痴呆症的亲属的指导，特别是在存在沟通困难的情况下。
