Financial Health Literacy and Community-Dwelling Older Adults: A Concept Analysis

Abstract

Aim. To examine and clarify the concept financial health literacy (FHL) within the context of aging and healthcare. Background. Older adults have a high chronic disease burden and low financial and health literacy levels which often leads to high healthcare costs and poor self-management. Clarification of the concept FHL is necessary to better support nursing care and successful self-management. Design. Concept analysis using literary synthesis. Data Sources. Electronic databases were used to find scientific literature (i.e., PubMed, CINAHL, and Business Source Complete), and online dictionaries were used to find basic definitions. Review Methods. Walker and Avant’s eight-step method was used as a guide to construct a concept analysis of FHL. Clinical, aging, financial, and economic studies were reviewed to determine defining attributes, antecedents, and consequences of FHL on the older adult’s health. Results. FHL is defined as the knowledge, skills, and ability to make decisions that allow an individual to manage finances to optimally meet healthcare-related and household expenses, including resources to self-manage health, and plan for short-term, long-term, and end-of-life healthcare. Personal context, opportunity, and access are antecedents to FHL. There are 3 defining attributes: knowledge about health and financial-related concepts, skills in health and financial planning, and healthcare and financial-related decision-making behaviors. The 4 consequences of FHL include effective healthcare utilization, effective cost management, effective self-management, and positive health outcomes. Conclusions. FHL is a complex, multidimensional concept. A better understanding of this concept has significant nursing implications for research, clinical, practice, education, and policy development. Older adults have unique health and financial needs due to the complexity of retirement, living on a fixed income, and self-management of chronic diseases. Development of a FHL assessment tool and intervention is needed and may be supported based on the results of this concept analysis.