Is Capability to Manage Finances Stable Over Time?

Christina M Lazar, Anne C Black, Marc I Rosen
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Abstract

Procedures to determine when people receiving disability payments are incapable of managing their money recently have been re-examined by the Social Security Administration. Understanding the time-course of financial capability is necessary because people who are judged capable of managing their funds at one point may go on to need supports in the future, and those judged incapable and assigned a fiduciary will need re-evaluation so they have the most possible autonomy over their funds management. The financial capability of 132 individuals was examined during acute treatment and twenty-four weeks later. The extent to which baseline variables predicted future capability were examined. More participants were assessed as financially incapable at baseline (n=72) than at the twenty-four-week follow-up (n=43). Most participants had stable capability across assessment periods (n=35 remained incapable; n=52 remained capable), however a substantial minority (n=37) moved from incapable to capable. People who transitioned from incapable to capable had greater net reductions in psychiatric distress ratings and days of alcohol use from baseline to follow-up, compared to people who remained incapable. In multivariate analyses, incapability at follow-up was predicted by having been rated incapable at baseline, drug use at baseline, and having a psychotic disorder. The high baseline rate of incapability determinations suggests that admission into intensive psychiatric programs may be a good time to assess an individual's financial capability. However, these findings also suggest the importance of periodically reassessing beneficiaries' capability because high proportions rated incapable were rated to be capable twenty-four weeks later.

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管理财务的能力是否长期稳定?
最近,社会保障局重新审查了确定领取残疾补助金的人员何时无能力管理其资金的程序。了解财务能力的时间进程是非常必要的,因为那些在某一阶段被判定有能力管理自己资金的人可能在未来需要支持,而那些被判定为无能力并被指定为受托人的人则需要重新评估,以便他们在资金管理方面拥有尽可能大的自主权。在急性期治疗期间和 24 周后,对 132 人的财务能力进行了调查。研究了基线变量对未来能力的预测程度。在基线期被评估为无经济能力的参与者(72 人)多于在 24 周后的随访期被评估为无经济能力的参与者(43 人)。大多数参与者在各个评估期间的能力保持稳定(35 人仍无能力;52 人仍有能力),但也有相当一部分人(37 人)从无能力转变为有能力。与保持无行为能力的人相比,从无行为能力转变为有行为能力的人从基线到随访期间的精神压力评级和饮酒天数的净减少幅度更大。在多变量分析中,基线时被评为无行为能力者、基线时使用药物者和患有精神障碍者都会影响随访时的行为能力。高基线无行为能力判定率表明,进入重症精神病治疗项目可能是评估个人经济能力的好时机。不过,这些发现也表明定期重新评估受益人能力的重要性,因为被评为无行为能力的受益人在 24 周后被评为有行为能力的比例很高。
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