高齡者財務濫用與專業人士的旁觀者介入模式：以失智症為中心的回顧

Elder financial abuse and the professional bystander intervention model: a review centered on dementia

過往的高齡照護研究專注於長者身心狀態的維持，忽略了身心狀態與其財務安全的關聯。近年來不少研究團隊開始關注高齡者失智如何增加財務濫用的風險、財務濫用的型態以及降低此類風險的措施。本文針對此一主題進行重點式文獻回顧與評論，首先整理高齡者財務濫用的定義與類型，特別關注高齡失智者，並介紹「專業人士的旁觀者介入模式」與其降低財務濫用風險的效果。本文在第二部分整理並分析國內近十年與失智者財務濫用相關的新聞，資料來源包含《中國時報》、《聯合報》、《自由時報》、《蘋果日報》四家報紙，分析的內容包含財務濫用類型、濫用者身分、財物損失的內容以及金融專業人員的角色。本文依照濫用者身分將新聞分為三類：家人侵占、外人詐欺、本人濫用，發現在後兩者情境中，銀行行員常扮演旁觀者介入的角色，防止財務濫用事件發生。後續研究方向建議：調查行員對於失智者財務濫用的辨識敏感度並強化其介入能力，與發展在地化的失智友善銀行培訓課程。

Research on senior care has focused on both physical and mental health care, but the relationship between elders' financial security and health has been overlooked. Recent studies have investigated how dementia increases the risk of elder financial abuse-focusing specifically on types of and measures against elder financial abuse. In the first part of this paper, we define and contextualize elder financial abuse, with specific respect to elders with dementia. We then introduce the professional bystander intervention model and discuss its potential to reduce the risk of financial abuse of elders with dementia. In the second part, we analyze news articles related to financial abuse of elders with dementia in Taiwan from 2009 to 2018. News articles published in four major newspapers (China Times, United Daily News, Liberty Times, and Apple Daily) are included. We analyze the types of financial abuse, identities of the abusers, types of property lost, and roles of bank staff. We categorize elders with dementia's financial abuse into three ones based on the identity of the abuser: ''family embezzlement,'' ''third-party fraud,'' and ''self-misuse.'' In the cases of third-party fraud and self-misuse, bank staff were more likely to act as bystanders to prevent financial abuse. We propose two future research directions: first, to survey the bank staff's awareness toward the financial abuse of people with dementia, and second, to develop training courses for banks to assist them become more dementia friendly.