Without secure routines, money can disappear at the nursing home.

This text is written based on Swedish conditions, but can perhaps be an inspiration for people from other countries.

Many people living in elderly homes are dependent on help managing their own money. If nothing else, money is needed for the hairdresser and other personal needs at the residence. It is important to have secure routines so that money does not disappear. It is also important to have safe procedures for how the business should react if money or valuables disappear.


Management of residents' money in elderly care homes

It is common that staff at the elderly care home need to help the residents manage their money, payment cards, keys and other private belongings. Those who live in the elderly care home need money for haircuts, travels, outings and small purchases of various kinds.
Many residents have their own responsibility for their money and some may have a relative, legal guardian or conservator to assist them in financial matters. More and more residences have the possibility for safe storage in the resident's apartment, but there still needs to be procedures to ensure that nothing disappears. If staff is to manage money, it should be written in the aid decision or implementation plan.

It can be important to set limits for how large amounts are handled and to have routines for how the manager is informed that the operation is responsible for the resident's money. If the operation takes responsibility for private property, it may be necessary to pay compensation if money disappears. There also needs to be procedures that limit access to private funds to a few people in the unit. This is to be able to trace what has happened if money is missing.

One way to limit the risk is to use payment cards where only the contact person has access to the code. Another way is that the code for the card is stored by someone who documents when it has been handed out to an employee. On payment cards, the amount of money available can also be limited. If you as an employee help the resident to shop with a card, always save the receipt and leave it with the card after the purchase.

Never accept jewelry, bank boxes or codes for mobile banking or anything else that could be theft-prone. Employees should never withdraw cash for the resident. However, employees can accompany residents to the bank or ATM if the resident wishes. There should be a written agreement with the resident or their representative if the operation is to assist with managing money.

The operation also needs to have procedures to regularly count money that is stored for residents. One way to count is that two people together count the money and sign that the amount matches what is recorded. If a long time passes between counts, it can be difficult to remember what happened, for example, that the resident got a haircut six weeks ago. If someone passes away or moves, the money needs to be accounted for.

An important part to consider is that even the handling of the resident's money is covered by the duty of confidentiality. Cash books and other documentation on how the money is used therefore need to be handled with care. Staff in elderly care homes should not be responsible for paying bills for the resident. If this type of assistance is needed and there are no relatives who can be authorized to help, the resident needs to apply for a legal guardian.

By keeping a record of withdrawals and saving receipts, employees and the resident or the person helping the resident can reconcile and double-sign when the cash is refilled with more money. A written power of attorney or agreement on how the money should be managed and how the resident's representative should be informed creates secure routines.

A difficult situation that occasionally arises in elderly care homes is that the resident lacks money. It can become really troublesome, for example, if the resident cannot get their medication at the pharmacy. Sometimes it is due to mistakes from the person helping the resident with money, but it also happens that there is no money. Then the resident may need to receive social assistance to meet their necessary needs.

Managing the residents' money in an elderly care home is a sensitive and important task that requires diligence and security for both the residents and the staff.

Secure the handling of private funds

Responsibility and training Appoint a responsible person or team who is responsible for handling the residents' money. They should have training in how to handle money at the elderly care home.
Documentation and reconciliation Create a cash sheet with the residents' money when you receive money for the first time. Make sure that the person delivering and receiving the money both sign. If there is anything other than cash being stored, it should be included on a list. Each withdrawal is noted and the receipt is placed next to the money. If possible, both the staff and the resident sign. The money is counted at each withdrawal. When refilling, the person responsible and the person delivering the money count to ensure that the amounts match.
Safe storage All money and valuable items should be stored securely at the elderly care home. It could be cash safes or boxes where a limited number of people have access. Some elderly care homes have lockable cabinets in the apartment where the resident themselves store the key.
Regular review The manager or someone they appoint should conduct regular reviews to ensure that the routines work.
Staff education Ensure that all staff who may be involved in the handling of the residents' money are trained and aware of the elderly care home's guidelines and procedures.
Reporting If there are discrepancies in connection with the handling of the residents' money, this should be reported. Thefts should be reported to the police in consultation with the resident. Relatives may also need to be informed.

Care staff:
- Do you ever handle the residents' money?
- Are there secure routines for handling valuables and contacts in the elderly care home?

Manager, nurse, occupational therapist and physiotherapist:
- Does it happen that residents cannot get medication or anything else that is important for safe and secure care?
- Has it happened that money has disappeared at the residence?

Residents and relatives:
- Have you found a way to handle money that feels safe?

Erland Olsson
Specialist Nurse
Better care every day.

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