Getting Your Ducks in A Row … and the continued Vigilance Required to Be Prepared

I recently lost a client who chose to control his own destiny. None of us knew he has been planning this end, but now his call to me to talk through the Estate Plans makes sense.

I reminded him that three years ago we had gone to the bank to provide them with his Trust and he made his checking account POD (payable upon death) to his Trust. The bulk of his wealth … his home and investment accounts … were already in the Trust. ** He chose to make the Trust the beneficiary after death, even though the lawyer had recommended titling the account to the Trust.

Last week I returned to his bank to provide them with the death certificate and transition his account into his Trust so we could pay his bills. The beauty of the Trust allows the Trustee (or in this case Successor Trustee) to carry on and avoid probate and additional taxes. However, the bank CAN’T FIND the Trust document or the POD instructions on his account! It is a big bank and they are going through a merger. Even the best-made plans can fail.

Just having the legal Trust document doesn’t mean your assets are held in Trust. You MUST take an extra step to ensure your home, investment account, financial assets are titled to/listed as the account holder.

PLEASE SEEK and follow THE ADVICE OF YOUR ESTATE LAWYER.

I am not a lawyer, but on a weekly basis run into all the ways great Estate Plans fail. Usually, it is because the people that paid to create the plans didn’t follow the instructions on how to implement those plans. Your work didn’t end the day you left the lawyer’s office after signing the papers … it really just began. Call your lawyer to find out if you are prepared.

Practically, what can you do to ensure you are prepared for when you need help? First, assume that you will need help before you die. According to the Department of Health and Human Services, 70 percent of all adults over the age of 65 will need 3 years of help to manage the activities of daily living. Don’t wait until you need help. It can take weeks and even months to work with financial institutions.

  • Get Estate Plans in place by working with an Elder Law Attorney. This includes a variety of legal documents they will discuss with you.
  • Follow the instructions you are given. For those people that have a Trust, you should receive a document that recommends which accounts you title to the Trust (instead of the account being in your name “Kay Bransford” it would be “The Kay Bransford Trust” and I would be listed as the Trustee). They will also provide information on which beneficiary updates need to be made for all of your asset accounts.
  • Monitor your mail to make sure the accounts are titled properly. Several years ago, I got a piece of mail from an investment account that was titled to “Kay Bransford.” Three years prior I had provided them with the Trust and for years, the mail was arriving titled to “The Kay Bransford Trust.” When I called to find out what was going on I was told they went through a computer update and somehow, it resulted in my account retitling. I was able to get it immediately addressed.

I hope these steps can help you understand the importance of truly implementing your Trust. Contact your lawyer when you have questions.

If you need some help monitoring and managing your accounts or your bill pay, you can contact a Daily Money Manager. They fill the void of practical actions needed when it comes to making sure you lead the rest of the life you envisioned. Summarized.

Fending off the Fraudsters

Sometimes humans are terribly disappointing. I do not understand those people who are behind all the robo/scam calls. I know I am fortunate to live in the U.S. and had parents that provided a nice, stable life and opportunities to thrive.

Every week I deal with older adults who have fallen prey to a crook. Some of them hooked in over a phone call, while others walk into their homes and overcharged or stole money from their wallets. The most heart-breaking are those clients that have “friends” taking advantage of their good nature, good fortune, or inability to even recognize their “friend” is taking advantage of them.

The best way to help is to just be available to your loved one. Listen, watch, be curious. Most people have myriad systems to manage their financial accounts, personal information, and online usernames and passcodes. For an easy way to open the door, you could buy them a workbook to get organized on Amazon for around $20 or direct from the author for less than $15 plus shipping. It is one way you can start the conversation about all of the information that you might need to be able to help a loved one.

If you have someone who is having trouble managing, but doesn’t recognize it, be ready to help when they ask for it. Sometimes you have to let someone fail before they will allow you to step up and help them.

Patience. It is one of the hardest skills I continue to work on honing. When it comes to helping out a loved one, it is one that could benefit you both. Suggested.

To learn more, check out this story from Equifax. You do not need to pay for their services to get your credit report. Every year they are required to provide one for free. If you set up an online account, you can usually get an updated version monthly.

A Conversation with Professionals Who Can Help with the Day to Day Finances and Protect Against Fraudsters and Scams

While I was caring for my parents, I realized how difficult it was to be a caregiver and get a handle on and manage all of the day-to-day finances. It led me to write my best-selling book MemoryBanc: Your Workbook for Organizing Life and changed my career path. For nearly a decade I have been helping families navigate the financial issues that surround caregiving and have protected my clients against a variety of scams while helping them maintain their dignity.

If you have questions about how we can help you or a loved one, join us for this conversation on June 10th at noon. This is hosted by ProAging which is a network of professionals serving older adults, but will provide some valuable insight into how Daily Money Managers help individuals, and their families.

Meet the Daily Money Managers
Join us for the first in our monthly series of discussions with members of the American Association of Daily Money Managers AADMM. A Daily Money Manager (DMM) is a financial professional who provides personal financial services to individuals and families, and who manages personal daily money matters such as bills, budgets, and record keeping and much more.

This month our panel features:
Amanda DesBarres of Help Unlimited
Kay Bransford of MemoryBanc

Time Jun 10, 2021 12:00 PM in Eastern Time (US and Canada)

Honored.

My Mom repeats herself. Is that a symptom of dementia?

stylish women leaning on pillars on station
Photo by Daria Sannikova on Pexels.com

We have all done this at some point in our lives — and we either realize it mid-sentence or are told by our conversation partner. If this is a common occurrence and the person repeating themselves doesn’t recall having the conversation before, then it is time to bring it up with the primary care doctor. 

Any change in behavior by a loved one should start with a visit to their doctor. There are a variety of things that could cause changes (medication, lack of sleep,  a urinary tract infection) and not necessarily dementia. However, I do advise you start with the primary care doctor and discuss the changes. The more specific you can be the better so consider starting a journal to help you recall how often this is happening as well as help define exactly what is occurring.  My mom dismissed my concerns when I went to the doctor with her, and she focused on my Dad’s forgetfulness. I didn’t have specific details and facts to frame my concerns. 

Time and time again I know of many families that recognize something is off, but it is not something a primary care doctor can easily identify. Often, dementia won’t be diagnosed until later in the disease progression and early treatment could help slow the advance of the disease. So be persistent. Ask for a referral for a neuropsychological examination. Even after my Dad was diagnosed, he would score 28 on the mini-mental exam out of 30 — push for more nuanced testing.  

Looking back, I now recognize so many issues and signs that alerted us to mom’s dementia, but it was a long difficult road to even get to a diagnosis for a variety of reasons. The biggest one being my mom and dad fought to keep their independence fiercely. I arrived when I was given the opportunity to help them. I just hope that I won’t repeat history if I end up with the same condition. Prayed.

Why the Scammers are Winning and What you Can Do to Help

The scammers are winning over and over again. They give attention, value, and even a mission. A recent New York Times OpEd “My Grandmother’s Favorite Scammer” clearly illustrates how much this woman desired to be heard, counted on, and involved. When we step in to help our family, we often forget to honor the human in front of us.

Feel free to punk this scammer who tried to phish me into responding to the offer.

I often talk with adult children who want to know how to protect their loved ones. The most important way to help them is to listen, engage, and be available to them when they want it. Consider why they are continuing to answer the phone and get fooled by generic texts. They want to connect, which for many that stay at home all day, means conversations on the phone. The last year has made the phone the only life-line of human interaction and the scammers made the most of it … and don’t seem to be slowing down.

I have heard several individuals who I have worked with after they were scammed that they didn’t mind giving the “gifts” to the individuals that were giving them attention. One family friend was told by her sister that it was worth 10% of her wealth to have the interesting conversations and engagement she was having with her European “boyfriend.”

While I do recommend you consider spam blocking software and apps for email, the computer, and the home and or mobile phones, I just ask that you consider the emotions behind the interest in talking to a stranger on the phone.

Are there some other ways to help with engagement, purpose, and meaning when your loved ones goal is to live in their home alone? Contemplated.

I would love to hear if and how you have had success – whether it’s a roommate moving in or the use of some technology or apps.

The last year of life is the most expensive

For twenty years, my Mom told me she never wanted to live with her children. They bought into a Continuing Care Retirement Community (CCRC) also referred to as “Life Care” Communities so they would “never be a burden” to their children. For those of you that have seen the first few years of my blog … helping my parents was a very complicated affair. I won’t say it was a burden, but I wish knew then what I learned over the course of her care.

The Costs of the CCRC Path:

Non-refundable deposit to get into the CCRC $500,000 (1999)
This was in 1999 when that was how it worked.

Annual “rent” for their Independent Living apartment $ 38,400
This was the average cost from 2000 to 2012 for a total of $499,200.

At the end of 2012, the community required they move from Independent Living into the Assisted Living community. These were their “discounted” rates for their community since they paid the half of million to move in.

Annual cost for Assisted Living (for two) $117,600 (2013)
Dad passed away in 2013.

Annual cost for Assisted Living (for one) $ 94,800 (2014)
Annual cost for the required personal care
assistant for my Mom $ 98,208

Assisted Living was not the right place for my Mom with dementia. The residents didn’t want to eat with someone would couldn’t learn their names. She no longer wanted to eat in the community dining hall. As you may know, there is no kitchen in Assisted Living and my Mom was unable to prepare her own meals.

After my Dad passed away, my mom became agitated and they required we hire a personal care assistant for 12 hours each day. The memory care community in the CCRC was only for end-stage care, so neither the Assisted Living or the Memory Care were the right fit. We made the choice to move her to a Memory Care community outside of their “Life Care” community.

Annual cost of Memory Care community $ 81,600 (2015)
Annual cost for the necessary personal care
assistant for my Mom $111,600

My Mom was unsteady on her feet after a medication put her in a state of delirium in 2015. She kept falling and ending up in the Emergency Room (ER). We hired someone who could help her use her walker and assist her and keep her out of the ER.

Me with my Mom on our way to the Grocery Store.

So at the end of this journey, my parents spent over $1.5 million. They saved and invested well so they had the money to pay for their care. But knowing what I know now, we could have used that money better to manage the last fifteen years of their lives.

After watching many clients in communities cut off from family during COVID, several had a marked decline. They didn’t have many people to talk with because they were locked in their rooms and their physical stamina decreased from little movement.

For $1.5 million, I would have preferred to have a home where my parents could have lived with us, but still had the freedom to be independent. When they needed care, we could have arranged to bring it in. Thankfully, our community has many programs to stay engaged and active. We could have used that money to maybe deliver a higher quality of life to their final years. Would it have been better? I will never know.

From 2012 through 2015, I was spending more than 20 hours a week helping them in one form or another. The last three years of my Mom’s life cost over $500,000. Had she been living with us, I could have spent more time being a daughter instead of a family caregiver, bill payer, medical support and care manager. I now know how to bring in the support to help fills these roles and that would have been much less expensive and I believe more joyful for me and my Mom. Imagined.

The reality is that things change and what is important today, may not be important tomorrow. So leave some space for adaptability.

To learn more about my journey and the tool I created to help families manage and coordinate the personal information to be a great advocate, get a copy of MemoryBanc: Your Workbook for Organizing Life

Managing Email and a Dementia Diagnosis

While ANYONE can be at risk of identity theft, helping someone with cognitive impairment or a dementia diagnosis is an amplifying factor in considering risk.

woman in pink sweater sitting on bed
Anyone can be a victim of email fraud.
Photo by Ivan Samkov on Pexels.com

I am a huge advocate of helping an individual maintain dignity, meaning and purpose, but want to suggest a few ways to minimize the risks of fraud and identity theft.

1) CREATE A UNIQUE EMAIL PASSCODE. The number of breaches to our online accounts means that if you use repeating passcodes, you need to make sure your email has a unique passcode. Some scams include monitoring your email and sending a message to your Financial Advisor or Mortgage Lender with NEW instructions and can lead to a major financial loss. I was surprised that some fraudsters are putting the work into this one, but after one client had over $40,000 wired out of her IRA to a new bank account, I learned how prevalent the threat of this occurring has become. The next time your financial advisor calls you to confirm you requested the money, be THANKFUL. They are doing this to protect you and your money.

2) DON’T USE THE COMPUTER FOR FINANCIAL ACCOUNT ACCESS. I recommend having the computer used to connect with friends online not have any financial access URLs saved or passcodes stored. Too often, I have had a client respond to a pop-up, or have someone call saying they are “APPLE SUPPORT” and get access to the computer. If you are using it to connect to financial accounts, there is an increased risk of identity theft and fraud.

One of my colleagues walked in to help a client to see someone in the online banking and trying to transfer money out of the account. Thankfully they shut off the computer before any money was taken — but that was too close for comfort. We had a sweep done of the computer and removed the saved links and discussed with him why we did this, and how we could help him access this information in other ways. He is happy he can still get email and access the Zoom calls with his church.

3) SET UP TEXT ALERTS FOR FINANCIAL ACTIVITY. I have done this for my own accounts, and have set this up for clients so I know when money is being spent from the bank and credit card accounts. It’s just a simple way to ensure we get a first alert on any fraudulent activity.

The best offense is a good defense and I hope this give you a few ideas on how best to support a loved one. Suggested.

Navigating the Early Days of Dementia – Part II

A reader (thank you Debbie) reminded me how important it is to make a connection with the individuals surrounding your loved one. Thankfully, these days are behind me. However, the issues surrounding helping my parents reshaped my life plans. Nearly a decade ago, I launched my own business to help other families deal with financial confusion and disorganization and have learned who the key players are that you should have on your support team.

The key advisors in addition to the doctor and banker who can be invaluable when caring for a loved one.

Debbie cared for her mom for ten years. Her mom would add her to the bank account, and within days revoked that permission. Most people don’t recognize dementia or notice memory issues when they don’t know you, so the bankers would follow the wishes of their client. Debbie kept a diary of her mom’s behavior and was able to provide that information to her mom’s long term primary care physician along with a letter of concern. This at least allowed the doctor to diagnose and recommend medications.

Debbie spent time meeting with the bank manager, social services, and lawyer so they were all notified of the situation. Sometimes it is all you can do. Similar to my family situation, guardian and conservatorship were recommended but for anyone who has witnessed this, it is often not something you want to pursue. You basically would be declaring your loved one incompetent in a court of law and in a public record. It can be very costly and if the individual hires a lawyer to fight it, the costs in our area are typically in the tens of thousands. There are many cases in which this is a necessity, but often it gets really messy when families end up in court.

When I was the caregiver, the financial advisor for my parent’s disregarded our calls. Most modern financial advisors know that incorporating the adult children into the fold early is a smart move. Most adult children will immediately move the money the moment they can when the advisor presented as more of a roadblock that a resource. I know we did when it was time to help organize my parent’s finances.

There are many others I recommend to help you along the way as illustrated in the diagram. If your loved one won’t let you help, spend your time building a bridge to other resources that may provide the support needed. For a few more posts related to this topic, follow the links below. Shared.

A Quick Way to Ensure You are Well-Represented What you need to be an effective advocate. Includes a free download.

Strokes, Free Will, and Frustration For All Some basic things you can do if you someone continues to drive when maybe they shouldn’t be due to medical concern.

Dreamwork Makes the Care Team Work I discuss the individuals that are key for keeping someone safe in their home.

Navigating the Early Days of Dementia

Imagine if your friends and family started to treat you like you needed help with your day-to-day life. All of sudden, your spouse is taking over and trying to get you to visit the doctor, or your brother is suggesting that you stop driving. You have been living your life and all of sudden it feels like people you love are picking apart your lifestyle and over-stepping their boundaries into your affairs.

man busy using his laptop
Photo by Marcus Aurelius on Pexels.com

You would be angry, appalled, frustrated and probably kick back.

Consider that if you are the family that is stepping in to help a loved one who doesn’t recognize that their behavior or thinking has changed. I frequently write about Anosognosia, which is the inability of someone who has a condition to recognize its existence. More complicating is if no doctor has even been seen to help diagnose the issue — particularly early on. The family and close network of friends are always the first to notice the changes.

If you do have a loved one that is having trouble managing their day-to-day affairs, assume they can’t recognize it. I always encourage families to get to the Primary Care Doctor and get a referral to a neurologist. There can be a host of reversible issues causing memory loss, and the earlier you see a doctor the better. The next steps are usually and MRI and a neuro-psychological evaluation.

However, you are already noticing a change in your loved one and are concerned. This is the toughest time to navigate. I feel like it’s human nature for the person to almost over manage their life and if there are truly memory issues then you often see a host of double paid bills or even what seem to be knee-jerk moves to manage their lives outwardly.

One client who was complaining of a tooth issue, scheduled and had her tooth removed and major bone graphing done. She was supposed to pre-medicate with antibiotics, which we know didn’t happen. Then, after the procedure, was given a prescription for a week of antibiotics and a daily oral rinse. Thankfully, a timely visit uncovered the hand-written prescription that could be fulfilled and now we are working to help ensure she completes the course of antibiotics.

I have been the one who stepped in. My parents would agree to something, a small change, and then undo any progress made within days. At first I was angry. Then I recognized that my parent’s were not doing it to minimize me or my help, but were doing what they believed was best for them. In most cases, I don’t believe they remembered the change made or why.

I see families and loved ones who feel thwarted and are upset. I get it. However, I just ask that you recognize that they are working very hard to manage on their own as they have for decades. I can now only imagine how frustrated they are to feel so challenged to do things they have always done for themselves and how it be hard to do. Considered.

New Life Care Models

The devastating impact to the lives of those living in community care has made the discussion about finding new and better care models a priority.

For my clients that are still at home and living independently, and those who are in community settings and have been basically sheltering in place, the change in their cognitive and physical health is notable.

Heck, I think we have all felt the impact and worked hard to retool and find outlets to replace connections. However, for some this just isn’t easy to do if you don’t use technology, or you are unable to walk around freely in your community.

I wanted to share two interesting options that have been shared with me lately. I’m hopeful more of these multi-generational models will blossom.

Carehaus (Baltimore, MD) In a Carehaus, disabled and older adults, caregivers and their families live in independent living units clustered around shared spaces. In exchange for their labor, caregivers receive good wages, childcare, and various benefits. An additional team engages residents in shared meals, horticulture, art, fitness, physical therapy, financial literacy courses, and more.

Granny-Pods A granny pod is a modified ‘guest house’ that allows caregivers close proximity to aging loved ones. They are also called ADUs, or accessory dwelling units, and are designed with safety and accessibility top of mind (for example, slip-resistant floors, wide doorways, and rounded countertops). Some versions offer high-tech medical extras.

I have seen a few 3-D printed homes that integrate universal design and technology into the home and am hopeful more of these options will emerge in the coming years.

What I have learned is that I don’t believe a “forever home” is truly a practical option. At least for now, I see moving to a new setting can offer many more benefits to our emotional and physical health. I’m working hard to keep an open-mind. Hopeful.

Music and Emotions

Music evokes positive and negative emotions that last long after the song has played.

Most of us have heard that music can provide positive engagement and responses from individuals living with dementia. However, a report from The Washington Post today shared that it can elicit both positive and negative emotions that last even after the music is no longer playing.

“Both positive and negative emotions lingered for up to 20 minutes in both healthy adults and in participants with Alzheimer’s disease, whether they remembered listening to music or not, the team reported in November in the Journal of Alzheimer’s Disease.”

Caring for a loved one can be challenging as well as deeply rewarding. I am hoping this information provides you with another tool to serve you and your loved ones in the years ahead. Discovered.