I arrived to find my Dad on the floor

My girlfriend was leaving to visit her parents and asked for a copy of the MemoryBanc workbook to help her mom get a handle on the accounts and finances. I gave her two and suggested she show up to her parents home with the plan that they would work through the book together. Most of our parents won’t appreciate us showing up and telling them we think they are disorganized so make it a project you do in tandem for your individual households.

After her mom picked her up at the airport, they return home to find Dad on the floor. This isn’t the first time.

She shared that there was no way her mom could have helped get her dad up, she is younger and in better health than dad but is now exhausted caring for him and growing frail. Her dad is adamant that he wants to “age in place” and won’t considering moving to a life care community.

If you are in a similar situation, here are some things to consider:

  1. If your parent is falling and can’t get up, don’t continue to run over and help them if you are local. Tell them to call 911. I say this because I was local and kept driving over when this happened to my parents. It finally dawned on me that I was enabling them to stay in their home by showing up and making light of the issue when neither of them was hurt in the process. We were lucky that Dad didn’t fall on mom, but in many cases the caregiver is the one that ends up getting hurt. My parents finally recognized it was a big deal that they had to call 911 and made changes.
  2. Suggest your parents get on the wait list to a community of their choosing. They don’t have to move in, but for those that get on a wait list to a life care community, they usually have the ability to go there if they need Rehab or Skilled Nursing. In general, when you are being checked out of the hospital, you only have a few choices of the stand-alone facilities that have an open bed (versus have good reviews). The Life Care Communities generally have better ratings and most importantly, you are choosing where you would like to go rather than having to go to the bed that is open and maybe further away from family and friends.
  3. Ask the individual who is falling if they realize that their next fall could harm their loved one. Most people think of their issue as something that only impacts them and don’t realize that their next fall could start a chain reaction that puts their loved one in the hospital and will also impact their options for daily living assistance.

Falls are reported as the leading cause of death from an injury for older Americans. One of every five people who breaks a hip after age 50 dies within a year. According to the CDC, three quarters of those with hip fractures are women.

This is a tough situation and there are a lot of ways to assist and manage toward safer choices. Sometimes, our loved ones don’t recognize the risk to those they love if they don’t make some changes. Experienced.


How to Protect a Loved One’s Finances

If you find you have a loved one who is in failing health, has hired caregivers in the home, or is living in a care community, minding the day-to-day finances and spending is a simple task you can manage from a computer. Unfortunately, this can also happen to very health adults who get fooled by clever fraudsters as well. 

After caring for two parents with dementia, I remind myself how much the checkbook meant to my mother. She had always managed the household finances and the suggestion that she was unable to manage a checkbook safely was something that needed to be left unsaid. I found that out after I said it a few times. ; <

 

The biggest problem I faced was a lost purse that contained the checkbook. She thought she left it in a cab, a store, at a bridge game … I couldn’t manage the hours each week spent looking for her purse. Today you can at least get a tile which would have been immensely helpful in keeping track of her handbag, but it wasn’t an option yet.

There are several simple ways to help track the daily spending from the convenience of your computer: 

  • Get a tile and insert it into the wallet so you can easily find it if it get’s misplaced. You can use their online portal to track it’s location.  
  • Open up a new checking account and fund it with a small amount of money that can afford to be lost. You can easily move money into the account in small amounts as it needed to be replenished. If the checkbook is lost or you suspect fraud you can easily close the account.
  • Consider setting up a TrueLink card. It is basically a credit card where you can set up limits on how much can be charged as well as products and services that it won’t fund. There is a fee for it, but the small expense is worth the money it will most likely save in potential losses.

Unfortunately, I have recently had clients both at home and living in communities be a victim of caregiver exploitation. One got my client to write her a small check, one purchased some face cream for my client and asked her for repayment of $85, and another apparently kept asking for gas money. Most agencies and communities require their caregivers agree to never accept money or gifts from clients. Should a client give them money, it needs to be reported to the community or agency. In the past month, I have reported three caregivers for violating this condition of employment. Sadly, I know they will just turn up at another agency.

What I struggled with was that this was one of the few remaining freedoms for my mom. She could no longer drive, or run the bridge games she loved, and that checkbook gave her an empowered sense of self. Now as a Daily Money Manager, I see all the ways that people are trying to get at the money of my clients.

Ultimately, someone needs to be vigilant about minding the finances as well as considering how to layer in these protections. A few bad apples spoil the lot. I hope these options help you and your loved ones. 

Brush away Alzheimer’s?

I can hardly wait until they have some proven options to prevent and even cure Alzheimer’s … and maybe even all of the other forms of dementia. It’s so devastating to the individuals and their loved ones.

It was hard to witness the changes in my parent’s and it was sad to slowly lose those beloved traits and quirks their dementia’s stole away.

I do see some older adults who start to skip the health maintenance tasks they regularly followed as they age. Some make sense … like the colonoscopy. Is there an age where you might stop getting this screening?

I do know my parent’s no longer wanted to visit the dentist. I fear the day when my current dentist retires. Seeing him and everyone in his office is like visiting dear family friends. Will I some day feel the same way?

Could dental hygiene be one of the best prevention’s? If you haven’t seen the news, here is a link to a recent report on the study. Hoped.

Simple Steps to Safe Guard a Loved Ones Finances

After caring for two parents with dementia, I remind myself how much the checkbook meant to my mother. She had always managed the household finances and the suggestion that she was unable to manage a checkbook safely was something that needed to be left unsaid. I found that out after I said it a few times. ; <

The biggest problem I faced was a lost purse that contained the checkbook. She thought she left it in a cab, a store, at a bridge game … I couldn’t manage the hours each week spent looking for her purse. Today you can at least get a tile which would have been immensely helpful in keeping track of her handbag, but it wasn’t an option yet.

There are options to consider if your loved one would like to continue to manage their purchases:

  • Open up a new checking account and fund it with a small amount of money that can afford to be lost. I did this for my Mom. She had her checkbook, and I could move money into her account in small amounts as it needed to be replenished. If the checkbook never turned up or she had a check stolen we could easily close the account.
  • Consider setting up a TrueLink card. It is basically a credit card where you can set up limits on how much can be charged as well as products and services that it won’t fund. There is a fee for it, but the small expense is worth the money it will most likely save in potential losses.

Unfortunately, I have recently had clients both at home and living in communities be a victim of caregiver exploitation. One got my client to write her a small check, one purchased some face cream for my client and asked her for repayment of $85, and another apparently kept asking for gas money. Most agencies and communities require their caregivers agree to never accept money or gifts from clients. Should a client give them money, it needs to be reported to the community or agency. In the past month, I have reported three caregivers for violating this condition of employment. Sadly, I know they will just turn up at another agency.

What I struggled with was that this was one of the few remaining freedoms for my mom. She could no longer drive, or run the bridge games she loved, and that checkbook gave her an empowered sense of self. Now as a Daily Money Manager, I see all the ways that people are trying to get at the money of my clients.

Ultimately, someone needs to be vigilant about minding the finances as well as considering how to layer in these protections. A few bad apples spoil the lot. Reported.

The law in Virginia to protect elders fails us all.

This is a follow up to my last blog about being subpoenaed in an elder fraud case. Sadly, the commonwealth attorney and police detective both know that the woman stole money money from my client. At 91, she suffers from Parkinson’s but can walk on her own, feed herself (and help feed others), and you can often have pleasant conversations with her and she initiates questions back to you. She also has the cognitive issues that can come in tandem with Parkinson’s. When I first met her she presented with more short-term memory loss and had organization issues. The Parkinson’s was diagnosed a year after I stepped in to help with the daily money management and bill pay support.

The caregiver admitted to the detective she asked for the money. My client apparently told the detective the woman asked her for money. Taking money from clients is against the employment agreement she signed in addition to being an ethical failure.

I do know that my client had no idea where the checkbook was located in her apartment, nor could she have written the check on her own. The caregiver rooted through my clients belongings to find the checkbook.

I studied the check and it was easy to see that my client started to write the check (shaky, sloping hand-writing), but then someone else finished writing the check. I had samples to show that the way the check was written was very different (she wrote dollars and cents which my client never did). I figured a handwriting expert would not be on hand, but as a Daily Money Manager I could point out how I could tell that someone else finished writing the check.

After waiting for three hours for the case to be called, the attorney tells me (and the community care manager who was also there to testify) that only if we can confirm that my client didn’t understand that writing the check took money from her account would we get a conviction. So they DISMISSED the case. It will be VERY hard to convict someone based on how the current law is written. You will see the statute below which also illustrates the lack of knowledge around dementia.

Two good outcomes from this include:
1) The charge is now on her record so hopefully it will dissuade other
home care agencies and communities from hiring her again.
2) She is paying back the money.

The reality for those of us that have loved ones with dementia is that we know one could NEVER truly say they don’t understand that the money came from their account until very late stages of the disease. We witness a variety of ways their intellect shines through this horrible diagnosis.

So the LAW will fail us … at least in the Commonwealth of Virginia. I am putting together best practices to consider now that we know our hands are tied when we try to prosecute those who would take advantage of older adults with cognitive issues. Even if we can’t get the conviction, it is in our best interests to always report it to the police. The fighter in me is just getting going. Alerted.

§ 18.2-178.1. Financial exploitation of mentally incapacitated persons; penalty.

A. It is unlawful for any person who knows or should know that another person suffers from mental incapacity to, through the use of that other person’s mental incapacity, take, obtain, or convert money or other thing of value belonging to that other person with the intent to permanently deprive him thereof. Any person who violates this section shall be deemed guilty of larceny.

B. Venue for the trial of an accused charged with a violation of this section shall be in any county or city in which (i) any act was performed in furtherance of the offense or (ii) the accused resided at the time of the offense.

C. This section shall not apply to a transaction or disposition of money or other thing of value in which the accused acted for the benefit of the person with mental incapacity or made a good faith effort to assist such person with the management of his money or other thing of value.

D. As used in this section, “mental incapacity” means that condition of a person existing at the time of the offense described in subsection A that prevents him from understanding the nature or consequences of the transaction or disposition of money or other thing of value involved in such offense.

How our aging brains fail us.

aging brainWhile caring for two parents with different forms of dementia, I tried to understand how I could better help them. In doing so, I also found a ton of research about the how and why we may not recognize our own failings when it comes to managing our finances and day-to-day lives.

 

What I finally came to learn was that my parents were unable to perceive they were making poor decisions and just yearned for independence and control over their own lives.

 

Turns out, that our aging brains make us more vulnerable as we age. We perceive people as more trustworthy. I would have thought the school of hard knocks would actually make us trust people less. Apparently that is not what the science tells us. 

You can read the full report: Neural and behavioral bases of age differences in perceptions of trust.  In summary:

 

“Older adults are disproportionately vulnerable to fraud, and federal agencies have speculated that excessive trust explains their greater vulnerability. Two studies, one behavioral and one using neuroimaging methodology, identified age differences in trust and their neural underpinnings. Older and younger adults rated faces high in trust cues similarly, but older adults perceived faces with cues to untrustworthiness to be significantly more trustworthy and approachable than younger adults. This age-related pattern was mirrored in neural activation to cues of trustworthiness. Whereas younger adults showed greater anterior insula activation to untrustworthy versus trustworthy faces, older adults showed muted activation of the anterior insula to untrustworthy faces. The insula has been shown to support interoceptive awareness that forms the basis of “gut feelings,” which represent expected risk and predict risk-avoidant behavior. Thus, a diminished “gut” response to cues of untrustworthiness may partially underlie older adults’ vulnerability to fraud.”

 

I am seeing how some unscrupulous home services vendors are taking advantage of older adults. An elderly neighbor paid a plumber over $7,000 for some minor repairs that were later assessed to cost around $1,200 by a Master Plumber. He had no idea that the work should not cost that much until he showed me the invoices. He lives on his own and was just trying to keep his home in good repair. Unfortunately, there are no protections in the Commonwealth of Virginia against predatory pricing … nor in many states. Once you sign the agreement and they do the work, there is little you can do. 

There may come a time when we might need someone to at least bounce things off of. At minimum, it will help to always ask for at least two bids for any work estimates over $500. That little extra effort may save you thousands of dollars. 

It’s time to show up and fight back against Elder Fraud

As this appears, I will be testifying in court against elder fraud. A personal care assistant in my client’s memory care community coerced her to write her a check. Her story is ridiculous and includes tasks sadly my client has been unable to perform for over a year.

This woman has been working in elder care for nearly a decade. Not only did a check get written to her but I also found that my clients credit card was missing. The problem is that most families faced with these issues just don’t have the energy to fight.

I know. I could have fought the many banks that were refusing to accept my power of attorney, but after all of the visits, and tasks to help mom, starting a law suit was the last thing on my mind.

I have pledged to my clients that any work done to fight against fraud is done pro-bono. Many Daily Money Managers donate their time to help out fight frauds and scams on behalf of their clients and I’m honored to be in such a stand-up group of professionals. It is in all of our best interests to get these creeps away from our loved ones and I’m always game for a good fight. Bring it.

Brain changes make ALL older adults vulnerable to fraud

Many of us with loved ones living with cognitive issues face a never ending struggle to “protect” them from harm. My siblings and I battled with our parents when we could see they were making poor decisions and were at risk of jeopardizing their life savings. My parents were angry with their over-reaching children and our opinions.

What I finally came to learn was that my parents were unable to perceive they were making poor decisions and just yearned for independence and control over their own lives.

Turns out, that our aging brains put all of us at risk to be more vulnerable as we age. You can read the full report: Neural and behavioral bases of age differences in perceptions of trust.  In summary:

“Older adults are disproportionately vulnerable to fraud, and federal agencies have speculated that excessive trust explains their greater vulnerability. Two studies, one behavioral and one using neuroimaging methodology, identified age differences in trust and their neural underpinnings. Older and younger adults rated faces high in trust cues similarly, but older adults perceived faces with cues to untrustworthiness to be significantly more trustworthy and approachable than younger adults. This age-related pattern was mirrored in neural activation to cues of trustworthiness. Whereas younger adults showed greater anterior insula activation to untrustworthy versus trustworthy faces, older adults showed muted activation of the anterior insula to untrustworthy faces. The insula has been shown to support interoceptive awareness that forms the basis of “gut feelings,” which represent expected risk and predict risk-avoidant behavior. Thus, a diminished “gut” response to cues of untrustworthiness may partially underlie older adults’ vulnerability to fraud.”

Yikes.

Right now, I’m in the midst of two battles on behalf of my clients. One overpaid for work in their home and the other where a caregiver talked her into writing a check and also stole her credit card. I was just subpoenaed for the trial and hope that the outcome will ensure this horrible human can never be hired for senior-serving employment in the future.

The loss of this internal ability means we all need to step up to do what we can to protect our elders. I sure hope someone will be there to do the same for me. Driven.

Surviving as a Digital Immigrant

blogMy sister-in-law shared the idea with me years ago that we are digital immigrants which are defined as “a person born or brought up before the widespread use of digital technology.”  My first major in college was computer science … but I freely admit that I am a digital immigrant. I have gotten used to the idea that you are “talking to” someone even if you haven’t spoken on the phone or in person just by texting and conversing on a social media platform. I resisted this notion for years but finally gave up because I needed to be able to communicate and understand my two digitally native children.

While I can now manage quite well in our new digital frontier, I marvel at how difficult it is for most American’s who don’t use a computer, have never had an email account, and only respond to the idea of online banking with fear. The reality is that most people are tricked into giving away their information versus having someone hack into your computer and steal it. Sadly, the government, the credit bureaus, our health and credit card providers have also failed to adequately protect our personal information through no fault of our own.

Back in 2011, Social Security stopped mailing out annual statements. I tremble at the idea of spending hours at a Social Security office. I have helped many clients set up their online account at https://www.ssa.gov/myaccount/ so they can avoid having to call or visit to access their Social Security statements or even order new cards.

Social Security is just one example of the many agencies, companies, and providers that expect everyone to serve themselves. For the generations above me, this is really a barrier that is just too difficult to navigate. They do have call-in options and my clients regularly complain of the HOURS they have spent on the phone waiting to talk to a person … and then the right person.

I get it, they save money but cutting out the personal service. But they have also dehumanized many of the ways we interact with our government, our health care providers, and even our retirement accounts. Sadly, most older American’s need more help and guidance and it’s interesting to me to see how the services industries are adapting by responding with more personal interactions than ever than before.

I have seen a new generation of financial advisers that are high touch and deliver deep resources as they watch how technology is isolating many of their clients who find operating in today’s world very foreign. Evolved?

Do I schedule the colonoscopy?

poop in box memeI remember the internal debate I struggled with as my parent’s cognitive decline progressed. When they first moved into Assisted Living, they were scheduled for visits with the dentist. I knew it had been at least two years since their last exam and with a dentist visiting the facility, it was simple enough to have the staff take them down when it was time for their appointment. However, my parent’s both refused to see the dentist. We tried three different times and each time one or both of them dug in their heels and declared that they no longer needed to get their teeth cleaned. Six months later, my Dad was diagnosed with a tumor on his tongue. Would that dental visit have eased his pain or changed the outcome?

I consider this experience as one of my clients, an 85 year old who has been diagnosed with Alzheimer’s and is managing in her own home, was recommend to be screened for colon cancer using the new Cologuard kit. Cologuard is a do-it-yourself, mail-in DNA test that helps detect some colon cancers. Having just experienced this test myself, it’s not as simple as on would imagine, and does require that it be shipped back in a timely manner once you “collect” your sample. I have to say, I had a lot of fun joking around about the process and the “package” I needed to ship. Sorry to those of you who don’t like potty humor, I am a self-confessed big fan of it.

I brought up the topic to my husband because I found it tricky and wasn’t sure my client could manage the steps for the do-it-yourself part. You basically need to preset the kit in the commode for the collection, then take a sample and ship both the small sample and collection which requires a few extra steps before sealing the package. Once your package is sealed, it needs to be shipped back in 24 hours using UPS. Sounds easy, but since I just did it knew it took a little planning to complete.

As I’m wondering to my husband if my client can follow the steps, and ensure it gets shipped back in a timely manner — he is wondering what the family would do if they found out mom has colon cancer. He felt that he would probably be skipping his testing when he is 85 and battling other health issues.

Are there some things we need not test for once we reach a certain health status? Is the guide really to focus on those things that can prevent other health issues like a dental visit to maintain good oral hygiene versus testing for a cancer that may kill you when you are 85 years old? There is only the answer that is right for you.

I wondered if my Dad’s refusal to see the dentist was because he knew something was wrong and didn’t want anyone to find out or intervene. I do recall sitting with his primary care physician a few months before the tumor was diagnosed while she opened up his month and checked his teeth and tongue to see if she could figure out why he was drooling more. They chalked it up to swallowing issues related to his Alzheimer’s.

When it’s our job to monitor the health and well-being of our loved ones, when do we choose to stop the testing?  I think for all of us that answer is very different. Hopefully, you got a sense of the choices for end-of-life care your loved ones would make and can use that as your guide. Caregiving ain’t for sissies. Convinced. 

 

 

 

The indignity of aging: Predatory Home Service Providers

Every week I visit a client and we do a quick review of his two checking accounts. I was alarmed to find 2 payments charged to his debit card for more than $2,000 by a local plumbing company.

This client is nice and trusting and unfortunately, a local plumbing company took advantage and charged him more than $7,000 to plunge the toilet and change the hot and cold valves on three bathroom sinks. I was alarmed at $2k and then found a 3rd charge of $5,000 on his credit card.

The three invoices were all written in one day. Since we couldn’t even read the handwriting on the invoices, we called the company to ask about the services performed. They promised to send before and after photo’s of the work justifying the services performed, but a call by his daughter asking for the detailed explanation of work has never been provided.

I called in a second plumber to do an assessment of the work performed who said that it should have cost no more than $1,500.

Sadly, I have learned that in Virginia, there are no measures in place to protect consumers from predatory pricing. Maryland on the other hand has a process to protect consumer from predatory pricing practices.

For now, I’m in the midst of a claim with Better Business Bureau who gave this firm an A+ rating. Checks on Yelp and Google all list other complaints about predatory pricing — especially targeted it seems to older adults. The next step will be a call to County Attorney since this is a form of Elder Abuse.

In the meantime, we are working on other ways to protect him from predatory home service providers, but also keep him engaged and involved.  We started by posting “recommended providers” on his refrigerator.

It’s discouraging to learn that some businesses are taking advantage and I am dedicating my personal time to help fight every one I come across. Disgusted.