The Link between Dementia and Mismanaged Finances

Eureka! What I recognized anecdotally for years is now published research that concluded financial symptoms of cognitive issues are surfacing up to six years before a formal clinical diagnosis.

SIX YEARS.

You are noticing changes in your own thinking, or you are seeing changes in a loved one that is concerning, but the primary care doctor just reassures you that you are “fine.” I witnessed this all play out with my parents for years. By the time we finally had a formal diagnosis, both of my parents were diagnosed with MODERATE forms of dementia. Dad they believed to be Alzheimer’s and my mother had primarily Vascular Dementia.

If you are having more difficulty with bill pay and managing the checkbook balance, it is time to share that with a loved one and your primary care physician.

Many financial mistakes were made for many years preceding this, including the decision to stop paying for long-term care insurance. Most of my Dad’s retirement accounts were unattended and forgotten.

For more insight into this visit this Washington Post Story.

After living the journey with my parents, and now supporting individuals and families as a daily money manager, I have seen and cleaned up many of these issues. It is rewarding, but sometimes takes my breath away, when I calculate how much money was wasted or lost over the years that could have been used to help pay for their care.

The research primary looked at payment delinquency. If someone is missing bill payments, when they were prompt payers before, this change could be a sign of a cognitive issue.

If you are experiencing this, or are having trouble making your checkbook balance when that has been a lifelong habit, it’s time to share this with a loved one as well as your primary care doctor.

The earlier you identify an issue, the more options and control you can have over it’s future course. Believed.

Just say NO to Memory Supplements

While we all hope there is a quick fix to memory or cognitive issues, Consumer Reports confirmed that “By avoiding memory supplements, consumers can both save money and avoid unnecessary health risks.” You can learn more in this recent Washington Post story.

If you are noticing issues, the place to start is with your Primary Care Doctor. Are you taking drugs that might be impacting your memory and recall? Are there other factors that could be contributing to what you are noticing?

If you see your Primary Care Doctor, and are not satisfied with the recommendation or response, get a second opinion. I watched as my parent’s had issues that went unaddressed for years. It was frustrating to know something was wrong, but have their doctor’s just dismiss concerns.

Yes, it could have made a difference. If diagnosed early, individuals can be involved in planning for their future instead of us having to make our best guess on choices that had to be made for them. It was during the time we knew something was wrong that they also decided to stop paying for the long-term care insurance they been paying for nearly two decades. They have since required policy holders to designate a reporting contact so this doesn’t happen to others.

While my parents thought they had thoroughly planned everything, plans need to change when health and key members of your plans are unable to fulfill their obligations. So often spouses assume their spouse will be able to speak for them. In our case, both parents failed simultaneously. Other families report the spouse is in denial and sadly the result is the same.

I encourage you to be diligent in helping find a provider who can help you if you are noticing changes in your memory, or for a loved one if you are seeing changes in thinking and behavior.

My brother in law sent me a link to a website with resources by Biogen called CatchItEarly. They share while Alzheimer’s disease is usually diagnosed in people 65 and older, it starts earlier with subtle neurological changes occurring years or even decades before symptoms appear.  Many people are experiencing early, often unrecognized, signs of mild cognitive impairment and this site offers educational resources about the signs and resources for several drugs in clinical trials.

We still don’t have a cure, but hope the information provided is helpful to you and your family. Recommended.

Praying on Those Who Would Help

The number of COVID scams continues to grow. I got this email yesterday and wonder how many people immediately jump to volunteer — we have more time (seemingly) and we all want to help kick COVID to the curb.

What bothers me about these types of messages, besides just being poorly executed (not my email address; the “From” email address that is goobly-gook behind the name of “Clinical Research”, what is it a “Verification” of?) is that I know many people are interested in helping. The fact that a good deed gets punished by a scammer bums me out.

For those of us with loved ones that we know are feeling more isolated, the phone and computer can be a source of entertainment … and danger. I have had several clients fall for pop-ups and they called and gave out login and banking information to the bad people. Thankfully, we could shut down and recover quickly and no money has been lost — but to have it happen so frequently now tells me it’s important to be more vigilant.

For several clients, we have created a “white list” so they get their messages from the people they know, but all the others get either blocked or filtered. When we visit (or when family visits) they can go through the other messages together. Some family members do a daily check-in and filter out the bad messages. A little more vigilance can go a long way. Protected.

Adulting NEVER Ends

My day job supporting individuals who are too busy or overwhelmed by paying bills and managing a household as a Daily Money Manager has helped me refine how I want to lead the rest of my life.

I have adopted the concept of “adulting” (thank you millennials) which is described as “the practice of behaving in a way characteristic of a responsible adult, especially the accomplishment of mundane but necessary tasks.” However, I want to extend this idea to add stages of adulting that take us through the end of our lives. That is if we want to “Adult” well.

Check out this Adulting Roadmap, and let me know what you think. In my world, retirement is not a finish line, but a launchpad to new endeavors. Those in my life aging successfully have planned, are adapting, and open to sharing with their loved ones, asking for, and accepting help when it’s needed. You can listen to this podcast where I discuss this concept with Debbie Miller who hosts the podcast Move or Improve. Interviewed

If you need help getting your personal and financial information organized, you can order a copy of MemoryBanc: Your Workbook for Organizing Life on Amazon. It’s less than $17.00 and will make it easy to get to the stage of Adulting Master.

Yes, And …

It took me a while to adapt to how best work with my parents and support them through Vascular Dementia (Mom) and Alzheimer’s (Dad).

My Dad got quieter, and my Mom grew suspicious.

I participated in a program recently and our trainer discussed how using the simple sentence starter of “Yes, and …” can help validate the person you are speaking with and help create a collaborative solution to what that person just told you. It was a general business training … not one for caregiving, but I immediately saw the value in how it might help me work better with my clients and loved ones.

I’ve already used it with a client diagnosed with dementia and it has been a helpful tool to manage through some conversations that could create fear, suspicion, or worry.

As an example, here is the conversation I had with a client who has a broken front door that we are in the midst of getting repaired. While it is still minimally functional, we want to keep it closed, locked and use it as little as possible. It is possible that the handle breaks and we won’t be able to keep the door closed … or lock it. The homeowner is ignoring the note that is posted on the door and using it to let in cats and visitors.

When I mentioned the next step for the repair, he commented that “The door has always been this way. It’s alright if I keep using it.” So I responded “Yes, it has been tricky to use for several years, and the last time we got it fixed, the locksmith said if it fails again, we will need to get replacement parts. Until they arrive, we need to keep it locked and use it as little as possible. Can you help me make sure that happens?” He answered “Yes” in response and we talked through how to best do that (update signs on the door and a note to the next few days of visitors). I let him know I would help communicate the door issue to the rest of his care team visitors.

Together, we came up with a solution on how best to move forward that we both believed would work. Solved.

Managing Through the COVID Lockdowns

The community where one of my clients has been living happily for over a year, sent me a note about new cases found and the process they were going to take to test everyone. This morning I learn that my client is one of 17 residents who tested positive today and my heart breaks. My colleague was going to visit because we have noticed she has been a little down lately.

No wonder. Many of us have seen the report that isolation is as harmful to us as smoking a pack of cigarettes’ a day. Forbes just shared the grim statistics of community residents across the county. “90 percent said they never left their campus, 60 percent said they never even went outside their building to take a walk, and more than half said they had no access to any activities within their facilities.”

In the beginning, we noticed that the forced lock-down actually benefited “Susan” because she was finally meeting and spending time with the other residents. However, when they went into full lockdown, where they have to stay in their rooms ALL DAY LONG, and eat their meals alone in their rooms, we can hear the sadness in her voice when we call.

This time I am going to start a silly postcard campaign so that she is at least getting a note and knowing that we miss her. We are all calling her too. Her family doesn’t live nearby so phone calls help. However, nothing is worse than being sick alone … AND too sick to even answer the phone.

My hope is that this former teacher will enjoy some silly postcards. Are there other ways to stay connected with someone who doesn’t use a computer, a smart phone, and for now, is too sick to talk on the phone.?

I sure hope that she ends up with a mild case. While she is in her 80s, she has very few other pre-existing conditions besides mild-cognitive impairment.

Please send me a note if you have any other ideas on how best to help those isolated during quarantine, and even worse, all alone as they fight COVID. Asked.

The Link Between Hearing Loss and Mild Cognitive Impairment (MCI)

The Lancet produced a report in July 2020 on dementia prevention, intervention, and care. In the report they state that a growing body of evidence supporting modifiable risk factors for dementia that include:

  • less education
  • hypertension
  • hearing impairment
  • smoking
  • obesity
  • depression
  • physical inactivity
  • diabetes
  • low social contact

The bottom line: “It is never too early and never too late in the life course for dementia prevention.” They are citing many of the factors as things WE CAN DO SOMETHING about — whether it is getting more education which affects our cognitive reserve to health factors that can trigger neuropathological developments.

The single factor with the highest impact and in our control is hearing loss. If you or a loved one has some hearing loss and are concerned with some recall and memory, you need to have a discussion with your audiologist. Ultimately, you won’t recall what you didn’t hear, so could some of your issues be from hearing loss?

For many of us concerned about changes to our memory and recall, I found this report reassuring. We can be our own best health advocates, and I hope you will download this report and figure out if there is something that you can do for yourself or a loved one. Empowered.

Whatever it Takes to Keep Our Loved Ones Safe

COVID frustration and fatigue. I am most frustrated that we don’t have clear information, guidance, and an understanding of what is safe or uniform protocols for managing the risk of spread. I don’t go anywhere without a mask because that much seems clear to me. I can’t fathom being the reason someone else is exposed to COVID.

Zoom and phone calls have had to do to stay connected with family, friends, and clients. Given the uncertainty, I’m gonna fall on the side of caution.

I know … I look MARVELOUS in a hair net.

I was happy to finally get to visit my client in person in their new community. During the screening process at the front of the community, I was asked if I had left “Virginia” in the past 14 days, I shared that I had been in Washington, DC — which is less than one mile from my home. It’s also less than 7 miles from the Adult Community I was visiting. Because I had been “out of state” I was given a hair net and a plastic smock.

I had never heard of these “covid precautions” but was fine to do whatever I needed to do so I could visit.

I’m a rule follower but find it hard to understand the rules. If it means it will keep someone else safe, I’m gonna do what is asked of me.

I hope you and your family are finding ways to stay connected and support your loved ones. I’m seeing how the isolation is impacting several of my clients and hope we have a clear way forward soon. Prayed.

A Quick Way to Ensure You are Well-Represented

When my parents health started to fail, I was the adult child that was local and stepped up to help. While my parents had planned well, what I needed was information on their accounts, the locations of their personal documents, and access to their online accounts to help reset codes and update account information.

While I wrote a book that will walk you through this process, I am happy to give you a summary of what you need to collect and organize so you can do it yourself. Having a summary of this will help your spouse, partner, and loved ones that will step in to help should you need it.

Every adult should have a Durable Power of Attorney. It gives someone the ability to step in for you and pay bills, and manage your financial affairs if you are unable to do this — even temporarily. We did this for my son when he turned 18, and I used it to file his taxes one year when he was traveling.

For those of you caring for someone, you know how important, frustrating, and necessary it is to have this document in place. What many people don’t know is how difficult and time-consuming it can be to have a financial institution recognize the document. Many couples don’t realize until, it is a problem, that being married does not give you instant access to a spouse’s account if you are not named on it.

In hopes of giving you a simple guide to organize this information for yourself, I am releasing this free download.

Get a free copy of this guide at http://www.MemoryBanc.com/POA

Feel free to share it with everyone you love. Offered.

Adulting and Life Preparedness: Are YOU Ready?

While I am commonly asked to talk on topics of What to Save and What to Shred, the REAL question is what do we need to have organized and WHY.

We all think we are doing just fine managing all this information in our heads, on our computers, on our phones, and in file cabinets … but if you have EVER had to step in to help someone else, I am telling you that 90 percent of your frustration will come from the search and your inability to help.

While I got passionate about this topic as a caregiver, I am now admiring the millennial concept of “Adulting” and working to expand the topics beyond the “having kids” and “buying a home” milestones.

The reality is that retirement is not a finish line, it’s just a new stepping stone in life and we need to continue to learn and grow as we age — especially since many will be in retirement for nearly a third of their lives.

Check out this Ask the Expert session hosted by Ann McClure.

For an inexpensive workbook that will walk you through the process of getting all of your information organized, you can check out this product on Amazon. Full disclosure: it is my book and I will get a few nickles if you order one. It did win an award and several thousands of families have used this to help organize their household information.

Strokes, Free Will, and Frustration For All

I am working for a gentleman who had a stroke. He is challenging every tool I have as well as frustrating his family who is very concerned for his safety and fiscal well-being. It’s hard to help someone that can’t recognize they need the help. While he saves up the mail and is happy to have us manage his bills and medical claims, he is taking cash out of his ATM regularly and has no recollection of where his cash went.

He left the rehab facility after his stroke and returned home where all daily living rules have changed. His habit of eating out could no longer be met. The doctor told him he should not drive, yet he is driving all over. His friend is bringing in meals for the two of them and now he is spending way beyond his means but has no awareness of money management.

I walked into this account while he was in rehab to find he was already $70,000 in debt and no longer had any credit on either of his cards.

The family members are beyond frustrated. I fully understand. You try to help and then your loved ones undo all the help you layered in not recognizing or appreciated the help. Then they usually get mad at you for butting into their lives.

A caregiver is coming in daily to help, but “Mike” keeps getting in his car and driving around. He doesn’t understand the need for social/physical distancing. He also doesn’t believe that he needs to stop driving. The doctor told him he had to go to the DMV to get assessed and put in a request to suspend his license. He still has a license with a valid date in his wallet and is continuing to drive. That is the biggest challenge – what are some options to stop the unlicensed driving?

When my parents were driving on suspended licenses, I quickly ensured that we first followed the need that caused the driving. Do they need groceries? Do they need to get to a medical appointment and aren’t used to calling cabs?

Once we knew those basic needs were met and this was more about control and freedom than need:

  1. I made sure they had umbrella insurance. If they were in an accident, my guess is that their auto insurance would not cover them since they were driving on suspended licenses.
  2. I calmly conveyed the possible consequences that they could harm themselves or others (they poo-pooed this idea); that their insurance didn’t cover uninsured drivers and an accident could consume their savings (they pulled out a valid license … they had torn up the notes from DMV suspending their licenses and requiring they turn in the driver’s licenses); that they could be taken to jail.
  3. We unplugged the starter (a neighbor helped to reconnect it after they told them what their horrible children were doing to them).
  4. My brothers came into town to help once things got REALLY bad and hid their cars. This is the one that finally worked.

Some other suggestions from other care managers include:

  • Offer to schedule defensive driving lessons. There are specialists that work with individuals who have lost their license and help coach positive skills behind the wheel.
  • Call the local police and see if they will visit the driver and offer a friendly warning. One family that did this put a boot on the car following the visit from the police.

The balance of free will and safety with love and family dynamics can make all of this so frustrating. I hope some of those suggested might help you. Experienced.