Tag: caregiver

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.

44 Million Unpaid American Caregivers

taskoverwhelmingYup, those of us doing it are often surprised to find out our friends and colleagues are in the same situation. Most of us step in and do it quietly. We may share the critical events as they occur, but often our feeling that this is a family duty usually means we don’t share the many ways that caregiving impacts us.

I was recently interviewed about the experience and am honored to be included in the stories that appeared in the NY Post, and Moneyish.

For those of us that have lived it, we know it’s overwhelming. My wish is that more employers will start to recognize and consider programs to help those stepping in to help their loved ones. Hoped.

Caregiving or Enabling?

pushI’m intrigued to listen and learn from those of you who have a healthy parent and are helping them care for loved one. Several of you face many of the same frustrations my siblings and I faced:

  1. Refusal to make changes to status quo living.
  2. Dismissal of concerns regarding current situation.

We want to help, but get lured into thinking if we comply with the things wanted, we build trust to help them make the real changes they should be making.

In my experience, helping someone maintain a poor living decision doesn’t create a pool of good will, it just lengthens the time before the critical incident happens so you can make the needed change for better health and safety.

I vividly recall my mom calling me one evening to come over and help with dad, “it’s urgent!” I was so hungry to hear my parents ask for help, I would jump the moment they requested assistance. However, this was the third alarm this week and I happened to be on my way to take the kids for their flu shots. I had to decide if I was going to serve my parents over my kids. The fact that I kept responding to my parents alarms was wearing on my marriage. I needed to realign my priorities, and in effect, I was spending a lot of time keeping their status quo afloat.

After this incident, I decided to step back and let them fail.The next time my mom called with an emergency, I told my mom to call 911. This event helped illustrate the depth of the problems my parents had functioning and it turned into a 3-day stay at the hospital for my dad. Until this incident, most of my concerns about my parents were dismissed by my siblings. To be fair, my parent’s were good at putting on a good show when my siblings came to visit. I realized that my constant involvement was allowing my parents to continue with their status quo lifestyle.

Once I had made the decision to give up, I mentally detached myself just as my siblings were starting to engage. I was so weary at the this point, I told my siblings they needed to deal with it. The resulting conversations with my siblings resulted in me re-engaging, but now, my siblings were part of the support system for me. We set up regular phone calls, scheduled interventions, and moved toward solutions to keep our parents cared for and safe.

What I learned was that there is a fine line between enabling and being an involved adult family caregiver. Is now a good time to figure out where you might be? Asked.

 

My Journey As a Caregiver … in 3 Parts

KaywParents2013I was asked to share my caregiving journey on Healthline. It turned into a three-part series, and might have some information that you find beneficial.

1) The Fight to Become My Parents’ Caregiver

2) What It Means to Be a Caregiver

3) The Painful Choices End-of-Life Brings for the Caregiver

I’m happy to be on the other side of the journey, and can now treasure all the skills I learned, and the moments I shared with mom and dad. Traveled.

How Much $$ Could a Flu Shot Save You?

needledollarAs a caregiver, I started to think about how my health (or poor health) would impact my parents. I didn’t want to be the one to bring the flu to them, so made sure I got annual flu shots.
In my role as a Daily Money Manager, I research varied ways to save my clients money—from simple things like reviewing phone and cable plans to bigger issues like refinancing and downsizing options.
At a recent training workshop, I learned that the lack of vaccinations is estimated to cost the American people $15.3 billion. It never really dawned on me how much money NOT getting a flu shot costs me either directly on medication and doctor visits, or indirectly through lost wages and discomfort.
In addition to the flu vaccine, three other vaccinations are recommended for adults over 65 years of age. Not only should you check with your doctor about these vaccines for those you are caring for, but they might also benefit you and I hope you will discuss them with your doctor.They include:
  • Shingles or herpes zoster vaccine — if you know anyone who has developed shingles, you know how debilitating it can be. The healthcare cost of treating shingles is estimated at $1 billion a year.
  • Tdap — while many of us with kids still in the household are familiar with this vaccination, only 16% of adults over 65 have gotten it. My son received the vaccination that includes vaccines for tetanus, diphtheria, and pertussis but did contract whooping cough. It was awful in a 13-year-old, but apparently, it’s even more devastating for adults. Next time you need a tetanus shot, ask if you can get Tdap instead.
  • Prevnar 13 and Pneumovax 23 for the prevention of pneumonia, which kills more annually than any of the others mentioned.
I still giggle when I think about my dad’s dedication to getting his flu shot every year. During the last month of his life (which we didn’t know at the time it would be), when he was just diagnosed with a tumor on his tongue and having a hard time managing, we took him to the Emergency Room. I left the room for a moment and while I was gone, apparently they asked him and he agreed to get his flu shot. Remembered. 

20 Things to NOT Say to a Person with Dementia

20-things-not-to-say-to-aperson-with-dementia-updated-6june2014.jpgThis list comes from Kate Swaffer who after being diagnosed offers a fresh perspective on how to live beyond dementia rather than only die from it, and how family, friends and dementia care professionals can more positively support people post diagnosis to do this. She has lovingly challenged, advised, and counseled me quite a few times on my journey. We even launched a Q&A blog where we peppered each other with questions.

As a follow-up to my go-to strategies for family visits, I plucked a few key tips to consider and am listing my top ten:

  1. Don’t tell the person they are wrong.
  2. Don’t say “Remember when … “
  3. Don’t correct or challenge trivial things.
  4. Don’t assume they can’t understand you because they are silent.
  5. Don’t think they can’t communicate just because we can’t speak.
  6. Don’t talk about them to someone else in front of them.
  7. Don’t remind them of a death of a loved one or pet.
  8. Don’t blame them for the changes in their behavior.
  9. Don’t assume they can’t answer for themselves.
  10. Don’t assume because they can’t tell you, that your words or actions don’t hurt their feelings.

It is easy to read the list, but not as easy to make these part of your actions when you are visiting. I am going to share my individual experiences with each of these over the next month. It time for me to learn and I hope my mistakes will help you learn faster than I did!

Be mindful of the words you use, and forgive yourself when you make a mistake — just build on what you are learning. Recognize that the person diagnosed with dementia still has the same craving for meaning and purpose that is the core of every human.

The changes in behavior are not hidden personality traits. As the brain is changing, so is the person living with dementia. When you have met one person with dementia, you have met one person.

Thank you to Kate who continues to be a beacon of hope living with dementia working to provide us with inspiration, love and truth. Admired.

Why a Trust Was Beneficial to This Caregiver

NewYear
My parents and kids celebrating a new year.

Most of us associate “estate planning” with death. I know I viewed it that way when my husband and I did our will the first time. It was right after we had our son and were taking a trip overseas without him. We wanted to make sure we had the plans in place in case we died on our trip. Very unlikely, but it is a big fear for many new parents and it’s usually the first time couples create estate plans. At that time, our plan consisted of a will and a durable power of attorney.

Good Estate Planning is for the Living 

After caring for two parents, my opinion of estate planning has radically changed. In general, lawyers do a terrible job of educating us on the legal documents every adult over 18 should have in place. The failure to communicate the benefits of creating powers of attorney (financial and healthcare) just adds overwhelm to caregivers already working to help their loved ones. Rightly or wrongly, most of us view estate planning as planning for what happens after we die.

If you are on the path to becoming a caregiver, you will need these two documents to be an effective advocate for your loved one:

  1. Durable Power of Attorney (DPOA). Simply stated, a DPOA allows someone to act on your behalf for legal and financial reasons.There are several situations where even a spouse needs to have this document to act on behalf of their betrothed.
  2. Healthcare Directives (otherwise called a medical power of attorney) gives an individual the ability to be your medical advocate and typically includes your wishes if you are severely ill or injured.

These two documents should not cost you more than a few hundred dollars. I recommend you work with a lawyer, because WHEN you run into resistance for the durable power of attorney, you will want the lawyers help.

The Department of Health & Human Services tells us that 70% of American’s turning 65 will need three or more years of long-term care services. That means most of us will need someone who can act as our advocate for our finances, and possibly even need to sell a home or use our assets to pay for our care.

My parents had property and a variety of retirement and investment accounts and set up a trust when they redid their estate plans in 2002. It made several aspects of managing their affairs much easier for me while they were alive and even more so after they passed away.

During my time as their primary adult caregiver, many of their financial institutions refused to acknowledge their durable power of attorney. We have a statute in Virginia that would have allowed me to file a lawsuit, but on top of caregiving, that was the last thing I wanted to add to my checklist of to-dos.

It doesn’t make sense that the trust was more accepted document, but it was and several elder care attorneys have confirmed this response from financial services firms. Luckily, I didn’t have to solely rely on the durable power of attorney that was declined by firms such as Wells Fargo, USAA, and Fidelity.

The trust gives you the ability to define how you want to live your life and for that reason, it was incredibly helpful to me when I needed to be able to help my parents. It also and include a host of instructions on how to use the money.

I’m not a lawyer, just an adult family caregiver who found this legal tool incredibly useful. Let me know if you would like the name of a trusted lawyer to help you draw up your documents. Believed.

 

 

 

 

 

 

Caregivers’ Circle – How to organize financial, personal and medical information on behalf of an aging relative

webtalkradioBy: Stephanie Erickson for Web Talk Radio
It is very difficult to get all of the information we need to make the right decisions on behalf or with our aging relatives. How do we organize finances? Manage investments? Gather medical information? Organize personal appointments? This week’s guest, Kay Bransford, developer of MemoryBanc: Your Workbook for Organizing Life offers her personal experience and how this led to the development of a simple method to keep track of all necessary information. She and I discuss all of the essential financial, legal household and personal information that should be collected and organized to assist you in helping another.

Caregivers struggle with knowing what to do when individuals with Dementia present with challenging behaviors and symptoms. There is an APP available that offers step by step interventions to manage a variety of symptoms such as incontinence, bathing challenges, repetitive discussions and aggressiveness. Learn more about Dementia Caregiver Solutions.

About: Stephanie Erickson is a Family Caregiving Expert and has a host of resources. She interviewed me for her show and I wanted to share the conversation with you in case we cover some new tips and resources that you may find helpful. Aired.

A Listening Tour about Which Papers are Important

Robert Sharpe, host of Bringing Inspiration to Earth radio show interviewed me about my journey. He focused in on the important documents and records I needed to be a competent family caregiver. We also discussed how the fact that my parent’s had dementia made this task much more difficult.

We talk through some real life stories and discuss the how and why these details are important to document for ourselves, as well as for our loved ones should they need the information to help us along the way.

To listen to this podcast, visit BlogTalkRadio.

Download a copy of the Important Documents Summary if you need this information for you or your family. Listen to this podcast for a walk through the list and how and why each item is important.

Wells Fargo Continues to Refuse to Accept my Durable Power of Attorney

wellsfargopt2Last Friday I posted Will Wells Fargo Accept Your Power of Attorney? Most people are shocked to hear that many banks will freely, but politely, decline to accept a durable power of attorney (DPOA). This is not the first financial services firm to say no. Three years ago Fidelity told me they would not accept a DPOA more than 2 years old; and a second one declined because it was more than 5 years old. The fact that they are doing this is frustrating and not supposed to happen. It’s complicated. I will continue to recommend you work with an estate lawyer who can help navigate this issue.

My parents did their initial DPOA in 2002. When I started to get the refusals, we worked to update their DPOA. Now that my mom is into a later stage of dementia, I need it to work so I can help continue to get mom the care she needs.

After my post @Ask_WellsFargo responded on April 30 and asked me to private message them my name and phone number. I did that. It’s been a week and no one has reached out to me.

Two days ago, the estate lawyer followed up with a letter asking that they honor my mother’s DPOA and allow me to access her funds so that they can be used for her care.

Dear Wells Fargo, The caregivers journey is already hard. Please don’t make it harder by refusing to accept the tools my mom put in place so that I could help her should she ever need it. Pleaded. 

POSTMORTEM
After getting no response from the letter to legal department of Wells Fargo, I went into my local branch every week to discuss the issue with the manager. Eventually, they worked with me to contact my siblings who were all named in the Trust to confirm that the money was to be used for my mom’s care. While in Virginia, I could have initiated a law suit, having that on my plate was one more task I wasn’t willing to consider. Thankfully, the employees at the local branch worked with me to help serve mom’s interests.

 

 

 

Lost in Translation: Recognizing the language barriers and today’s caregivers

twopillsOver the past year, I have interacted with at least 20 different individuals who have been involved in the care of my mom in which english was a second language. There were several phone calls where I had a very difficult time understanding the person calling to report on my mom. I also witnessed several times where my mom had trouble understanding her caregiver.

I appreciate the wide variety of individuals who have helped my mom. Luckily, because I live nearby, I could follow-up in person which made understanding the conversation easier.

Usually, this hasn’t been a big issue. However, last fall, when my mom started to have back pain, during the medical consult, I heard that they were going to give my mom “Tylenol.” I didn’t think much about it, but the medicine resulted in her transition into hospice. It was more than a week before I understood that my mom was given “Tramadol” not “Tylenol.” Within one day of the new medication, my mom was unable to interact or control any of her movements and I was totally confused about what had happened.

I now question and ask about possible side-effects even when I just think it’s just over-the-counter. Maybe that would have helped me understand what my mom was being prescribed. I have done this when something new was recommended, but it didn’t dawn on me to ask about “Tylenol”. There are so many varieties of dementia along with other drug interactions that can happen, it’s worth asking the follow-up questions to eliminate any misunderstanding. Suggested.