I am the durable/financial/ POA for my mother (72 yo), who lived alone and independently. She had a life-event (CHF) in mid-February this year, and I suspected that something else cognitively was going on as well since December 2020. During her hospitalization, I demanded that the doctors test her. Based on those initial results, they recommended further follow-up with a geriatric Internist.
Post-hospitalization, we followed up and had her more formally tested (MMSE). Her Geriatric Internist suspects other medical conditions may be a factor and does not want to formally diagnose her (with Dementia) until she is under treatment for 4-6 months then assess her again. During her hospitalization recovery, we have hired a 5-day week care-giver to assist her with treatment plans, health and medication checks, social, physical, and mental engagement. My brother and I support these activities on weekend (alternating) so that it is not such a financial crush while she can still somewhat make meals.
I had a chance to peek into her finances, and I am appalled. She has more credit card (CC) debt than she says (flagrant spender personality); There are clearly fraud charges on her account that she has not caught or realized they are hers. She easily thinks money has not been received, which I have shown her was deposited into her bank account. I believe she is spending more money than what is coming in. I have shown her the CC statements and asked her which ones are actually her purchases/charges so that we can submit fraud. We have even received notices from a few of the CC companies that they suspect fraud on her account, but she has not actioned on them (loss of executive function?).
She has never been one to be fiscally responsible. I would like to set her up on a sort of monthly budget to address the debt, and so that she is aware of where her money is going and what is coming in. She has resisted my attempts so far, and I have even suggest if she is not comfortable with me doing that she hires someone. I want to make sure she has the funds to support her for the long-term, as I am concerned that we will get that formal diagnosis of dementia and need MC/ALH. I think she believes I am trying to take over. I have read a few posts about others with family members with dementia and this disease appears to be a long one (12+ years), and we are fairly early in her situation.
Am I fretting about financials too early? What lessons have you learned during your caregiving time that you wished you knew sooner or would tell your younger self?
You won't need to resort to the DPOA for this, your mother can give her permission for the company/ies to discuss her account with you over the phone.
She has been ignoring the situation intentionally, and that probably means it hasn't stopped her feeling sick with worry about it. Get it sorted and out of the way, and perhaps the relief will be a good basis for better management (and confidence in you) in future.
What you do next will depend upon what authority you do or do not have. I would not waste any time setting up a budget. 1) she has proven to not care or live in reality regarding her finances, and; 2) if she does have cognitive impairment a budget will be for you to manage, not her. She won't be able to follow it.
A PoA's power may be in force if she is temporarily cognitively incapacitated, so you may want to check the document and then decide to try to clean up her mess or not. No, it is not too early to have your finger on the pulse of what's going on since you'll be managing it eventually, anyway.
The lesson I learned was to take advantage of your mom being out of her house and look for other problems and struggles she's having. My MIL had countless cartons of checkbooks that she kept ordering because her short-term memory was fried. She'd write one check out of one book then open another carton (12 boxes of checks in a carton) and write another check and nothing was documented in her checkbook ledger. Other bills weren't getting paid, she was upside down on a ballooning 2nd mortgage, behind on property taxes, medications weren't being taken correctly, food was spoiling in her fridge, etc. It shocked us because she didn't seem "that bad". She was not even remembering to feed herself.
I took the opportunity to take pictures of her driver's license, Medicare card, SS card, bank account number, homeowner's and car insurance, and took possession of cc's that she wasn't (or shouldn't be) using. By doing this I opened up online banking for her so I could monitor her account for balance and fraud and set up BillPay for more important bills to be paid on time. I sorted through her mail first to find the bills and throw out tempting junk mail. I found any medical records and took pictures. In short, I saw a train wreck coming and all I could do was minimize its impact on the both of us by being preemptive.
FYI your mom should designate you as her Medical Representative so that her medical team can discuss her health issues with you without her being present. This is separate from medical PoA and has to do with HIPAA rules. Ask the clinic or receptionist at each doctor's office for this form for her to sign.
Finally, please be aware that unless she is very wealthy, she might need Medicaid to pay for her care and many states have a 5-year "look-back" period on the application. Please find out what it is for her state. I recommend you and her invest in a consult with an elder law attorney to understand the minefield of financial transactions that could easily delay or disqualify her. Even if she doesn't go, you should. My in-laws were selfish spendthrifts their whole lives and never learned their lessons from being in debt over and over. They put their entire family into a terrible position by never planning and going into their retirement not only broke but deeply in debt yet expecting us, with a young family and a business to run, to be their hands-on caregivers and retirement plan. Don't feel guilty if she winds up in a less-than-ideal care situation: this is what she planned for. She had her entire life to learn and save and chose not to do either. You are not responsible for her happiness. Just do your best and eat the elephant one bite at a time, especially if you start early. I wish you all the best!
Everyone should have a HIPAA draw up by an attorney that specifically says that it never expires and is intended to be valid in any jurisdiction that it is presented in.
The ones that you sign in clinic are only valid for 12 months. The time that you find this out, usually in the middle of a crisis and the office staff are happy to tell you that you don't have a valid HIPAA release.
It is worth the effort to get a lifetime HIPAA release for your DMPOA.
I wish you good luck.
I have DPOA over my Mom (at the time, 2015, she had early stage Alzheimer’s).
She was sending checks to every piece of mail that looked like a bill (most were just junk mail trying to get you to buy things). She was paying bills twice sometimes, and logging the checks incorrectly.
she would dial 911 every time the power went out (in her mind, it WAS an emergency..!). These behaviors started to pile up, so I started a log with behavioral notes from every time I went to visit her.
I had to sneakily get her Credit cards away from her and with my DPOA, cancel them all. I told her that as POA, I needed to make copies of the CCs.
She even told me she had a CC somewhere but couldn’t remember what happened to it..!
maybe she could be given a Visa gift card as her official “credit card”?
it is tricky as they still have cognitive ability early on, and become more paranoid as the disease progresses.
I did take her to a well known geriatric neurologist to get her officially diagnosed, and to seek advice from her on how to best proceed with approaching these topics such as bathing (or lack of), money issues, etc.
good luck it is a long road. You have to remember to take of you first.
The doctor had her brain scanned, did a memory test and assessed that mom has normal aging as well as vascular dementia progressing to ALZ symptoms. This was not evident to mom other than she kinda knew she needed help. I was in the meeting with her and every meeting with doctors. I specifically asked the doctors for a treatment plan to help mom and they all said that there is no reversal. When I got mom home, I prayed for wisdom and early in the day (she is worse in the evening), I offered to set up her accounts to get the most benefit and reduce the negative impact of debt. Once I got her agreement, I got all her accounts in front of me, did a budget and let her know that she needed $$ to live (food, insurance, maintenance, bills). I showed her what was left over (after I pulled out a percentage for emergencies). I was serious and concerned and told her I wanted her to be as independent as possible and me handling her finances is what rich people do-except they pay for a bookkeeper!
Then, I went about reducing her debt. I got a DPOA for her and called each of the CCards and cancelled the card. I did not tell her this because she is not wise. I got her a debit card and asked her to keep all of her receipts and daily keep a record (on a calendar) of what she spends...every penny so she can see her outlays.
This effort showed mom that she was spending more than she thought and also that she struggled with doing this simple task.
Once the CC had cancelled accounts, I sent them a reduced amount (less than the minimum because she could not afford it with the explanation that there was a medical issue and no more money was available for payments. Eventually, the CC people negotiated with me and most settled for 50 percent of what she owed. She had these card for years and the interest was killing her. Prayer prepared my words and mom’s heart for all interactions and I am grateful that she is safe and her finances are in order.
Now his kids have a father with no income. The stories are legendary.
My mother, for example, decided to close her main bank account, not realizing that all of her deposits went into it. When I explained that, she was shocked. "I don't get deposits," she claimed. She was clueless, typical of her generation but still a problem.
One thing I have learned in this role is that it is better to be little too early than a little too late. When you think it might be time, it is time.
How to do this? Be creative. You know her. Read up. There is loads of information. But make it happen. Take charge or regret it later!
Good luck!
That said, rather harshly, let me say this. Mom will deny forever that she has a problem, If dementia is a factor here, she will only be more and more confused or in greater denial about money. It is going to be natural for her to deny she needs help, not only because her abilities to handle money properly, but because she literally will not see what is happening. She believes/feels she is fine with all of it. Please understand, her reality is in her mind and she believes she is OK. Don't try to convince her otherwise, just take over.
This is not going to be an easy process, she will fight you every way she can. If you have signed the documents for POA, you have the legal right to take over. I would verify this with the Attorney, but that is what I found when I had to do this for my Mom. All I had to do was -- "do it". It is, in fact, what she wanted when she gave you POA.
All this is meant to say, in part, that when we are a "caregiver" for a parent/whomever we also find ourselves giving our own excuses for our inaction. That inaction being the taking over some of the necessary activities of living -- usually the financial dealings, activities that our loved one has always been able to handle. It is in some ways our own denial, seeing those parts of our loved one failing and we don't want to see nor accept this ourselves. In ways we are now the adult and the adult is now the child. Just a fact and does not need to be explained to them, they will not understand. Just give all the love you and no matter what the reaction. AND talk to someone, not family, someone who can listen, perhaps a counselor. You, too, need to be able to express your concerns, finding a way to help you understand all of your decisions. Someone not invested (Involved) in the situation.
Do all this with the love and strength you can gather. It is our love and acceptance of the loved one as they are today, not what we have been used to or with they still were, that will allow us to move ahead with grace. When our loved one has Dementia, it is never too early (NOR TOO LATE) to step in and take command. Do it with love and always tell them what you are doing. I did this until Mom was no longer interested (and she let me know when).
Stay Calm, Stay Safe, Stay Loving. It is a journey and not always a good one, but one that one day you will be able to say "I did the right thing". God Bless all of you!
According to the OP, mom is only 72 and her doctor doesn't want to make a formal dementia diagnosis for another 4-6 months. So I don't believe there's a lot that can be done in the meantime. I would suggest continuing to monitor as you are able, and come up with a sample budget that you can leave with her to review. Don't nag, but don't give up. Consider anything you can accomplish financially a victory...paying off one credit card, adding you to her checking account...anything. But definitely keep your antennae up regarding finances.
Side story: My mom was stubborn too. Would not get a will or anything like that, so I felt the responsibility was on me to get my own affairs in order in case something happened to me before her. So I set up a revocable living trust for myself. When she heard about this, I guess she didn't want to be left behind. So that was how I got her to the attorney. Not a total victory: she got the will, but not the trust because she was only willing to pay for the will. :) So try and think outside the box. Good luck!
Despite having a stroke and being hospitalized, no one had diagnosed either of them, their family doctor was pretty much useless. It seems the neighbors knew they had problems, but the professionals around them didn’t.
My mom had gone on a spending spree in 2012, bought a new car (which my dad couldn’t / shouldn’t have been driving) because it was too big, and purchased a 50k cruise with no medical insurance in 2013. My Dad was hospitalized on the ship most of the time.
Back to the Ops issue. I never received the POA from my parents because they were both too far gone by the time I realized anything was wrong. Although they both showed signs of dementia in 2009, we didn’t actually get a formal diagnosis until 2016. By that time, my father was in late stage Alz, and Mom had been suffering cognitive decline for 15 years.
I started by just letting her see the bank statements at the end of the month. Although she added me as a beneficiary, she never added me to any accounts, so I’m still an outsider, but I did know her financial advisor before this all started, so he’s been very helpful
without me having a POA.
I've found just giving her the statements every month works, and most months she forgets about them.
I also never obtained a medical POA, and let me say that again, it didn’t seem to matter. When my dad was sick, the medical staff all wanted me to sign off on everything. I was the one forced to sign the DNR when my Dad ended up in hospital for the last time.
As for my Mom, she continues to have cognitive decline, and refuses most medical treatment.
One final note - occasionally she asks me about taxes, and I tell her they are filed. This always makes her happy, though I omit to tell her how much she had to pay in taxes each year.
I had a client once that was given phony money, it looked real but was a little smaller. She never knew the difference. You could try this.
I hope both of them see a neurologist that specializes in dementia. I had one for my mom and he was a big help.
1 - Get doctor to declare her mentally incompetent now. When she has recovered, the doctors can reevaluate her cognition and upgrade the diagnosis.
2 - Contact all the places that your mom has financial dealing with so they will work with you.
3 - Set up plans with financial institutions to streamline payments: auto bill payments, replacing credit card with reloadable gift card for "fun spending", and fraud/scam alerts that go to you.
4 - Use your judgment about how you explain this to your mom. You might want to say that you are "helping to make sure her bills are paid while she is recovering" which is the truth.
I’m in the process of getting one so I wish I had more detailed info for you. Fyi I also have a joint account with my mom - she agreed to that - and have paid for various ‘mom bills’ via that.
Best of luck!!
These documents are required when contacting banking and investment, etc., institutions. And, then they STILL may want their own documents used.
Setting up a budget doesn't mean MD intervention is needed unless you are managing her actual finances, i.e., taking out of her account. You might want to get your name on her account(s) if that is easier.
You need to keep very accurate records.
It is strongly suggested that you do NOT co-mingle accounts, i.e., as needed have separate checking etc accounts (in your name for her).
Re-search POAs requirements and as you feel necessary contact an elder care specialist / attorney (which I presume many here have suggested). Gena
We were informed by the bank that although the power of attorney is effectively immediately upon her incapacity or us just deciding to take over the POA does not give me power to act in behalf of the trust and since the bank account is in the trust I have no power to take over.
In order to take over as successor I have to have a doctor declare she is totally incapacitated. And not only do I have to have a doctor's letter, I will need to have two letters. This is because of some weird thing my parents put in their trust. "Incapacation has to be proved by committee, which consists of two doctors and a pastor (if they have a pastor). I had to consult with the lawyer to see if this was correct interpretation by the bank, and she said yes. The other option wars a noterized letter signed by mom saying she is resigning from her role in the trust.
Distance and moms conditions are making both options extremely difficult. So I am trying to get the letters fro the doctors. I have one but have been trying to get the other for weeks. Now that she is totally incapacitated it is impossible to get her to the doctors and now it's like a hot potato. The doctors and social workers want to pass this around like a hot potato. I think I FINALLY have this resolved and expect the second letter in the mail in a day or two.
This has been so difficult I cannot tell you. We need access to the funds to pay for her 24 hr day help at home and I have been paying out of my pocket.
I could go on for hours as I'm sure many of you can. We did hire a lawyer because the worse mom gets and as we search for documents we need, the more we find that needs to be fixed. Although we have a lawyer I try and do as much as I can as every contact with the lawyer costs. It has been very helpful to have the lawyer and I think the only way to navigate some of these difficult issues.
Good luck to you.
However, my mother was recipient as survivor of my dad's pension - federal! NO federal entities honor any POAs. They have their own rules. I wrote to mom's doc about getting a letter. I sent a copy of ALL the documentation AND a copy of the POA, HIPPA, etc. They made us come in. That was a LONG day - about 1.5 hrs just to get to mom's, then driving unfamiliar areas, etc. I was in the room when the tech/nurse came in to begin. Mom got so snippy/nasty that I left the room. Doc was at the counter and saw this, so he chatted with me. He said he would do the letter. NINE months later, after multiple portal pings and phone calls, resending them copies of the documents I had sent, as they said they needed it (told them they got it BEFORE the appt!!), I still had nothing. Two of us were already on her account, so I could pay her bills, but she would often misplace stuff, and I would need the 1099s for taxes. Once we moved her to a facility, I would need all paperwork sent to me because we planned to sell (or rent, but don't want that going to a renter!) You can't forward federal mail either.
NINE months and I never got anything from them. It took 2 tries to get just the right words to get approved. What a nightmare that was!
I was able to do everything else with the POA. SS transfer to another account can be done through the financial institution. I had to do that initially, so I could close another account she opened so she'd have access to local ATMs and bank, if needed. None of them knew me from a hole in the wall, but they accepted the document and did what I asked. I had mom in tow both times, but she never said boo, she just stood there rifling through her wallet and purse!
If that first doctor had been local, I would have been up their behind IN PERSON every day to get the deed done. Even their phone system left a lot to be desired. You'd go in circles with the menu and end up with the hospital operator again. UGH!
How sad to set up accounts that way. I understand the concept - protect oneself from over-aggressive family (it happens!) As noted, thankfully we were on mom's account and had the POA (nothing I found in it specified if/when to take over, I just did it when it was necessary - never had even looked at the account before that. The trust was set up as a result of her showing signs of dementia. We caught it early enough that the atty was able to question her and accept she knew what she was doing.
There are a lot of people who charge up credit cards and buy plenty of things they don't need or someone else's wouldn't agree with.
So, the most you should do is talk to her about your concerns.
She may be more receptive to help if she thinks the bank is worried about her money/acct
You are in a rather touchy position. She hasn't been declared, but clearly is in over her head. If she is refusing and the POA specifies needing medical documentation, you're going to have to try to wear her down. Although you alternate weekends, could your brother be there to back you up? Document everything as simply as you can:
* total income for the month
* list average billing for all regular bills (utils, etc)
* list minimum for all the CCs
Tally the income minus the other two. If the balance is negative, make that plainly clear. If it isn't, show her how each minimum CC payment is only paying a small portion of the balance - the rest is eaten up by interest and fees.
Also, work on the potential fraud. IF you can call them from her phone and get her to agree to let you talk to them, you can discuss her options with them. Find out what she/you need to do to handle the fraudulent charges (for starters, the cards should be cancelled and if desired have a new card/different account number sent.)
Since she is "recovering" and you have care givers, perhaps you can approach the finances in that respect - let me help you get this all straightened out while you are recuperating. We can work on it together.
This is one area where sometimes dementia makes it a little easier. Not always - some have some battles when taking over finances. I had offered once to take it on, when she was complaining it was all too much. Immediate about-face, saying "It gives me something to do." More likely that should have been "It gives me something to mess up."! Fortunately mom's finances were not in bad shape. Previously I had spent a lot of time trying to balance her register (she waited way too long to ask me to do this!) Generally I will stick with it until I resolve all discrepancies, but it finally came down to a few dollars and some change. I decided I'd spent enough time on it and wrote that off.
For me the clincher was "The Year of the Neverending Snow." She lived in a condo and they had exceeded their snow removal budget, so they were hitting everyone up based on where in the complex their condo was. This was broken into 3 payments, to make it less painful. Hers was something like $239 per payment and she wrote a check for $2.39. I contacted the condo office and asked them to shred that check and I would send the correct amount. After I took over, I discovered she was adding a tip to the monthly newspaper bill (Sunday paper only) AND was writing a check out to the delivery man too! He would leave an envelope with the paper. She would forget that she added tip to the payment. He got something like $70 in less than a year. Needless to say, he didn't get another tip...
In her case, once I took the checks and put temp forward on her mail, she more or less forgot about it. For a while I let the statements go to her, but she was messing those up (she would file the pages separately, sometimes tearing the pages in half.) That combined with digging out old papers and confusing me with statements about people dying and leaving her money (1099 said Death Benefits!), I asked YB to take her out for a bit and I would "sweep" the place. By then I knew where most papers were, so I just grabbed them all and bagged them! All was good until the yearly insurance bill arrived - I'd missed that with the temp forward. She requested checks, which were sent to me. She requested again and they told her I had them. Never said a word to me!
BTW, none of the billers (utils, water, RE tax) ever asked for the POA. I just had them change the billing address and used the online system to pay them (not the auto payment, I don't care for that myself!)