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?
I wish you good luck.
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.
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.