Often to the outside world, an elder may appear to be managing well. In many areas of life, they may well be. However, sometimes, when we start to dig deeper (think of peeling an onion), we find things under the top layer that raise a red flag.
Managing finances, such as bills, taxes, and banking, might be an issue for your elder loved one long before it becomes evident to your family. Mailboxes, both virtual and actual, are inundated with Junk Mail, and sometimes important items are not dealt with promptly. Forgetting to pay a bill can happen to us all, but if you are dealing with sensory deficits, especially failing vision, memory loss, confusion or cognitive dysfunction, it becomes a more significant problem that can get out of hand quickly. To acknowledge that they are struggling to manage their finances, once considered a hallmark of adulthood, is an embarrassment to your elder. You will need to approach this with sensitivity, patience, and strategy.
Financial abuse = elder abuse.
Today, it is the most prevalent form of elder exploitation. Aberdeen Caregivers regularly report the arrival of callers or visitors to our Clients' homes, seeking donations for one cause or another. Most often these solicitors lack proper identification from the organization that they claim to represent. We read in the paper and hear in the news about caregivers stealing from clients, financial professionals diverting funds from accounts, the "IRS" or "Electric Company" calling looking for money, however, it may come as a surprise (and a shock) that financial exploitation and abuse often comes from someone known to the elder.
How do we protect the finances of our elder loved ones?
If your elder does not have Power of Attorney in place, I urge you to seek professional legal services. If you are not already working with an Elder Law Attorney, I refer you to the Essex County Estate Planning Council, a local organization consisting of professionals specializing in a wide range of services relative to elder care. Visit their website at EssexCountyEPC.org to find a list of elder specialty attorneys who can help set up comprehensive and secure legal protection and advocacy.
If your loved one has always been the person who “paid the bills,” it may be hard for them to let go of that role and transfer the responsibility to someone else. If your elder loved one has any background in banking, accounting, or finance, allowing someone “in” could be particularly challenging.
Take an inventory of their current process and assess the extent of the problem.
Bill paying can easily become a stressor for elders. Personal finances are often held extremely “close to the chest,” even more so than medical information. Accepting help, even from family, may be a challenge. If you try to have the conversation and meet a lot of resistance, consider a visit with their financial professional or banker. They could offer a variety of options to manage bill paying differently, which may normalize it as an “updated” way of doing things.
Create a system for managing cash.
If you have a team of family members or caregivers helping to meet your loved one's needs, managing the expenses of household inventory and groceries can be a challenge. Centralize the process by use of a petty cash system (a running in-home cash balance tally) or use of a debit card and recording all receipts (cataloged using your method of choice). If there are many members of the support team, this can quickly become chaotic. Simplifying the system can eliminate at least one headache for all involved. There is always the risk of having cash diverted or debit cards misused. Perhaps restricting access to cash and debit card to a select few can increase accountability and reduce the possibility of errors and exploitation. You must monitor whatever system you choose; statements need review and cash expenses need receipts.
Management of cash is an ongoing challenge for elders. Your father's normal lifestyle and routine may have always been to carry $300 cash in his wallet. Without that amount of money available, he may become agitated and suspicious that a theft has occurred. Depending on your elder's level of awareness, a few large bills inside a wallet filled out with many small bills can satisfy the need to have "plenty of cash" on hand. Often, elders with dementia or cognitive impairment move things around from place to place, wanting to make sure “it is safe.” I have found passports, jewelry, large sums of cash, expensive household items, checkbooks, medications, and other important legal documents in places like the freezer, oven, dryer, under mattresses, in shoes, under carpets, and the list goes on. I imagine, like me, you have “put it in a safe place” and promptly forgot where that was. If it can happen to us with no diagnosed cognitive issues, imagine how it is for our elders who have been.
Just like medications, nutrition, and home safety, your elder may need your support with financial management. You may come up against barriers when offering help, even when your elder’s efforts to self-manage are not successful. Sometimes our elder loved ones continue to see their children and family members as the “youngsters,” even though they may be well into their 50’s and beyond.
Receiving help for sensitive and private money matters may be very difficult for them, and they may resist. If that’s the case, reach out to your resources. If you have a comfortable and confident relationship with an accountant, lawyer, banker, or financial advisor, call them for help. Sometimes, it is easier to accept a suggestion if it comes from a third party and not those in the elder's “inner circle.” If you do not have these resources to draw on, call your local Council on Aging. As much as you think your situation is unique, scores of other families are dealing with the same issues. As we always say, “no need to go it alone.” Help is a phone call away.
Joanne MacInnis, RN, is the founder and president of Aberdeen Home Care, Inc., of Danvers, a concierge private duty home care agency in business since 2001. With 35 years of nursing practice, management and administration experience focused on home care and hospice, Joanne and her team specialize in advising and supporting families addressing the elders in their lives retain dignity and quality of life.
