Q. My aunt is in the early middle stage of dementia. She lives out of state, alone but in assisted living. I have financial Power of Attorney but she doesn’t want me involved. I worry about the consequences if I don’t get involved, but worry about damaging her sense of dignity if I keep trying to convince her that I should be involved. If I push too much, I fear she will shut me out completely and I won’t be able to help at all. How much should I push?
A. The POA does not legally obligate you to take over a person’s finances, for example, but if dementia is a concern, that person’s finances are at risk. Financial loss due to error or scam could seriously affect a person’s ability to pay for medical expenses and long-term care in their last years. It could affect that person’s ability to pass wealth on to descendants or other people or entities. It could even affect the security of other family members’ finances. So it’s worth continuing to push for involvement. Even if it feels uncomfortable.
A person with dementia might have problems managing bills, making investment decisions, or recognizing and avoiding phone, text, email, and mail scams. Sometimes it’s easy to recognize a scam, but other times scammers can be much more deceiving. A person with dementia may not be able to recognize the tricks scammers use to steal identities, max out credit cards, and wipe out bank and investment accounts.
Those with dementia might have problems with self-regulation – exercising delayed gratification, moderation, and risk temperance. They may fall prey to get rich quick schemes, gambling problems, or loaning money to others. In addition to faceless scammers, financial “predators” may also be people within the sphere of a person with dementia.
Invoking “Third Party Bad Guy”
In a recent post, I proposed a “third party bad guy” strategy that may work when trying to get a loved one to stop driving. Today I propose a similar approach for convincing a loved one to let you, or another loved one, be involved in or oversee the financial matters. Lately I’ve been working with a dementia caregiver on this issue and my “third party bad guy” strategy seems to be working.
I have mentioned scammers twice so far. Phone, text, email and mail scammers are the scapegoats I recommend when finances are at risk during the progression of dementia. Similar to the driving example, the conversation about financial involvement/oversight and Power of Attorney paperwork should be based not on the loss of skill a person with dementia is experiencing but rather the fact that scammers are so rampant and the damage could be potentially colossal.
Chances are, you can share some stories about friends, sadly, who have been trapped in these scams. You can talk about how devious the scammers are and how authentic they can make their solicitations seem. You can talk about the real or potential loss of money and the problems the scammers create. If you don’t know anyone who has fallen prey to scam, and some details of his or her story, an online search can reveal a huge supply of real life stories to draw from as you add dimension to the potential vulnerability we all have.
Make it personal
Then bring the scenario close to home and give some examples of the damage scammers could cause to your loved one’s plans and intentions for legacy and loved ones. Be careful – the goal is to make it seem plausible (because it is) without causing undue anxiety.
Implying or suggesting a loved one is mentally incompetent often backfires. But blame the vulnerability on “senior scammers” and cyber attackers and you may have more success. Invoking the third party bad guy, with stories as dire and compelling as possible, takes the focus off of your loved one. I recommend that you never bring up the topic of cognitive changes or dementia. Instead, center your concerns on your loved one’s vulnerability as an aging person, particularly in the light of this modern day surge in scams. The third party bad guy strategy casts the focus and scrutiny away from the loved one with dementia.
Finding a middle ground
Loss of financial independence will likely be psychologically devastating for many of us. For a person living with dementia, whether aware or not of a decline in his or her cognitive skills, giving over Power of Attorney and/or financial privacy/agency may seem too much. Some may feel that they are being robbed of their joys, their purpose, and/or their identity because independence is being taken away. Others may feel that giving financial power to another person is surrendering to their cognitive loss. And some will resist relinquishing their privacy. A middle ground position may work to encourage those with dementia to trust their POA and allow his or her involvement.
In this middle ground, the person with dementia still has a discretionary spending account and/or savings account he or she can manage independently. The POA makes regular, small deposits to this discretionary account(s) – but not enough to be consequential if it did fall prey to scammers – and the loved one has decision making, spending, and managing powers over it. In this middle ground, the person with dementia maintains some independence, while caregivers with Power of Attorney can be confident that they have acted to protect their loved one against financial loss while preserving the long standing spirit of the relationship.
Over time, dementia will affect a person’s ability to interpret and process visual data, auditory data, tactile data, and olfactory data to protect them. When a person with dementia can no longer rely on these skills to survive and thrive, he or she feels, and becomes, increasingly vulnerable. Living with dementia, a person has no option but to rely on others. If a person with dementia, already feeling vulnerable, cannot trust a caregiver, it is hard to give him or her care, let alone succeed in caregiving.
The sage poet Maya Angelou advised us that (paraphrased) people won’t remember what you said or did, but they will remember the way you made them feel. This is especially true for those with dementia. As a person’s dementia progresses, he or she will rely more on emotional data than factual data. Any time a dementia caregiver suggests or does something that makes the loved one feel vulnerable, trust is eroded. If trust is eroded, that loved one may shut caregivers out.
When financial matters and health matters are only attended to by the person with dementia it can be devastating to families. So it’s important to seek to establish Power of Attorney protocols – even if you anticipate resistance at first – and use them once they are granted. If a person won’t accept your POA involvement, keep attempting to present it as the protection that it is rather than a referendum on his or her cognitive health or ability.