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The Summer 2012 issue of the American Society on Aging’s journal “Generations” got me excited. Why you ask? For the first time we have a document summarizing the current knowledge of elder financial capacity and competency in America. Experts from economic, clinical, legal, and public policy research write up informative articles about this growing problem. One of the most important articles, I think, was written by Kristen L. Triebel and Daniel C. Marson titled “The Warning Signs of Diminished Financial Capacity in Older Adults.”
Individuals with mild cognitive impairment or those with early stage Alzheimer’s are particularly at risk for declining financial capacity and competency. They are the focus of this article. These individuals are likely to develop issues with the following financial skills perhaps even before they are diagnosed.
The Warning Signs
- Memory lapses – forgetting to pay bills, paying them late, or paying the same bill repeatedly
- Disorganization – misplacing financial documents, missing deadlines like when taxes are due
- Declines in checkbook management – changes in one’s ability to use a checkbook, for example incorrectly filling out checks, writing the wrong payee or payment amount, or calculating the wrong balance after a transaction
- Arithmetic errors – difficulty with making change to pay at the store or figuring out the tip in a restaurant
- Conceptual confusion – declines or confusion in general knowledge about concepts like your will, annuity, or mortgage
- Impaired judgement – judgement about the use of money or how to invest declines
The authors point out that considering an individual’s baseline (or normal financial ability and functioning) is the first step. Then look for any of the previously mentioned warning signs. Often the first financial skills to decline are the ability to manage a checkbook and the ability to do mathematical computations. The authors suggest action once warning signs are detected, and encourage family members to discuss any concerns with the older adult. It is important to respect the elder’s autonomy so they suggest the following:
- simplifying and setting financial routines
- consolidating accounts so the financial caretaker can keep track of the flow of funds
- putting the proper legal documents in place
- taking advantage of new bank technology (direct deposit, automatic bill pay, over-draft protection, and online banking) to help monitor and maintain the accounts
Financial exploitation is an increasing concern in the United States. Often these victims had decreases in their financial capacity but perhaps did not notice or did not acknowledge the decline. As the elder law attorney William Brisk mentions in a later article, “Being old does not make one incompetent, but aging is often accompanied by declining memory and other cognitive deficits, which can lead to poor judgement and even irrational behavior. The classic view of competence is that you either have it or you don’t. Like a light switch, it’s either on or off.” In reality, it is not that black and white.
Today the University of Massachusetts Boston has made the fourth edition of “The Guide for Elders: Planning that Protects You and Your Assets” available for free online. The Guide which started in 1993 and has continued to be revised over time (most recently in 2010) hopes to be a resource for older adults so they know what steps to take to get and keep their affairs in order. There are “increasing numbers of reports of elderly people being abused, exploited, or victimized in ways that rob them of their life savings and their dignity. Those cases involving financial exploitation saw elders victimized by friends, neighbors, and even family members.”
Financial and health care matters are often confusing and the Guide provides their readers with clear descriptions and scenarios to illustrate problem areas. After reading the Guide you should be able to answer a number of questions: Why do I need a power of attorney, health care proxy, or will? When should I consider entering a nursing home? What can I do if I get “ripped off,” or if I am the victim of a crime or abuse?
Although not intended as a substitute for individual counsel and assistance, the Guide will allow you to prepare and determine if your situation needs additional professional advice. As clearly stated in the introduction, “Elders need to know what steps they can take to avoid being victimized and what they should do when and if it happens to them. This Guide’s…emphasis is on prevention and avoidance of problems, with the recognition of the old adage that an ounce of prevention is worth a pound of cure.”
2010 saw the passing of the Elder Justice Act (EJA), the most comprehensive federal elder abuse law in U.S. history. We know from earlier studies that roughly 11 to15% of people ages 60 and older face some form of elder abuse each year. Experts agree this number is under-reporting and the scope of the problem is larger than we realize. According to a 2008 study by the Metlife Mature Market Institute et al., the perpetrators of elder financial abuse are typically not strangers. They are often businesses, service providers, family and friends who have gained the trust of the older adult. Here are some interesting findings:
- The victims of elder financial abuse are losing a combined total of $2.9 billion dollars annually.
- Women are twice as likely to be victims of financial abuse as men. Most of these women are age 80-89, living alone, and requiring some help in the home or with their health care.
- Nearly 60% of the perpetrator were men, mostly aged 30-59.
- The amount of money stolen by family or friends increased during the holidays.
Recently the researchers at MetLife updated these numbers, discovering that elder financial abuse cases have risen 12% since 2008. Though instances are increasing, data suggests that only one out of 43.9 financial exploitation cases are reported. Unfortunately the newly passed EJA can do nothing without the support of Congress and the President. Currently the Act only provides Congress with the authority to spend up to $777 million over the next four years on elder abuse. To actually see the money used, however, a separate bill must be passed by Congress and signed by the President.
Until this can get sorted out, and the EJA can strengthen existing adult protective services (APS), here are ways the report says you can watch out for yourself:
- Stay Alert – Don’t leave valuable items, cash, or checkbooks out in the open. Don’t be left out of decisions about your finances. Don’t sign anything without reading first and having someone you trust review it. If you are a concerned family member, be sure to ask periodically about the elder’s financial situation and keep an eye out for changes in their behavior (i.e. sudden worry about money) and any other sudden financial changes or unusual expenses.
- Stay Organized – Keep track of possessions, mail, and checking and savings account balances. Know who is calling and use an answering machine or caller ID to screen calls. Know who is asking for personal information and why (never provide this over the phone!)
- Stay Informed – Know where to go if you suspect abuse (your local APS, the police, or get help from bank employees). Talk to an attorney and keep track of your will, future caregiving arrangements and power of attorney.
- Report Abuse – Anyone (e.g. elder, family member, physician, bank teller, etc.) suspecting elder abuse should be reporting it to the local APS. Reports can be made confidentially and reporters are protected from civil and criminal liability. It is always better to err on the side of caution.
The Elder Justice Act comes almost 40 years after the passage of the Child Abuse and Neglect Prevention Act. Congress, and the general public, see the value in protecting vulnerable children from abuse and today we spend upward of $7 billion to help this effort. Surely vulnerable older adults deserve the same protection.