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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.

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I’m not a medical doctor but I hear so many older adults say things like “I can’t find my keys, am I getting Alzheimer’s?” or “My sunglasses were right on my head!  I hope I’m not losing it.”  I feel the record needs to be set straight. Cognitive illnesses are a growing concern for older Americans. The increasing number of delirium and dementia cases among elders have advanced the general public’s awareness of these issues. That’s great but don’t let it confuse you into thinking you and everyone around you has a problem (After reading below if you are legitimately concerned you should get the opinion of a medical professional right away).

Forgetfulness comes with age and you may now have a harder time remembering. But when you get tested for dementia they are not exactly checking to see how forgetful you are. Can you draw an analog clock showing it is 2:35? Will you know how much change you’d receive paying for a $1.95 pack of gum with a $5? Can you name 12 different animals? As you can see, these questions have nothing to do with how often you misplace your keys. John Hopkins Medicine tells us that doctors consider both your short and long-term memory loss AND one or more of the following:

  • aphasia – language problems
  • apraxia – organizational problems
  • agnosia – unable to recognize objects or tell their purpose
  • disturbed executive function – personality and inhibition

Dementia is a progressive decline in memory and at least one other cognitive area (attention, orientation, judgment, abstract thinking and personality). Types of dementia all involve structural damage to the brain. Dementia is rare in under 50 years of age and the incidence increases with age; 8% in >65 and 30% in >85 years of age. Alzheimer’s Disease is a type of dementia.

Delirium is an acute disorder of attention, memory and perception and is preventable and treatable.  It is typically of short duration but severe, and is believed to either disrupt brain metabolism or brain chemistry, both of which can significantly affect brain functioning. The diagnosis is unfortunately missed in more than 50% of cases.

Mild Cognitive Impairment (MCI) is a condition involving problems with memory or another mental function (for example language) severe enough to be noticeable but not serious enough to interfere with daily life. This can progress to dementia and the risk of progression to dementia is elevated for people with stroke, depression and a high burden of other medical conditions.

If you want to do more to help, the Alzheimer’s Association’s Walk to End Alzheimer’s is happening in the next few months all around the country. I know I’ll be walking to increase knowledgeable awareness about dementia and delirium and to raise money to help find a cure (or even just a better understanding) of these heart-wrenching diseases.

Employment over one’s life time is rarely with a single company. Individuals often change jobs or employers over their working years. People leave to have children, to go back to school, or to try their hand at running a business.  All these changes in employment could confuse retirees trying to determine what pensions they are entitled to. And let’s be honest, who couldn’t use an extra $100 a month.

For New England residents there is a free resource that I’d love to share with you. The Pension Action Center was launched in 1999 and is based out of the University of Massachusetts Boston. Its primary program, the New England Pension Assistance Project, brings together pension experts, pension lawyers and a group of dedicated, knowledgeable volunteers to help you understand or obtain your pension benefits.

As their website states, the goals of the Center are to:

• offer individual counseling and assistance
• help you negotiate layers of bureaucracy
• help locate pension funds
• explain the benefits and rights under your pension plan
• supply referrals to attorneys if needed
• supply a listing of financial advisers if needed

The Pension Action Center complied this informative booklet in 2009 to help retirees answer a few burning pension questions. Am I entitled to a pension from my former employer or my spouse’s former employer? Where do I start looking? What documents will I need to understand my situation? What resources are available in my state? I think I have a lost pension, now what?

Employers are not required to provide a pension, so everyone’s results will be different. But now more than ever it is important to make sure you are getting all the benefits you are entitled to from your years of hard work. Check out the booklet to read more or contact the Center if you’d like to talk to someone directly. No one should be missing out on their much needed and well deserved retirement income.

The New England Pension Assistance Project
Phone: (617) 287-7307 or toll free (888) 425-6067
Fax: (617) 287-7080
E-mail: npln@umb.edu

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