August 15th, 2011 at 11:10 am
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Are there problems with the checkbook?

by Kathryn Kilpatrick, M.A. CCC/SLP

Have you noticed your loved one is struggling to pay the bills? Does a checkbook appear unbalanced? Are bills being paid late? Although you may not be involved with the day-to-day financial management of an elder’s life, it is important to pay attention to money. Why? These financial miscues could be red flags for other problems.

Elders and money issues: what to watch for

Keep an eye out for the following items if you are concerned an older adult or loved one may be experiencing money management issues:

  1. Are regular bill payments being missed?
  2. Has the person stopped balancing checkbooks?
  3. Does the elder make mistakes when writing checks?
  4. Are bills accumulating?
  5. Has an account been overdrawn?
  6. Have there been major withdrawals or changes in investment accounts?
  7. Have the utilities ever been turned off?

Listen closely when your loved one mentions money or a financial scenario. For example, one woman–who never forgot a payment for anything–suddenly forgot to pay her car insurance. That was followed by the cable being shut off. Further investigation revealed the bill was not paid, even after late payment reminders were sent.

In another instance, a gentleman was about to withdraw all of the money from his investment account but his grandson contacted his parents when he overhead him talking about making the call.

Money issues? Where do you start?

Money and financial matters are not the easiest subjects to discuss. If you find it is difficult to talk about money without a reaction from the elder that closes the subject, turn up your powers of observation and wait for an opportune moment. Here are three steps to consider when you notice a loved one struggling to manage their financial life.

1. Offer some assistance

When I am assessing a client’s environment for any safety concerns, I try to learn more about how things used to be. While looking at the mounds of paper, a daughter shared they have been on her dad’s kitchen table for decades. She said he always knew what was where. Today, he lives alone and now has some short term memory problems as a result of a minor stroke.

My suggestion to this family was to monitor what is happening now. Reorganizing what was on the table may only confuse and upset an older adult. In this situation, he agreed for his daughter to work with him initially to assist in bill paying. He knew it would become obvious if he could handle it or if it was time to discuss some other options.

The daughter reported her dad could no longer keep up like he did before, and–eventually–the responsibilities shifted over to his family with his blessings.

2. Supervise the process

After suffering a stroke, a woman did not want to give up paying her bills, even though she was no longer able to spell or use her right hand. Although  therapy sessions focused on her goal of maintaining independence with writing her checks, she agreed to the recommendation of getting assistance.

She learned how to copy the names she needed with her left hand and she was given a cheat sheet so she could accurately print out the money amounts. The stipulation was that her sister had to double check everything before checks were mailed. For now, she was not having any issues and we set the stage for trust with sister should things need to change in the future.

3. Take it to the next level

One of my patients had several mini-strokes over a period of several months. After these episodes, family members reported him as being back to normal. However, when he experienced a major stroke later that year, the family needed to take care of his financial obligations.

Going into his checkbook they realized he had been unable to balance his checkbook. They could not make sense of anything. Fortunately, they were able to step in since the sister had been designated his Financial Power of Attorney after the first mini-stroke.

It is not uncommon for someone with Alzheimer’s disease or a related dementia to begin to show some difficulties in these areas while functioning fairly well in others. Discussions and interventions to assist earlier on may be easier than having to deal with it when there are more significant deficits.

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