I am the durable/financial/ POA for my mother (72 yo), who lived alone and independently. She had a life-event (CHF) in mid-February this year, and I suspected that something else cognitively was going on as well since December 2020. During her hospitalization, I demanded that the doctors test her. Based on those initial results, they recommended further follow-up with a geriatric Internist.

Post-hospitalization, we followed up and had her more formally tested (MMSE). Her Geriatric Internist suspects other medical conditions may be a factor and does not want to formally diagnose her (with Dementia) until she is under treatment for 4-6 months then assess her again. During her hospitalization recovery, we have hired a 5-day week care-giver to assist her with treatment plans, health and medication checks, social, physical, and mental engagement. My brother and I support these activities on weekend (alternating) so that it is not such a financial crush while she can still somewhat make meals.

I had a chance to peek into her finances, and I am appalled. She has more credit card (CC) debt than she says (flagrant spender personality); There are clearly fraud charges on her account that she has not caught or realized they are hers. She easily thinks money has not been received, which I have shown her was deposited into her bank account. I believe she is spending more money than what is coming in. I have shown her the CC statements and asked her which ones are actually her purchases/charges so that we can submit fraud. We have even received notices from a few of the CC companies that they suspect fraud on her account, but she has not actioned on them (loss of executive function?).

She has never been one to be fiscally responsible. I would like to set her up on a sort of monthly budget to address the debt, and so that she is aware of where her money is going and what is coming in. She has resisted my attempts so far, and I have even suggest if she is not comfortable with me doing that she hires someone. I want to make sure she has the funds to support her for the long-term, as I am concerned that we will get that formal diagnosis of dementia and need MC/ALH. I think she believes I am trying to take over. I have read a few posts about others with family members with dementia and this disease appears to be a long one (12+ years), and we are fairly early in her situation.

Am I fretting about financials too early? What lessons have you learned during your caregiving time that you wished you knew sooner or would tell your younger self?

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Start by reading your PoA document to see when exactly your authority is legally activated.

What you do next will depend upon what authority you do or do not have. I would not waste any time setting up a budget. 1) she has proven to not care or live in reality regarding her finances, and; 2) if she does have cognitive impairment a budget will be for you to manage, not her. She won't be able to follow it.

A PoA's power may be in force if she is temporarily cognitively incapacitated, so you may want to check the document and then decide to try to clean up her mess or not. No, it is not too early to have your finger on the pulse of what's going on since you'll be managing it eventually, anyway.

The lesson I learned was to take advantage of your mom being out of her house and look for other problems and struggles she's having. My MIL had countless cartons of checkbooks that she kept ordering because her short-term memory was fried. She'd write one check out of one book then open another carton (12 boxes of checks in a carton) and write another check and nothing was documented in her checkbook ledger. Other bills weren't getting paid, she was upside down on a ballooning 2nd mortgage, behind on property taxes, medications weren't being taken correctly, food was spoiling in her fridge, etc. It shocked us because she didn't seem "that bad". She was not even remembering to feed herself.

I took the opportunity to take pictures of her driver's license, Medicare card, SS card, bank account number, homeowner's and car insurance, and took possession of cc's that she wasn't (or shouldn't be) using. By doing this I opened up online banking for her so I could monitor her account for balance and fraud and set up BillPay for more important bills to be paid on time. I sorted through her mail first to find the bills and throw out tempting junk mail. I found any medical records and took pictures. In short, I saw a train wreck coming and all I could do was minimize its impact on the both of us by being preemptive.

FYI your mom should designate you as her Medical Representative so that her medical team can discuss her health issues with you without her being present. This is separate from medical PoA and has to do with HIPAA rules. Ask the clinic or receptionist at each doctor's office for this form for her to sign.

Finally, please be aware that unless she is very wealthy, she might need Medicaid to pay for her care and many states have a 5-year "look-back" period on the application. Please find out what it is for her state. I recommend you and her invest in a consult with an elder law attorney to understand the minefield of financial transactions that could easily delay or disqualify her. Even if she doesn't go, you should. My in-laws were selfish spendthrifts their whole lives and never learned their lessons from being in debt over and over. They put their entire family into a terrible position by never planning and going into their retirement not only broke but deeply in debt yet expecting us, with a young family and a business to run, to be their hands-on caregivers and retirement plan. Don't feel guilty if she winds up in a less-than-ideal care situation: this is what she planned for. She had her entire life to learn and save and chose not to do either. You are not responsible for her happiness. Just do your best and eat the elephant one bite at a time, especially if you start early. I wish you all the best!
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Isthisrealyreal May 2021
Great information, I just want to chime in on the Durable Medical Power of Attorney and HIPAA release.

Everyone should have a HIPAA draw up by an attorney that specifically says that it never expires and is intended to be valid in any jurisdiction that it is presented in.

The ones that you sign in clinic are only valid for 12 months. The time that you find this out, usually in the middle of a crisis and the office staff are happy to tell you that you don't have a valid HIPAA release.

It is worth the effort to get a lifetime HIPAA release for your DMPOA.
What triggered my stepping in for my mom with Alzheimer’s from a financial perspective was that I happened to be at her house one day when she was mailing a check for a car warranty. After digging, I found she had purchased 2 car warranties! I reported all her credit cards as stolen immediately. It me months to get her money back that had been paid (she actually made money after the companies paid all the fines and fees). I do have a durable PoA so took that to her bank and got myself put on her account (she went with me), went to her financial advisor and locked down all transactions without my approval and set up online access to ALL her accounts. I set up most bill payments to pay directly from her checking or her one reopened credit card. She does still have a checkbook and does still write a few checks here and there for items that are prepaid, but they post as credits and she doesn’t have to pay it next month. It has been extremely difficult for her to stop driving and turn over her finances to me, but after the mess with the car warranties and understanding she could have lost over $10,000 she has been more receptive to getting help in many areas. I have alerts sent to my phone on any credit card or bank account transaction so I can look into canceling immediately if needed. My mom does accuse me of trying to take over (I am), she does yell at me and tell me she doesn’t need a babysitter (she does) and does yell at me and tell me I’m not her momma and I’m bossy (guilt as charged) and most days that’s just how the cookie crumbles. My dad died with ALZ 10 years ago and I learned so much from him. I can’t say it’s easier the second time around but at least the learning curve is much, much flatter!
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I talked to the doctor (actually sent/faxed) details of my concerns and mom’s behavior. I related what my siblings had told me as well. I asked the doctor for a plan of treatment and assessment of mom’s abilities and inabilities. Specifically can she make financial decisions, pay bills, drive, etc.
The doctor had her brain scanned, did a memory test and assessed that mom has normal aging as well as vascular dementia progressing to ALZ symptoms. This was not evident to mom other than she kinda knew she needed help. I was in the meeting with her and every meeting with doctors. I specifically asked the doctors for a treatment plan to help mom and they all said that there is no reversal. When I got mom home, I prayed for wisdom and early in the day (she is worse in the evening), I offered to set up her accounts to get the most benefit and reduce the negative impact of debt. Once I got her agreement, I got all her accounts in front of me, did a budget and let her know that she needed $$ to live (food, insurance, maintenance, bills). I showed her what was left over (after I pulled out a percentage for emergencies). I was serious and concerned and told her I wanted her to be as independent as possible and me handling her finances is what rich people do-except they pay for a bookkeeper!
Then, I went about reducing her debt. I got a DPOA for her and called each of the CCards and cancelled the card. I did not tell her this because she is not wise. I got her a debit card and asked her to keep all of her receipts and daily keep a record (on a calendar) of what she spends...every penny so she can see her outlays.
This effort showed mom that she was spending more than she thought and also that she struggled with doing this simple task.
Once the CC had cancelled accounts, I sent them a reduced amount (less than the minimum because she could not afford it with the explanation that there was a medical issue and no more money was available for payments. Eventually, the CC people negotiated with me and most settled for 50 percent of what she owed. She had these card for years and the interest was killing her. Prayer prepared my words and mom’s heart for all interactions and I am grateful that she is safe and her finances are in order.
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It is never too early to fret about her financials. My mother went way too long managing on her own and I had a huge mess to clean up. And she lost a lot of money in various ways. I wasn’t able to step in prior to her completely becoming unable to manage anything on her own and it was either me or a state guardian. Long story. But after I stepped in, I hired an elder care attorney to review all my documentation and give me guidance. The hardest part was listening to my mother insist that she could manage everything herself, that she could still drive, that she could live on her own, that she wanted her credit cards to go shopping, she wanted to buy a house, and that I was stealing all her money and trying to kill her. With her advancing dementia I quickly realized that there would never be reasonable conversation about money or care. I just had to follow my gut. A social worker I know told me I just needed to trust in what I was seeing and that I was going to need to make hard decisions that I knew were in her best interest despite her accusations and anger. My mother lost a ton of money that could have been used for her care and comfort.
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Read this two times. If you are already on record as the POA then the only problem I see is -- Are you ready to step up and say to Mom I am taking over your finances. It is needed to straighten out all these charges on the Credit Cards and get her budget working for her again. Keep her informed at all times in all this, but take charge so she can be alright financially.

That said, rather harshly, let me say this. Mom will deny forever that she has a problem, If dementia is a factor here, she will only be more and more confused or in greater denial about money. It is going to be natural for her to deny she needs help, not only because her abilities to handle money properly, but because she literally will not see what is happening. She believes/feels she is fine with all of it. Please understand, her reality is in her mind and she believes she is OK. Don't try to convince her otherwise, just take over.

This is not going to be an easy process, she will fight you every way she can. If you have signed the documents for POA, you have the legal right to take over. I would verify this with the Attorney, but that is what I found when I had to do this for my Mom. All I had to do was -- "do it". It is, in fact, what she wanted when she gave you POA.

All this is meant to say, in part, that when we are a "caregiver" for a parent/whomever we also find ourselves giving our own excuses for our inaction. That inaction being the taking over some of the necessary activities of living -- usually the financial dealings, activities that our loved one has always been able to handle. It is in some ways our own denial, seeing those parts of our loved one failing and we don't want to see nor accept this ourselves. In ways we are now the adult and the adult is now the child. Just a fact and does not need to be explained to them, they will not understand. Just give all the love you and no matter what the reaction. AND talk to someone, not family, someone who can listen, perhaps a counselor. You, too, need to be able to express your concerns, finding a way to help you understand all of your decisions. Someone not invested (Involved) in the situation.

Do all this with the love and strength you can gather. It is our love and acceptance of the loved one as they are today, not what we have been used to or with they still were, that will allow us to move ahead with grace. When our loved one has Dementia, it is never too early (NOR TOO LATE) to step in and take command. Do it with love and always tell them what you are doing. I did this until Mom was no longer interested (and she let me know when).

Stay Calm, Stay Safe, Stay Loving. It is a journey and not always a good one, but one that one day you will be able to say "I did the right thing". God Bless all of you!
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I'd get the situation(s) with the credit card and suspected fraud resolved first, rather than trying to introduce a whole new set of healthy spending habits. You say she was resistant to the budget, but did she co-operate with identifying the credit card transactions?

You won't need to resort to the DPOA for this, your mother can give her permission for the company/ies to discuss her account with you over the phone.

She has been ignoring the situation intentionally, and that probably means it hasn't stopped her feeling sick with worry about it. Get it sorted and out of the way, and perhaps the relief will be a good basis for better management (and confidence in you) in future.
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In my opinion, you can never get started too early with this.
I have DPOA over my Mom (at the time, 2015, she had early stage Alzheimer’s).
She was sending checks to every piece of mail that looked like a bill (most were just junk mail trying to get you to buy things). She was paying bills twice sometimes, and logging the checks incorrectly.
she would dial 911 every time the power went out (in her mind, it WAS an emergency..!). These behaviors started to pile up, so I started a log with behavioral notes from every time I went to visit her.
I had to sneakily get her Credit cards away from her and with my DPOA, cancel them all. I told her that as POA, I needed to make copies of the CCs.
She even told me she had a CC somewhere but couldn’t remember what happened to it..!
maybe she could be given a Visa gift card as her official “credit card”?
it is tricky as they still have cognitive ability early on, and become more paranoid as the disease progresses.
I did take her to a well known geriatric neurologist to get her officially diagnosed, and to seek advice from her on how to best proceed with approaching these topics such as bathing (or lack of), money issues, etc.
good luck it is a long road. You have to remember to take of you first.
Helpful Answer (5)

Tough answer..My mom set up my POA when she felt the start of cognitive decline at 84. I took over very slowly. She requested I write checks and pay bills. She kept her credit card but was reasonable with spending. She had a Dx of Lewy Body Dementia {dementia varies from day to day}. A year later she had a real break with reality. She was in heavy dementia for 6 months..I took away the credit card quietly. She never asked for it..Now she is lucid again and I asked her what she thought about me giving her the reins..she said.......”no, I feel so relaxed with you paying the bills and helping me with purchases”. I will add she is 87 and in an assisted living. Moms doctor actually told me when to take over completely...there was a man at an independent retirement home showing a bit too much attention and taking her shopping! Her doctor felt she was at risk financially. Good luck!
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NO!!!!!!!!!!!!!!!! One false move on her part can ruin her. We have all heard so many horror stories, like the old man whose children called once a week to check on him--he was fine, shopping, gardening, watching the game. He neglected to mention that he applied for every credit card and rolled over every credit card until the bank fees were so high that they swallowed his retirement account.

Now his kids have a father with no income. The stories are legendary.

My mother, for example, decided to close her main bank account, not realizing that all of her deposits went into it. When I explained that, she was shocked. "I don't get deposits," she claimed. She was clueless, typical of her generation but still a problem.

One thing I have learned in this role is that it is better to be little too early than a little too late. When you think it might be time, it is time.

How to do this? Be creative. You know her. Read up. There is loads of information. But make it happen. Take charge or regret it later!

Good luck!
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I empathize with your situation and can relate. I was experiencing a similar situation with my 84yo mother a few months ago when I also got full POA. Many of her related dementia-type behavior was due to medication interaction (10+ daily), not taking meds correctly, dehydration and UTIs. Since I placed her in SNF, her cognitive abilities and overall health have improved substantially after 2 falls and COVID in her apartment. However, her finances were not being properly managed and her spending was totally out of control. She did not have any concept of her monthly rent and expenses and thus had high CC debt, unpaid bills, fraudulent charges, unopened mail, etc. My suggestion is to step in immediately and pay what seems to be legit. Call the CC companies to report the fraud, and communicate with her bank and vendors to explain the reality of your Mom's condition. This what I had to do and everyone was very understanding, all while I was still in shock over finding many unopened boxes for items she no longer needed (jewelry, electronics, kitchen gadgets, clothing, etc.) and discovered she had been hoarding for years. Also discovered food products out of date in her pantry and fridge as well as unsafe and unsanitary living conditions; her disregard for personal grooming (she was always meticulous about dress and makeup). No, you are not fretting nor are you infringing upon her rights; the roles are now reversed and you will be parenting her to give her the best gift for the present and for her future - a safe and healthy lifestyle. You have done a wonderful job hiring outside help, but you may want to consider researching a continuing care community which offers personal care, skilled nursing and dementia/memory unit. What I wished I knew sooner was how much trouble she was in, but our elders are very keen on masking their need for help. My mom was able to keep up appearances during our visits and phone calls. Best of me again if need be!
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