Audreyrose, Good for you for taking the bull by the horns! I'm a planner, too. Like you, I have no close family or nearby friends that I want to entrust or burden with my financial or personal care when I am no longer able. I think a POA might have a very hard time managing your affairs from 3000 miles away. Have you considered moving to where she lives? There are professionals who manage care for folks who cannot. I forget (!) what they are called, but I once did some searching and found a firm in the Tampa/St. Pete area that specializes in that.
I think you might want to research assisted living facilities now and select where you want to live to avoid the "undesirable" as you mentioned. There are some lovely assisted living places with nice memory care units. Pick a few places that look attractive, get a tour with a free lunch, and talk frankly with them about your needs and finances. You can probably find an attractive assisted living community that you could start out in as private pay that would continue your care on Medicaid if you become indigent. That way, you get to select where you will live and be comfortable with your choice for your future.
My fear about remaining in my home is probably the same as yours. I know there is likely to be a time when I can't do it anymore. From experience, I know it is very difficult to hire reliable help. Additionally, if I lose the mental capacity to manage, I want someone I trust to be in charge. I don't want to run out of money paying for help at home--or be swindled out of it unsuspectingly--and left with the government putting me in some dump on Medicaid. I am absolutely certain (from experience) that assisted living or even skilled nursing facilities are less costly than maintaining a home and hiring full-time nursing care. Not to mention the management skills required and the headaches involved. Trying to hire in-home personal care-givers from 3000 miles away as your POA--I can't imagine it would work. Have you talked to your POA about this?
It was a gradual process and made somewhat difficult because my mother had been an accountant so she was proud of her abilities. There was DPOA in place but I wasn't acting. First I got my name on a checking account. It was so I could get cash for her or make deposits. It also allowed me to quietly keep an eye on things online. I suggested that she get many bills on autopay which she liked. She still balanced her checkbook. At one point I asked if she would teach me about her finances in case I had to step in if there was an emergency. I let her take the lead and took notes. A couple times she was hospitalized and I took care of her bills. When she got out, I gave her a full accounting and she resumed control. Slowly I noticed she got anxious around bill paying and tax time. So I started sitting with her while she did it. I would sort her mail, toss junk, and put only bills in front of her. " I'm your secretary, mom." At last, she moved into Assisted Living. I suggested it was unwise to have financial records there. I started doing it all but went over it regularly and had her make out checks to charities and church or when we shopped. Finally she said it was too hard to write and it hurt her hands. I said I would take on everything and it was easier for me because she had always been so organized. In reality, I discovered many problems but I just worked it out and left her with the memory of her former skill. I started this slow and placating approach because my mother was a difficult, critical woman and I was basically manipulating her for her own good. Gradually , however, I came to feel compassion for her as I saw her abilities sliding away and I was glad I hadn't pushed.
Agingmyself I so appreciate your answers. It is only fair to say I am the one diagnosed in early stages of Dementia. I can right now think clearly about this subject and that's why I posted the questions! Still struggling with admitting it though!!! I do have a POA but she is 3000 miles away. Haven't found anyone locally I felt up to the mark. Do I wait until bills become too difficult to comprehend and pay. I may be trying to make a plan too far in advance but I am considering 3 plans A B C for each step of this disease. I don't have anyone to advise me that I trust so that's why I am on this board. It has already been of tremendous help especially looking at the videos and recognizing certain behaviors. I was diagnosed by my doctor in March 2017 for new at dealing with it and I don't have any family either. I guess the first thing I noticed was not being able to make Executive decisions. I can do it right now but feel next year is not definite. Any and all advice is appreciated. I am hoping to go to some Support groups because I feel the more I know about what to expect the better. Knowledge is Power! Finances are limited BUT I am trying to decide just how much money I should spend on caregiving, vs. CNA and RN when I NEED them, vs. board and care facility which is very expensive and I probably couldn't manage for more than 1 year. I have learned Medicaid will kick in if one is penniless and board me in a most undesirable place so that said is it better to sell my house to pay for private board and care when the time comes so I don't end up giving the house to Medicaid???
If you are the one who's been diagnosed with early stage dementia, I'd suggest getting together with your POA right away to get them familiar with your needs. Even if you want to continue taking care of your finances yourself as long as possible, you may want to have your POA look over your checkbook and bank statements regularly so he or she can notice any sign that you might be "slipping" and need intervention. That would be the time when you will want your POA to take over.
Audreyrose, Have you been entrusted with POA? If so, now is the time to go to the person and ask if you can help. If another has POA, go now to the person and ask if they feel that it's time for the POA to get familiar with their finances, and perhaps start to review transactions for accuracy. Do you have a concern that his/her management of finances is already a problem? If so, tell him/her. From the suggestions you have received and your expressed continuing uncertainly, we don't seem to know what you mean by "step in" and "take over." To me, "step in" is what I recommended. That's Step One. Sometime after that, there's Step Two, which I'd call "Assistance," a time of learning about affairs for the POA as they do some of the work. Then, after that, Step Three, when either the person OR the POA believes it's time for the POA to Take Over all financial responsibilities for the person's protection and well-being. Make sense?
Audreyrose, Have you been entrusted with POA? If so, now is the time to go to the person and ask if you can help. If another has POA, go now to the person and ask if they feel that it's time for the POA to get familiar with their finances, and perhaps start to review transactions for accuracy. Do you have a concern that his/her management of finances is already a problem? If so, tell him/her. From the suggestions you have received and your expressed continuing uncertainly, we don't seem to know what you mean by "step in" and "take over." To me, "step in" is what I recommended. That's Step One. Sometime after that, there's Step Two, which I'd call "Assistance," a time of learning about affairs for the POA as they do some of the work. Then, after that, Step Three, when either the person OR the POA believes it's time for the POA to Take Over all financial responsibilities for the person's protection and well-being. Make sense?
I have been told that it can cost $16,000 month for caregiving to Dementia patients at home. Don't think many people have that kind of money so any suggestions on what to pay caregiver, and what they should be experienced in. How many hours week if bathing not required.
I'd want to get involved early on so that you know what you could be facing in the future. Nothing like trying to figure everything out on your own, like I did with most of it with my dad. My husband, however, used to spend part of our weekly visit to his mom to pay her bills while she sat next to him and watched. It was also a source of pride for her as he explained everything he was doing. I think it took her back to when he was a little boy, though she was in her 90's and he was 60 at the time.
Interesting question! If I were the POA, I would just remind the person that you're available whenever they are ready for help in whatever capacity they want. You can often have utilities and medical providers notify you if their bill isn't paid. If you suspect funds might be misdirected to pay illegitimate or fraudulent bills, bring that up to your person, and offer to review all their payments for accuracy. They may be happy to turn over something or everything to you now, and that might be easier than waiting until the dementia makes them unable to do it and perhaps unwilling to let you do it. If I were the person with the early-stage dementia, I'd discuss this with my POA, and together make a plan for how and when everything will be turned over to the POA.
Each case can be different but it usually takes some finess, tact and sometimes a little fibbing.
My dad has dementia and turned bill paying over to my mom about 4 years ago. She did ok for awhile but I had them both authorise me on bank accounts and got a POA "Just in case y'all ever need help". Well, guess what..
I slowly took over everything. Just now finished getting their insurance bills and mail sent to me. Mom was getting bills mixed up with junk mail and missing due dates . I think she has mixed feelings about it, sad to lose her ability but glad I'm watching out for them.
Those envelopes sound lovely Gardenartist! What a wonderful idea.
I was fortunate that my LO told me to PLEASE take over and she was so relieved to be out from under the stress. Sadly, she had stopped opening mail, stopped paying bills and some things had been cancelled! I didn't have to do a thing, but, locate the Durable POA, file it with the Register of Deed's office and start handling her bills. I wish I had known earlier that things were so bad.
I'd likely keep check weekly, because, it's not always an error that can be a problem. The person with dementia may also lose the ability to discern in their finances, so they may freely give strangers money, account information on the phone or make huge purchases for things they don't need. They become vulnerable to exploitation, since they may lose their reasoning and judgment. For those reasons, I think it's good to have someone else handle their money. Automatic drafts for the monthly recurring bills is also an option.
You can offer to help by decorating the envelopes. I save all the lovely stamps sent by charities as an inducement to donate, then add them to exteriors of the envelopes, matching postage stamps, address labels and freebie stamps.
I used to also be able to buy little stickers for seasons and occasions; they were in the card department at one of the local grocery store chains.
I used to then just unobtrusively review the checks and bills when putting them in the envelopes so I could catch any mistakes.
Just creating such lovely scenes elevates my mood. I used to use a lot of rubber stamps, creating scenes consistent with winter...e.g., I had one of a charming Victorian cottage which I stamped in green during spring and summer, in a reddish brown during fall, and navy during winter. For spring, I added pastel flowers. For fall, I added stamps of leaves floating down across the envelope. In winter, I added snowflakes, and sometimes reindeer.
Friends told me they enjoyed seeing the artistic designs on the envelopes. That could be something you and your mother do together, accompanied by hot chocolate, or decaffeinated tea or some other treat. Make it an event.
I agree with Worried; every time someone loses the ability to manage something he/she has done for years, it's another little notch in the loss of self esteem and capability to manage one's affairs.
When you do think that help is needed, ask if it would help her. Some people are aggressive and demand to take over; that's the worst thing that can be done.
Yes, let the person do it because it gives them a sense of pride and purpose. Of course, you may have to double check to be sure a $2000 check is not written out for a $20 bill. Trust me, the less you do now, the better. Later, you'll have to do everything and it can be exhausting really fast.
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Good for you for taking the bull by the horns!
I'm a planner, too. Like you, I have no close family or nearby friends that I want to entrust or burden with my financial or personal care when I am no longer able.
I think a POA might have a very hard time managing your affairs from 3000 miles away. Have you considered moving to where she lives?
There are professionals who manage care for folks who cannot. I forget (!) what they are called, but I once did some searching and found a firm in the Tampa/St. Pete area that specializes in that.
I think you might want to research assisted living facilities now and select where you want to live to avoid the "undesirable" as you mentioned. There are some lovely assisted living places with nice memory care units.
Pick a few places that look attractive, get a tour with a free lunch, and talk frankly with them about your needs and finances.
You can probably find an attractive assisted living community that you could start out in as private pay that would continue your care on Medicaid if you become indigent. That way, you get to select where you will live and be comfortable with your choice for your future.
My fear about remaining in my home is probably the same as yours. I know there is likely to be a time when I can't do it anymore. From experience, I know it is very difficult to hire reliable help. Additionally, if I lose the mental capacity to manage, I want someone I trust to be in charge. I don't want to run out of money paying for help at home--or be swindled out of it unsuspectingly--and left with the government putting me in some dump on Medicaid.
I am absolutely certain (from experience) that assisted living or even skilled nursing facilities are less costly than maintaining a home and hiring full-time nursing care. Not to mention the management skills required and the headaches involved.
Trying to hire in-home personal care-givers from 3000 miles away as your POA--I can't imagine it would work.
Have you talked to your POA about this?
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I posted the questions! Still struggling with admitting it though!!! I do have a POA but
she is 3000 miles away. Haven't found anyone locally I felt up to the mark. Do I wait
until bills become too difficult to comprehend and pay. I may be trying to make a plan
too far in advance but I am considering 3 plans A B C for each step of this disease.
I don't have anyone to advise me that I trust so that's why I am on this board.
It has already been of tremendous help especially looking at the videos and recognizing
certain behaviors. I was diagnosed by my doctor in March 2017 for new at dealing with it and I don't have any family either. I guess the first thing I noticed was not being able
to make Executive decisions. I can do it right now but feel next year is not definite.
Any and all advice is appreciated. I am hoping to go to some Support groups because
I feel the more I know about what to expect the better. Knowledge is Power!
Finances are limited BUT I am trying to decide just how much money I should spend on
caregiving, vs. CNA and RN when I NEED them, vs. board and care facility which is very
expensive and I probably couldn't manage for more than 1 year. I have learned Medicaid
will kick in if one is penniless and board me in a most undesirable place so that said
is it better to sell my house to pay for private board and care when the time comes
so I don't end up giving the house to Medicaid???
If another has POA, go now to the person and ask if they feel that it's time for the POA to get familiar with their finances, and perhaps start to review transactions for accuracy.
Do you have a concern that his/her management of finances is already a problem? If so, tell him/her.
From the suggestions you have received and your expressed continuing uncertainly, we don't seem to know what you mean by "step in" and "take over."
To me, "step in" is what I recommended. That's Step One. Sometime after that, there's Step Two, which I'd call "Assistance," a time of learning about affairs for the POA as they do some of the work. Then, after that, Step Three, when either the person OR the POA believes it's time for the POA to Take Over all financial responsibilities for the person's protection and well-being.
Make sense?
If another has POA, go now to the person and ask if they feel that it's time for the POA to get familiar with their finances, and perhaps start to review transactions for accuracy.
Do you have a concern that his/her management of finances is already a problem? If so, tell him/her.
From the suggestions you have received and your expressed continuing uncertainly, we don't seem to know what you mean by "step in" and "take over."
To me, "step in" is what I recommended. That's Step One. Sometime after that, there's Step Two, which I'd call "Assistance," a time of learning about affairs for the POA as they do some of the work. Then, after that, Step Three, when either the person OR the POA believes it's time for the POA to Take Over all financial responsibilities for the person's protection and well-being.
Make sense?
If you suspect funds might be misdirected to pay illegitimate or fraudulent bills, bring that up to your person, and offer to review all their payments for accuracy.
They may be happy to turn over something or everything to you now, and that might be easier than waiting until the dementia makes them unable to do it and perhaps unwilling to let you do it.
If I were the person with the early-stage dementia, I'd discuss this with my POA, and together make a plan for how and when everything will be turned over to the POA.
My dad has dementia and turned bill paying over to my mom about 4 years ago. She did ok for awhile but I had them both authorise me on bank accounts and got a POA "Just in case y'all ever need help". Well, guess what..
I slowly took over everything. Just now finished getting their insurance bills and mail sent to me. Mom was getting bills mixed up with junk mail and missing due dates . I think she has mixed feelings about it, sad to lose her ability but glad I'm watching out for them.
I was fortunate that my LO told me to PLEASE take over and she was so relieved to be out from under the stress. Sadly, she had stopped opening mail, stopped paying bills and some things had been cancelled! I didn't have to do a thing, but, locate the Durable POA, file it with the Register of Deed's office and start handling her bills. I wish I had known earlier that things were so bad.
I'd likely keep check weekly, because, it's not always an error that can be a problem. The person with dementia may also lose the ability to discern in their finances, so they may freely give strangers money, account information on the phone or make huge purchases for things they don't need. They become vulnerable to exploitation, since they may lose their reasoning and judgment. For those reasons, I think it's good to have someone else handle their money. Automatic drafts for the monthly recurring bills is also an option.
I used to also be able to buy little stickers for seasons and occasions; they were in the card department at one of the local grocery store chains.
I used to then just unobtrusively review the checks and bills when putting them in the envelopes so I could catch any mistakes.
Just creating such lovely scenes elevates my mood. I used to use a lot of rubber stamps, creating scenes consistent with winter...e.g., I had one of a charming Victorian cottage which I stamped in green during spring and summer, in a reddish brown during fall, and navy during winter. For spring, I added pastel flowers. For fall, I added stamps of leaves floating down across the envelope. In winter, I added snowflakes, and sometimes reindeer.
Friends told me they enjoyed seeing the artistic designs on the envelopes. That could be something you and your mother do together, accompanied by hot chocolate, or decaffeinated tea or some other treat. Make it an event.
I agree with Worried; every time someone loses the ability to manage something he/she has done for years, it's another little notch in the loss of self esteem and capability to manage one's affairs.
When you do think that help is needed, ask if it would help her. Some people are aggressive and demand to take over; that's the worst thing that can be done.