Dementia/Alzheimer's (spouse)

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Workinghard
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Dementia/Alzheimer's (spouse)

Post by Workinghard » Tue Jan 12, 2016 6:18 am

I know there have been threads about dealing with finances as we age and dealing with dementia. I did a search but didn't see anything related to spousal dementia. I've had some concerns for the past 6-12 months. I won't go into that. I'm more interested in the practical aspects of financial control or moderation with a spouse who may be showing decline but is far from incompetent. When a spouse starts to use poor judgment how do you deal with it financially? Specifically credit card use, shopping, and online ordering?

I can't even begin to imagine the difficulty if the declining spouse was the one who handles finances. Thankfully that's not the case.

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lthenderson
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Re: Dementia/Alzheimer's (spouse)

Post by lthenderson » Tue Jan 12, 2016 9:29 am

I haven't had to deal with dementia but I do have notices on my debit and a credit card that automatically text me an alert when something has been charged on them over a preset dollar amount. I do that as a layer of fraud alert detection but I could see doing that with a spouse. It doesn't stop the transaction though it could probably be set up that way. It just alerts you that the transaction has been made.

If I were facing a similar situation, I would consider reducing your credit card limit on the spouses card to something manageable if maxed out and getting a new card with higher limit for yourself. Wish you the best.

ResearchMed
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Re: Dementia/Alzheimer's (spouse)

Post by ResearchMed » Tue Jan 12, 2016 11:45 am

Workinghard wrote:I know there have been threads about dealing with finances as we age and dealing with dementia. I did a search but didn't see anything related to spousal dementia. I've had some concerns for the past 6-12 months. I won't go into that. I'm more interested in the practical aspects of financial control or moderation with a spouse who may be showing decline but is far from incompetent. When a spouse starts to use poor judgment how do you deal with it financially? Specifically credit card use, shopping, and online ordering?

I can't even begin to imagine the difficulty if the declining spouse was the one who handles finances. Thankfully that's not the case.
This is potentially a problem for most of us, either wrt spouses/partners or parents.
I think a lot of the same issues would tend to arise.

One early problem is likely to be defensiveness (perhaps with anger) when the possibly affected person is told (even gently) that things are out of control or that limits are being placed, etc.
After all, it *is* a slippery slope: at the start, is the disagreement about purchases really about inappropriate spending or just a disagreement about precisely what is being purchased. That could be the so-called "reality" or it could be in the mind of the "spender", who is - perhaps reasonably from their point of view - incensed/insulted/etc.

Have you considered speaking with your physician?
They may have referrals for you to speak with, and perhaps some joint meetings/counseling.

After all, if it really is a degenerative competency setting it, things will likely keep getting worse, not better.

Good luck.

(We've dealt with this, thus far, only wrt driving. We've agreed that if either of us thinks the other is not driving safely - be it for that single drive or more generally - then that person will immediately and without current argument, surrender the keys. We'll then sort it out later. Yup, that sounds a lot easier than it is likely to be, once one of us has a concern... But spending money usually isn't potentially, and possibly immediately, fatal.)

RM
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Gnirk
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Re: Dementia/Alzheimer's (spouse)

Post by Gnirk » Tue Jan 12, 2016 12:14 pm

Just a few thoughts, having spent 12 years in the Alzheimer's world with my mom:
I agree with placing a limit on the spouse's credit card, as well as setting up text/email alerts when the credit card is used. I actually have our alerts set at $10.00 and neither of us have cognitive issues yet, but have made us immediately aware of fraudulent charges.

Another thing to be aware of are the calls from charities asking for donations. Once you are on the "donation" list of a charity, you will probably receive calls from many requesting donations, and they may ask for credit card numbers. And of course, the "you've won XXXXXXXX, and we just need your credit card to confirm" calls. One of the things it's difficult to understand, sometimes, is that your loved one's "reasoner" is broken. They may give out personal information that when they were healthy they would never divulge to anyone.

If your spouse holds Durable Power of Attorney for Financial and/or Medical you should update both, as well as any other estate documents.

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Sheepdog
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Re: Dementia/Alzheimer's (spouse)

Post by Sheepdog » Tue Jan 12, 2016 12:22 pm

I liked this NYTimes article from earlier this year http://www.nytimes.com/2015/04/25/your- ... .html?_r=0 titled "As cognitivity slips, financial skills are often the first to go" I believe that you may find some pointers in it while reading it.

A part of this article and one which I like says "He said he wishes all 65-year-olds would start by simplifying their financial lives, reducing the money clutter to just a few mutual funds at a reputable institution." I know that that does not apply directly to your question, but, by golly, if makes sense for many of us. I did that, by the way, after retiring, to make it easier on me, but also to make it easier for my spouse after I pass or become incapacitated.

Another good quote: Then there are the boilerplate tools, including wills, revocable living trusts, durable financial power of attorney, and health care directives. Financial institutions often want their own powers of attorney filled out, so it helps to put them in place before you need them. If ready access to more credit isn’t important, advisers suggested freezing elders’ credit files, so criminals cannot attempt to open accounts in their names. Automate bill payments.
People should not say everything they think. They should think about everything they say.

ddunca1944
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Re: Dementia/Alzheimer's (spouse)

Post by ddunca1944 » Tue Jan 12, 2016 12:33 pm

I am sorry you are having to deal with this. I had to deal with my mother's Alzheimer's diagnosis, but I can only imagine how much more difficult it would be if the afflicted were a spouse.

In addition to the excellent advice given above, I'd definitely start setting up my own support group. If you haven't already contacted the Alzheimers Assoc, to locate one, I'd do that now.

Allowing the afflicted spouse to hold onto a credit card allows them to retain some of their sense of dignity. I'd certainly make sure it had a low limit and sent alerts to my phone or email. I'd be concerned about a debit card.

I'm the spouse who manages the money and also has a family history of Alzheimers. My husband is quite content to let me handle the money as I enjoy it and he hates it. But I've told him, repeatedly, that he needs to be aware of what's going on with our finances in case I lose cognitive ability and start doing foolish things.

Dulocracy
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Re: Dementia/Alzheimer's (spouse)

Post by Dulocracy » Tue Jan 12, 2016 12:55 pm

As an attorney that sees a lot of guardianships and other planning issues, I will say to talk early. It is much easier to let them know what you see and that it is a concern. Let them know that you want to form a plan if EITHER of you winds up needing some oversight or restriction. Sit down together and plan what will happen. It goes a lot better that way than springing it on them at the last minute when it is almost too late anyway. Usually, the late conversations happen after a big error, which can be emotional. You want this to be as logical a conversation as possible. I am sorry that you are facing this, but it is good that you are facing it.
I'm not a financial professional. Post is info only & not legal advice. No attorney-client relationship exists with reader. Scrutinize my ideas as if you spoke with a guy at a bar. I may be wrong.

BigJohn
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Re: Dementia/Alzheimer's (spouse)

Post by BigJohn » Tue Jan 12, 2016 6:37 pm

Workinghard, my wife was diagnosed with early onset Alzheimer's about 4.5 years ago. This maybe more detail than you want but some things to consider based on my experience.

Especially early on, it's a very tough line between treating them as an independent adult who can/should have autonomy to make their own decisions and taking unilateral action to protect them from harm. The harm can be physical (eg driving) or financial but the challenges are the same. The issue for you right now is that without knowing if it's truly dementia, there is no way to know which side of this line you need to be on.

I'd start by asking others that frequently interact with your spouse if they have seen any signs or issues. If it's some type of dementia, it's very likely that they have seen manifestations that you have not. Depending on what you and others have seen, consider starting medical testing to get a diagnosis. While there is no cure or even a treatment to slow the progress of most types of dementia, there are a few that can be treated. As tough as it might be, knowing what's going on sooner is better both for possible treatment as well as developing your plan to address the issues you will face. If it is simple mind cognitive impairment, then you'll probably need to deal with it as you would a similar situation 10 - 20 years ago. If it's truly some sort of dementia, a very different plan of action will likely be required. If your spouse gets a diagnosis of dementia, consider the following.

It sounds like you're still at the stage where the advice to talk with your spouse about the issues and develop a plan is still valid. I'd advise you to do this sooner rather than later because at some point you will need to take action without your spouse's full understanding/agreement. It will be much easier for you to do this knowing it was what he/she wanted done. I would advise you not to constrain the discussion to just finances. Tough questions like when to stop driving and the pros/cons of long term care options should also be considered for discussion. I know this will be a very tough discussion but if you postpone it too long you may find that a productive discussion with your spouse is no longer possible when you need to take action.

If you have children or if your spouse has very close siblings, discuss the issues with them for two reasons. First, it's a long tough road and you are going to need their help. In addition, it will be a real strain on everyone and it will be much easier if they all know and support the tough decisions you are going to have to make.

Contact your local Alzhemier's association for resources, especially a care givers support group. It is helpful both practically and emotionally to hear how others have handled the challenges. For a long time I felt I didn't need the help of strangers and waited far too long to do this. The local Alzheimer's association can also give you resources to get educated on how the disease progresses and therefore what you have to be prepared to handle. When the time comes, they can provide resources on longer term care options in your area.

Make sure your wills, durable POA's, health care POA's and living wills are up to date in either case. If it is dementia, you'll need to consider who else other than your spouse should hold these powers for you. Again, don't wait too long, several people in my support waited and got to the point where a notary would not sign the documents because it was clear their parent/spouse no longer fully understood what they were signing.

Hope you find this helpful, glad to answer questions if I can either here or via PM.

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Wed Jan 13, 2016 4:49 am

OP, here. Thank you for all the thoughtful replies. They literally brought tears to my eyes. Hubs has surgery this morning. I'll write more later and respond to replies. Just didn't want you to think I disappeared after posting a question.

ilskeptic
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Re: Dementia/Alzheimer's (spouse)

Post by ilskeptic » Wed Jan 13, 2016 7:59 am

Dealing with this with my wife too. I hope the problem turns out to be less serious than you fear, but the advice above is all good. Here are a couple more thoughts.

-- I gather you do not have a formal diagnosis yet. If that's the case, and depending on your circumstances in general, you may want to apply NOW for long-term care insurance. Should your spouse be diagnosed with dementia, LTCI almost surely will be unavailable. If you get coverage and it turns out your spouse's problems aren't the result of dementia, well, maybe you wasted that premium money -- but that's a good outcome.

-- Again depending on your circumstances, and perhaps your philosophy on this sort of thing, you may want to consider various approaches to asset protection. You'll need to consult a lawyer specializing in eldercare law, including Medicaid rules and eligibility. As Big John suggested, if your spouse has Alzheimer's or other dementia, you'll want to do this ASAP.

Good luck.

BigJohn
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Re: Dementia/Alzheimer's (spouse)

Post by BigJohn » Wed Jan 13, 2016 8:22 am

ilskeptic wrote:- I gather you do not have a formal diagnosis yet. If that's the case, and depending on your circumstances in general, you may want to apply NOW for long-term care insurance. Should your spouse be diagnosed with dementia, LTCI almost surely will be unavailable. If you get coverage and it turns out your spouse's problems aren't the result of dementia, well, maybe you wasted that premium money -- but that's a good outcome.
This is worth considering but the LTCI companies are bleeding money. As a result, they have gotten much more selective on issuing policies. When I looked into this 5 - 6 years ago it was clear that at a minimum they were going to do a very tough phone or in-person interview screening to assess the potential for early signs of dementia for themselves. Based on the outcome, they can and will chose not to issue a policy even with no formal diagnosis. I never got this far but I'd read the paperwork carefully as well to ensure you understand the required disclosures. While having LTCI could be beneficial, you need to ensure you don't paying premiums and then not be able to collect because you failed to disclose as required.

Here are a couple of discussions on LTCI that might be worth reading
viewtopic.php?p=2295171
viewtopic.php?p=2613101

And here's a post with a link to one of the major insurers underwriting guidelines for LTCI
viewtopic.php?p=2465953

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Chicken lady
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Re: Dementia/Alzheimer's (spouse)

Post by Chicken lady » Wed Jan 13, 2016 11:43 am

Dementia/alzheimers runs in both my and my spouse's family. You have already received excellent recommendations. You may be a long way away from this point but the following helped us with our parents - though not directly related to financial management, the following helped us keep life orderly and us sane.

1. Enlist your spouse's MD to help. Talk about the issues (driving, even $$, going out alone, talking to strangers, etc.) - ask if they have any suggestions based on their observations of patients and family. If the doc has many older patients or is a geriatric specialist or is a palliative care specialist they have probably heard of many approaches that worked (or didn't). If your spouse isn't crazy about the MD, find another one. Bedside manner of the MD and his/her patient with these conditions cannot be overestimated when talking with people with limited understanding that is decreasing over time. Your spouse's MD may end up being your best friend through this journey.

2. Write questions you and your mate want to ask the MD or others - before you go to an appointment. Build the list of questions together, review them before the appt, then write the answers to the questions underneath each question. This can serve as a reference for you and for your mate when either of you gets 'fuzzy' about what something means or what to expect. You can also put in non-medical questions for 'future reference' like - "What to tell people is going on with me? Why I'm forgetful."

3. Type out the essential medical information about your spouse on a small enough piece of paper that you can put it in your wallet (or somewhere) so it is always available to you and your mate's MD's. Name, address, last 4 digits of SS, medications (exactly how much and when), the primary MD, relevant specialists - their names, addresses, contact info, insurance info (all of it including supplemental), your name/relationship/contact info, preferred pharmacy for short term/trial scrips and the preferred pharmacy (and customer support/fax #) for long term scrips. Sounds like a lot but ours are on 1/2 sheet of a 8"x10" paper in 2 columns. Virtually everyone accepts the information in this form though making a copy of insurance cards is also required - but you don't have to remember all this - especially important if you find yourself in an ER unexpectedly.

4. Keep a copy of #3 and a copy of the health care directive, DNR if there is one, and health power of attorney, and other docs ($$$ POA) in an envelope in your car if you typically drive so should you need to go to an ER in a hurry or the bank, you'll have all the documents you need to show the staff to start out on the right foot with the least confusion possible.

I am so sorry you and your spouse (and family) are going through this. Best wishes.

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Wed Jan 13, 2016 7:21 pm

lthenderson wrote:I haven't had to deal with dementia but I do have notices on my debit and a credit card that automatically text me an alert when something has been charged on them over a preset dollar amount. I do that as a layer of fraud alert detection but I could see doing that with a spouse. It doesn't stop the transaction though it could probably be set up that way. It just alerts you that the transaction has been made.

If I were facing a similar situation, I would consider reducing your credit card limit on the spouses card to something manageable if maxed out and getting a new card with higher limit for yourself. Wish you the best.
That's a great idea about a text alert. We have separate credit cards due to working on points and miles for our EU trip in the fall. I monitor the cards daily but didn't think about text alerts on his.

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Wed Jan 13, 2016 7:34 pm

ResearchMed wrote:
Workinghard wrote:I know there have been threads about dealing with finances as we age and dealing with dementia. I did a search but didn't see anything related to spousal dementia. I've had some concerns for the past 6-12 months. I won't go into that. I'm more interested in the practical aspects of financial control or moderation with a spouse who may be showing decline but is far from incompetent. When a spouse starts to use poor judgment how do you deal with it financially? Specifically credit card use, shopping, and online ordering?

I can't even begin to imagine the difficulty if the declining spouse was the one who handles finances. Thankfully that's not the case.
This is potentially a problem for most of us, either wrt spouses/partners or parents.
I think a lot of the same issues would tend to arise.

One early problem is likely to be defensiveness (perhaps with anger) when the possibly affected person is told (even gently) that things are out of control or that limits are being placed, etc.
After all, it *is* a slippery slope: at the start, is the disagreement about purchases really about inappropriate spending or just a disagreement about precisely what is being purchased. That could be the so-called "reality" or it could be in the mind of the "spender", who is - perhaps reasonably from their point of view - incensed/insulted/etc.

Have you considered speaking with your physician?
They may have referrals for you to speak with, and perhaps some joint meetings/counseling.

After all, if it really is a degenerative competency setting it, things will likely keep getting worse, not better.

Good luck.

(We've dealt with this, thus far, only wrt driving. We've agreed that if either of us thinks the other is not driving safely - be it for that single drive or more generally - then that person will immediately and without current argument, surrender the keys. We'll then sort it out later. Yup, that sounds a lot easier than it is likely to be, once one of us has a concern... But spending money usually isn't potentially, and possibly immediately, fatal.)

RM
You summed up perfectly where we're at....starting to talk about it, defensiveness, anger. And honestly, I don't know if I'm seeing signs and symptoms, if I'm "looking" for something, if I'm imagining it, or if it's just "normal" aging. But...it's been bothering me for about a year, I recently mentioned it to our son and a couple of friends,and I have felt the need for a plan.

Good point re:safety and prioritizing that. I think for us we need a written agreement to help minimize potential frustration over the loss of independence. I'm approaching it gradually. We're getting close to sitting down and talking more in depth. I suspect that will take place in the next week or so. I needed to give him time, but he did mention how his mom had to take the car keys away from his dad.

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Wed Jan 13, 2016 7:42 pm

Gnirk wrote:Just a few thoughts, having spent 12 years in the Alzheimer's world with my mom:
I agree with placing a limit on the spouse's credit card, as well as setting up text/email alerts when the credit card is used. I actually have our alerts set at $10.00 and neither of us have cognitive issues yet, but have made us immediately aware of fraudulent charges.

Another thing to be aware of are the calls from charities asking for donations. Once you are on the "donation" list of a charity, you will probably receive calls from many requesting donations, and they may ask for credit card numbers. And of course, the "you've won XXXXXXXX, and we just need your credit card to confirm" calls. One of the things it's difficult to understand, sometimes, is that your loved one's "reasoner" is broken. They may give out personal information that when they were healthy they would never divulge to anyone.

If your spouse holds Durable Power of Attorney for Financial and/or Medical you should update both, as well as any other estate documents.
Ugh! You're absolutely right. I totally forgot that we have durable PoA for each other. It definitely needs to be updated.

I was thinking about what you said with the "reasoner" being broken. A while back he ordered a new phone foe me off Amazon. I asked if it was an experienced seller and if he checked ratings. He said yes. There were problems, and I looked up the guy. He only had 5 ratings. That would never have happened in the past.

Dick D
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Re: Dementia/Alzheimer's (spouse)

Post by Dick D » Wed Jan 13, 2016 7:47 pm

We have a friend who had early alzheimer's. The spouse contacted an attorney who specializes in such cases who advised her on how to set up the assets. I suggest that you do the same.

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Wed Jan 13, 2016 7:49 pm

Sheepdog wrote:I liked this NYTimes article from earlier this year http://www.nytimes.com/2015/04/25/your- ... .html?_r=0 titled "As cognitivity slips, financial skills are often the first to go" I believe that you may find some pointers in it while reading it.

A part of this article and one which I like says "He said he wishes all 65-year-olds would start by simplifying their financial lives, reducing the money clutter to just a few mutual funds at a reputable institution." I know that that does not apply directly to your question, but, by golly, if makes sense for many of us. I did that, by the way, after retiring, to make it easier on me, but also to make it easier for my spouse after I pass or become incapacitated.

Another good quote: Then there are the boilerplate tools, including wills, revocable living trusts, durable financial power of attorney, and health care directives. Financial institutions often want their own powers of attorney filled out, so it helps to put them in place before you need them. If ready access to more credit isn’t important, advisers suggested freezing elders’ credit files, so criminals cannot attempt to open accounts in their names. Automate bill payments.
Thanks for the link. I'm definitely planning on simplifying our finances. With retirement 401(k)s will get moved to Vanguard. We'll start Roth conversions, and by the time I'm 65, I want to be in a Life Strategy Fund. I've never been a fan of automated bill pays, but I can see the benefit especially as one ages.

We signed a realtor contract a couple of days ago to sell our home. Time to downsize and simplify.

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Wed Jan 13, 2016 7:55 pm

ddunca1944 wrote:I am sorry you are having to deal with this. I had to deal with my mother's Alzheimer's diagnosis, but I can only imagine how much more difficult it would be if the afflicted were a spouse.

In addition to the excellent advice given above, I'd definitely start setting up my own support group. If you haven't already contacted the Alzheimers Assoc, to locate one, I'd do that now.

Allowing the afflicted spouse to hold onto a credit card allows them to retain some of their sense of dignity. I'd certainly make sure it had a low limit and sent alerts to my phone or email. I'd be concerned about a debit card.

I'm the spouse who manages the money and also has a family history of Alzheimers. My husband is quite content to let me handle the money as I enjoy it and he hates it. But I've told him, repeatedly, that he needs to be aware of what's going on with our finances in case I lose cognitive ability and start doing foolish things.
I'm going to put a support group on my future to do list. I'm not quite ready. Perhaps because I'm in denial. Perhaps because we don't have a diagnosis. Perhaps because I use to be a caregiver (nurse) and it's hard to seek help. I know it would be beneficial though. It's funny how you think of ideas and suggestions for others but not for yourself. I've suggested support groups numerous times to family members. Did I think about it for myself? Absolutely not. Go figure.

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Wed Jan 13, 2016 8:03 pm

Dulocracy wrote:As an attorney that sees a lot of guardianships and other planning issues, I will say to talk early. It is much easier to let them know what you see and that it is a concern. Let them know that you want to form a plan if EITHER of you winds up needing some oversight or restriction. Sit down together and plan what will happen. It goes a lot better that way than springing it on them at the last minute when it is almost too late anyway. Usually, the late conversations happen after a big error, which can be emotional. You want this to be as logical a conversation as possible. I am sorry that you are facing this, but it is good that you are facing it.
That's exactly what I want to avoid----reacting in an emotionally charged situation. I'd rather be proactive as much as possible. I mentioned the other day that there's always a risk something could happen to me. I'm 6 years younger, physically and mentally more active, but could still have a stroke and become impaired.

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Wed Jan 13, 2016 8:23 pm

BigJohn wrote:Workinghard, my wife was diagnosed with early onset Alzheimer's about 4.5 years ago. This maybe more detail than you want but some things to consider based on my experience.

Especially early on, it's a very tough line between treating them as an independent adult who can/should have autonomy to make their own decisions and taking unilateral action to protect them from harm. The harm can be physical (eg driving) or financial but the challenges are the same. The issue for you right now is that without knowing if it's truly dementia, there is no way to know which side of this line you need to be on.

I'd start by asking others that frequently interact with your spouse if they have seen any signs or issues. If it's some type of dementia, it's very likely that they have seen manifestations that you have not. Depending on what you and others have seen, consider starting medical testing to get a diagnosis. While there is no cure or even a treatment to slow the progress of most types of dementia, there are a few that can be treated. As tough as it might be, knowing what's going on sooner is better both for possible treatment as well as developing your plan to address the issues you will face. If it is simple mind cognitive impairment, then you'll probably need to deal with it as you would a similar situation 10 - 20 years ago. If it's truly some sort of dementia, a very different plan of action will likely be required. If your spouse gets a diagnosis of dementia, consider the following.

It sounds like you're still at the stage where the advice to talk with your spouse about the issues and develop a plan is still valid. I'd advise you to do this sooner rather than later because at some point you will need to take action without your spouse's full understanding/agreement. It will be much easier for you to do this knowing it was what he/she wanted done. I would advise you not to constrain the discussion to just finances. Tough questions like when to stop driving and the pros/cons of long term care options should also be considered for discussion. I know this will be a very tough discussion but if you postpone it too long you may find that a productive discussion with your spouse is no longer possible when you need to take action.

If you have children or if your spouse has very close siblings, discuss the issues with them for two reasons. First, it's a long tough road and you are going to need their help. In addition, it will be a real strain on everyone and it will be much easier if they all know and support the tough decisions you are going to have to make.

Contact your local Alzhemier's association for resources, especially a care givers support group. It is helpful both practically and emotionally to hear how others have handled the challenges. For a long time I felt I didn't need the help of strangers and waited far too long to do this. The local Alzheimer's association can also give you resources to get educated on how the disease progresses and therefore what you have to be prepared to handle. When the time comes, they can provide resources on longer term care options in your area.

Make sure your wills, durable POA's, health care POA's and living wills are up to date in either case. If it is dementia, you'll need to consider who else other than your spouse should hold these powers for you. Again, don't wait too long, several people in my support waited and got to the point where a notary would not sign the documents because it was clear their parent/spouse no longer fully understood what they were signing.

Hope you find this helpful, glad to answer questions if I can either here or via PM.
BigJohn, it's NOT more detail than I want! I so appreciate you sharing your personal experience. I think about "the line" and part of me is afraid to find out. On the other hand, knowing is easier in the sense that it affects how you deal with something. I feel like I'm between a rock and a hard place.

I haven't talked to any co-workers because I didn't want to plant ideas when it might be my imagination. I didn't want to jeopardize his job. I haven't been concerned about safety because he's been in the same position for years and it's all rote/muscle training. When he's not there, they have two people doing his job. It's all a moot point though as he was planning on retiring in April anyway and is currently out for a couple of months due to surgery. He may not be going back. There have been some inappropriate (I think) displays of anger from the way he's described the situation. I've also witnessed it at home. I don't really care for his primary care physician. Kinda got him by default wihen his other one retired. I do like his surgeon, and unlike most surgeons, he's easy to talk to. I guess we'll start there at his follow up appointment.

Thank you for the outline of steps. I know it can be time consuming responding to posts and I appreciate everyone taking the time to help.

I'll reply to other responses tomorrow. I'm totally wiped out, but his surgery went well!

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Re: Dementia/Alzheimer's (spouse)

Post by Lancelot » Wed Jan 13, 2016 8:25 pm

Workinghard wrote:
Dulocracy wrote:As an attorney that sees a lot of guardianships and other planning issues, I will say to talk early. It is much easier to let them know what you see and that it is a concern. Let them know that you want to form a plan if EITHER of you winds up needing some oversight or restriction. Sit down together and plan what will happen. It goes a lot better that way than springing it on them at the last minute when it is almost too late anyway. Usually, the late conversations happen after a big error, which can be emotional. You want this to be as logical a conversation as possible. I am sorry that you are facing this, but it is good that you are facing it.
That's exactly what I want to avoid----reacting in an emotionally charged situation. I'd rather be proactive as much as possible. I mentioned the other day that there's always a risk something could happen to me. I'm 6 years younger, physically and mentally more active, but could still have a stroke and become impaired.
My Dad had Alzheimers and my Mom was his primary care taker until she had several strokes and became impaired.

They lived in a small town so people would call Mom when Dad was making strange financial/purchasing decisions (such as cashing in a 4% CD before maturity, to buy a 3% CD, "Because rates were falling..." )

My Dad would become angry when he felt that people were ignoring him, even though I had been keeping him company for several hours. Dad was physically strong until the last few months, but his mind was completely gone.

Eventually she may become "challenging" to handle, more than one person can manage alone.

Good luck to you and
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ResearchMed
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Re: Dementia/Alzheimer's (spouse)

Post by ResearchMed » Wed Jan 13, 2016 8:29 pm

Workinghard wrote:
ResearchMed wrote:
Workinghard wrote:I know there have been threads about dealing with finances as we age and dealing with dementia. I did a search but didn't see anything related to spousal dementia. I've had some concerns for the past 6-12 months. I won't go into that. I'm more interested in the practical aspects of financial control or moderation with a spouse who may be showing decline but is far from incompetent. When a spouse starts to use poor judgment how do you deal with it financially? Specifically credit card use, shopping, and online ordering?

I can't even begin to imagine the difficulty if the declining spouse was the one who handles finances. Thankfully that's not the case.
This is potentially a problem for most of us, either wrt spouses/partners or parents.
I think a lot of the same issues would tend to arise.

One early problem is likely to be defensiveness (perhaps with anger) when the possibly affected person is told (even gently) that things are out of control or that limits are being placed, etc.
After all, it *is* a slippery slope: at the start, is the disagreement about purchases really about inappropriate spending or just a disagreement about precisely what is being purchased. That could be the so-called "reality" or it could be in the mind of the "spender", who is - perhaps reasonably from their point of view - incensed/insulted/etc.

Have you considered speaking with your physician?
They may have referrals for you to speak with, and perhaps some joint meetings/counseling.

After all, if it really is a degenerative competency setting it, things will likely keep getting worse, not better.

Good luck.

(We've dealt with this, thus far, only wrt driving. We've agreed that if either of us thinks the other is not driving safely - be it for that single drive or more generally - then that person will immediately and without current argument, surrender the keys. We'll then sort it out later. Yup, that sounds a lot easier than it is likely to be, once one of us has a concern... But spending money usually isn't potentially, and possibly immediately, fatal.)

RM
You summed up perfectly where we're at....starting to talk about it, defensiveness, anger. And honestly, I don't know if I'm seeing signs and symptoms, if I'm "looking" for something, if I'm imagining it, or if it's just "normal" aging. But...it's been bothering me for about a year, I recently mentioned it to our son and a couple of friends,and I have felt the need for a plan.

Good point re:safety and prioritizing that. I think for us we need a written agreement to help minimize potential frustration over the loss of independence. I'm approaching it gradually. We're getting close to sitting down and talking more in depth. I suspect that will take place in the next week or so. I needed to give him time, but he did mention how his mom had to take the car keys away from his dad.
You mentioned elsewhere that you hadn't thought about getting help, that was a role you previously play....
Think now about how you tried to explain (convince?) those others that they really did need help.
Well, that seems to be "you" now, right?
Let yourself get and use that help.

Among other things to deal with (and no doubt, there will be many - this is a nightmare we all fear, I think), you will probably want to think about how to make the transition from almost complete independence to... not quite... as easy as possible.
(Things like if he has his own car, if it gets sold, putting the money, including maintenance and taxes, into a "taxi/car service" fund to be used liberally. Chances are that he'll be unsafe driving long before [hopefully] he shouldn't be allowed out independently. But the online order you mention is worrisome. On the other hand, we do all just plain "goof" at times. As you pointed out, are you "looking for signs" and seeing some that aren't there? Chances are that if you have been noticing difficulties, they are real. But that doesn't mean that *every little thing* you "notice" is in fact a problem. But if it is something progressive, that's not too much comfort.)

Do you have any direct knowledge of how he'd want things to be handled, from earlier discussions, preparations of wills, proxies, advance directives?

Hopefully you have some idea, and also hopefully, there is still a window to get these documents in place (or think through them again).

Good luck.
This situation lurks in the backs of our minds, but we've only gently hinted about "what if's".
We already have the docs in place, but we are currently reviewing them.
We need to set up a special needs (doubling as a spendthrift) trust for another family member, so this is all currently right in front of us.
It's unpleasant and scary.

RM
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black jack
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Re: Dementia/Alzheimer's (spouse)

Post by black jack » Wed Jan 13, 2016 8:51 pm

After dealing with Alzheimers/dementia in both my parents: you've gotten a lot of good advice.

One other suggestion: consider freezing his (your joint?) credit accounts. As mentioned, your husband may give inappropriate information to callers, or may fill out credit card applications that he would have previously ignored.

My condolences.
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Re: Dementia/Alzheimer's (spouse)

Post by BigJohn » Thu Jan 14, 2016 1:09 am

Workinghard wrote:Thanks for the link. I'm definitely planning on simplifying our finances. With retirement 401(k)s will get moved to Vanguard. We'll start Roth conversions, and by the time I'm 65, I want to be in a Life Strategy Fund. I've never been a fan of automated bill pays, but I can see the benefit especially as one ages.

We signed a realtor contract a couple of days ago to sell our home. Time to downsize and simplify.
Workinghard, a few more things to think about based on these comments and my experience.

You may want to look into auto pay options sooner rather than later. One thing that keeps me up at night is the worry of what happens if I get hit by a bus tomorrow. Here's a link to my response regarding how I mitigated this risk in terms of managing financial issues viewtopic.php?p=2276692#p2276692

I hate to give you more to worry about but if you've been in your house a long time, a move to a new place can bring up issues for someone with dementia. It doesn't sound like your husband is advanced enough for an unfamiliar floor plan to be a major concern. The more likely issue will be driving to a new location. Right now all the routes to stores, shopping, church, etc are on auto-pilot for your husband so it may not be apparent. However, learning new routes is a much more complex task that we take for granted but can be a struggle for someone even in the early stages of dementia. It's even more complex/stressful because the learning has to be done while managing the base case complexities of driving. You may want to give some thought to evaluating your husband's ability to cope with navigating to a new location without your help.

I really wish I had more positive comments but hope you find some benefit in my sharing the issues I've encountered.

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Thu Jan 14, 2016 5:48 am

Lancelot wrote:
Workinghard wrote:
Dulocracy wrote:As an attorney that sees a lot of guardianships and other planning issues, I will say to talk early. It is much easier to let them know what you see and that it is a concern. Let them know that you want to form a plan if EITHER of you winds up needing some oversight or restriction. Sit down together and plan what will happen. It goes a lot better that way than springing it on them at the last minute when it is almost too late anyway. Usually, the late conversations happen after a big error, which can be emotional. You want this to be as logical a conversation as possible. I am sorry that you are facing this, but it is good that you are facing it.
That's exactly what I want to avoid----reacting in an emotionally charged situation. I'd rather be proactive as much as possible. I mentioned the other day that there's always a risk something could happen to me. I'm 6 years younger, physically and mentally more active, but could still have a stroke and become impaired.
My Dad had Alzheimers and my Mom was his primary care taker until she had several strokes and became impaired.

They lived in a small town so people would call Mom when Dad was making strange financial/purchasing decisions (such as cashing in a 4% CD before maturity, to buy a 3% CD, "Because rates were falling..." )

My Dad would become angry when he felt that people were ignoring him, even though I had been keeping him company for several hours. Dad was physically strong until the last few months, but his mind was completely gone.

Eventually she may become "challenging" to handle, more than one person can manage alone.

Good luck to you and
It was nice about the same community and people watching and helping out and letting your mom know about different things. We're kinda waiting to see where our youngest lands but also considering moving closer to our three adult nephews. I feel kinda isolated where I'm at. Due to work schedules we haven't even been involved in church lately.

I want to be close when our youngest starts a family but also want to be nearby family that can help. I know they have their own lives, but also know they would be there for us and by brother is planning on moving to that area too when he retires.

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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Thu Jan 14, 2016 6:14 am

ResearchMed wrote:
Workinghard wrote:
You mentioned elsewhere that you hadn't thought about getting help, that was a role you previously play....
Think now about how you tried to explain (convince?) those others that they really did need help.
Well, that seems to be "you" now, right?
Let yourself get and use that help.

Among other things to deal with (and no doubt, there will be many - this is a nightmare we all fear, I think), you will probably want to think about how to make the transition from almost complete independence to... not quite... as easy as possible.
(Things like if he has his own car, if it gets sold, putting the money, including maintenance and taxes, into a "taxi/car service" fund to be used liberally. Chances are that he'll be unsafe driving long before [hopefully] he shouldn't be allowed out independently. But the online order you mention is worrisome. On the other hand, we do all just plain "goof" at times. As you pointed out, are you "looking for signs" and seeing some that aren't there? Chances are that if you have been noticing difficulties, they are real. But that doesn't mean that *every little thing* you "notice" is in fact a problem. But if it is something progressive, that's not too much comfort.)

Do you have any direct knowledge of how he'd want things to be handled, from earlier discussions, preparations of wills, proxies, advance directives?

Hopefully you have some idea, and also hopefully, there is still a window to get these documents in place (or think through them again).

Good luck.
This situation lurks in the backs of our minds, but we've only gently hinted about "what if's".
We already have the docs in place, but we are currently reviewing them.
We need to set up a special needs (doubling as a spendthrift) trust for another family member, so this is all currently right in front of us.
It's unpleasant and scary.

RM
Haha, RM, fair enough---Approach myself as the family member.

Thankfully, not even thinking about this, we've already got started planning different things like selling our home. It's too big and getting more difficult to take care of. Around Christmas, the riding mower got (?) stuck. He got it out but didn't call me for help and injured his back which aggravated a previous injury and required surgery. Not sure how it got stuck since it our property is flat. We've also talked about going to one vehicle when he's no longer working and he's finally agreed to that. The carrot of buying a new one for road trips, ours are 14 and 16 years old, helps. Lately he's been wanting me to go to doctor appointments with him, so as much as I hate too, it's probably a good thing.

The one thing that hit home recently named was he totally embarrassed me in front of our realtor and I saw the realtor do a double take. Hubs has always hated me letting the phone ring and not answering it, so I'm conditioned to jump when it rings. I figure if it's important the person will leave a message or call back. Anyway, while the realtor was here the was a phone call. I jumped to answer it, forgetting he was expecting a fax. He got angry at stomped his cane. I had to calm him down and say they would refax it. He didn't understand later how his reaction was inappropriate for the situation and then started crying and apologizing. This has happened before but it was the first time in front of a witness.

Okay, talking through all has made me realize I do need to talk to a professional. Sigh.

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Thu Jan 14, 2016 6:17 am

black jack wrote:After dealing with Alzheimers/dementia in both my parents: you've gotten a lot of good advice.

One other suggestion: consider freezing his (your joint?) credit accounts. As mentioned, your husband may give inappropriate information to callers, or may fill out credit card applications that he would have previously ignored.

My condolences.
Good point. I don't 'think' he would fill out CC applications, but giving inappropriate information to a caller is a potential concern.sigh..

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Thu Jan 14, 2016 6:46 am

BigJohn wrote:
Workinghard wrote:Thanks for the link. I'm definitely planning on simplifying our finances. With retirement 401(k)s will get moved to Vanguard. We'll start Roth conversions, and by the time I'm 65, I want to be in a Life Strategy Fund. I've never been a fan of automated bill pays, but I can see the benefit especially as one ages.

We signed a realtor contract a couple of days ago to sell our home. Time to downsize and simplify.
Workinghard, a few more things to think about based on these comments and my experience.

You may want to look into auto pay options sooner rather than later. One thing that keeps me up at night is the worry of what happens if I get hit by a bus tomorrow. Here's a link to my response regarding how I mitigated this risk in terms of managing financial issues viewtopic.php?p=2276692#p2276692

I hate to give you more to worry about but if you've been in your house a long time, a move to a new place can bring up issues for someone with dementia. It doesn't sound like your husband is advanced enough for an unfamiliar floor plan to be a major concern. The more likely issue will be driving to a new location. Right now all the routes to stores, shopping, church, etc are on auto-pilot for your husband so it may not be apparent. However, learning new routes is a much more complex task that we take for granted but can be a struggle for someone even in the early stages of dementia. It's even more complex/stressful because the learning has to be done while managing the base case complexities of driving. You may want to give some thought to evaluating your husband's ability to cope with navigating to a new location without your help.

I really wish I had more positive comments but hope you find some benefit in my sharing the issues I've encountered.
Believe me, I have thought about the very issues you mentioned with moving! But having family nearby for support offsets the potential risks especially if we can do it early enough. GPS systems help. Either way it looks like we may have to move twice, locally after we sell and then somewhere place where our younger son settles or we move out state near family and then possibly relocate later on.

I didn't think about a back up funding for a checking account with overdraft protection. Right now I have multiple checking accounts and lots of CC being paid through different accounts and make multiple payments througout the month. Again for the sign up bonuses. That will be winding down soon. Your suggestion would be easy enough to set up with the cash from selling our home.

I also recently went over everything with my brother, who is financially stable, and gave him passwords to all the account info and where the backup info is kept. We may be able to start winding down that area sooner. Our first class/business tickets are booked, cruise will be booked soon with points, and most of our hotels will be booked with points, we're still working on cash back cards and bonuses. This trip will be our first non low budget trip ever. Hopefully we make it!

Speaking of potential moving issues, surgery and anesthesia is also worrisome. I've seen a lot of patients decline afterwards. Hubs is a nurse, works in OR area, so able to pick his team members. One of the few benefits there..

Unrelated question...he may have to go on long term disability from work once his short term disability runs out. If that happens will he be forced to take SS? We're planning on waiting until he's 70 due to him being the higher wage earner and survivor benefit. We'd rather go the long term disability, since he had planned on retiring at 65 (April) when eligible for Medicare than have to take it sooner.

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Thu Jan 14, 2016 6:57 am

ilskeptic wrote:Dealing with this with my wife too. I hope the problem turns out to be less serious than you fear, but the advice above is all good. Here are a couple more thoughts.

-- I gather you do not have a formal diagnosis yet. If that's the case, and depending on your circumstances in general, you may want to apply NOW for long-term care insurance. Should your spouse be diagnosed with dementia, LTCI almost surely will be unavailable. If you get coverage and it turns out your spouse's problems aren't the result of dementia, well, maybe you wasted that premium money -- but that's a good outcome.

-- Again depending on your circumstances, and perhaps your philosophy on this sort of thing, you may want to consider various approaches to asset protection. You'll need to consult a lawyer specializing in eldercare law, including Medicaid rules and eligibility. As Big John suggested, if your spouse has Alzheimer's or other dementia, you'll want to do this ASAP.

Good luck.
Almost missed replying to you! I have thought about LTC but it is so convoluted that I think we're going to pass on it and do things the old fashion way with family members helping out. I know Catholic Charities, at least in our area, has a day center wher people can bring family for 4 hrs for a token fee of $20 total. The issue escalates if a person becomes dangerous, although meds can temper that, or if they start being up all night. We have sufficient funds to help with in home care. I've often joked with a close family member that he's our LTC back plan, and I know he would help out in a heartbeat.

More importantly is probably looking into Medicaid rules and eligibility and making changes whiles it's still possible. That would be worst cas scenario but still something doable as an end game. Hubs hoards pain meds and we use to joke about that being our exit plan. Long ways from there....

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Re: Dementia/Alzheimer's (spouse)

Post by BigJohn » Thu Jan 14, 2016 7:12 am

Workinghard wrote:Unrelated question...he may have to go on long term disability from work once his short term disability runs out. If that happens will he be forced to take SS? We're planning on waiting until he's 70 due to him being the higher wage earner and survivor benefit. We'd rather go the long term disability, since he had planned on retiring at 65 (April) when eligible for Medicare than have to take it sooner.
Workinghard, I'm not expert in this area so can't be of much direct help. If the long term disability is a company benefit you might start by talking with someone in the company's HR dept about the issue. If you're talking about SS disability you might consider posting as a separate question on this forum, there are several SS experts here that might be able to help.

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Re: Dementia/Alzheimer's (spouse)

Post by supersharpie » Thu Jan 14, 2016 8:01 am

Most, if not all, long term carriers require that those approved for insurance payments file for Social Security disability. However, once he turns 66 he can suspend his benefits to accrue Delayed Retirement Credits (DRCs) until he turns 70. This means he will still have the option of earning his max SS benefit, even if he receives SS disability between now and 4/2017.

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Re: Dementia/Alzheimer's (spouse)

Post by bsteiner » Thu Jan 14, 2016 8:57 am

Make sure his Will is in good shape. If not, he should sign a new one while he still can.

He should give someone a power of attorney, so someone can act on his behalf. He may also want to designate a backup agent or agents. The power of attorney should give someone the power to deal with any retirement benefits he may inherit from you if you die first.

Review your Will to make sure the provision you make for him (if you die first) is appropriate under the circumstances. You would obviously provide for him in trust rather than outright, but make sure the trustees are appropriate, and the degree of control he has over the trust(s) for his benefit is appropriate.

He should also consider a living Will, and consider giving someone (and a backup agent as well) a health care proxy, so someone may make health care decisions for him if he's unable to do so.

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Re: Dementia/Alzheimer's (spouse)

Post by jackholloway » Thu Jan 14, 2016 9:57 am

My grandmother switched to a secured credit card that fed from a small checking account, so that whatever random thing she wanted to buy could not take more than $20.

The joy of small town banks,

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Fri Jan 15, 2016 7:14 am

supersharpie wrote:Most, if not all, long term carriers require that those approved for insurance payments file for Social Security disability. However, once he turns 66 he can suspend his benefits to accrue Delayed Retirement Credits (DRCs) until he turns 70. This means he will still have the option of earning his max SS benefit, even if he receives SS disability between now and 4/2017.
Thanks Supersharpie. We finally got the approval for short-term disability yesterday up to 4/5. He'll be eligible for Medicare 4/7. The main thing is insurance coverage. I think I had read somewhere if a person has LT Disability the amount is deducted from their SS checks. I could be wrong though as too much, too fast is happening with house going on the market and hubs possibly needing another surgery. He had tentatively planned on retiring in April but was considering part-time work.

As BigJohn suggested, I probably need to start another thread especially with new rules (although) he wasn't affected and the original plan was for me to file at 62 and him to file and restrict.

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Fri Jan 15, 2016 7:15 am

jackholloway wrote:My grandmother switched to a secured credit card that fed from a small checking account, so that whatever random thing she wanted to buy could not take more than $20.

The joy of small town banks,
Nice to know!

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Fri Jan 15, 2016 7:22 am

bsteiner wrote:Make sure his Will is in good shape. If not, he should sign a new one while he still can.

He should give someone a power of attorney, so someone can act on his behalf. He may also want to designate a backup agent or agents. The power of attorney should give someone the power to deal with any retirement benefits he may inherit from you if you die first.

Review your Will to make sure the provision you make for him (if you die first) is appropriate under the circumstances. You would obviously provide for him in trust rather than outright, but make sure the trustees are appropriate, and the degree of control he has over the trust(s) for his benefit is appropriate.

He should also consider a living Will, and consider giving someone (and a backup agent as well) a health care proxy, so someone may make health care decisions for him if he's unable to do so.
I'm glad this thread is saved under "Your Posts". I need to make a To Do List! We have the living will, health care proxy covered. I can't remember if we had a back up agent and we definitely didn't consider the possibility of him inheriting my retirement accounts. We currently have just a simple will. Thank you for the suggestions.

Workinghard
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Re: Dementia/Alzheimer's (spouse)

Post by Workinghard » Sat Jan 16, 2016 11:08 am

Chicken lady, so sorry I missed responding to your post earlier! i was reading all the responses again and saw I hadn't replied. Thank you for the suggestions. I have a document in the computer with his meds and medical history but gathering key docs and keeping them in a vehicle is a great idea.

He also needs to get another primary. His current one is by default since his primary left the practice. I wasn't too impressed with the new one when he popped in after surgery. I really, really like his surgeon though, and will talk to him at his next visit.

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