Friday, April 8, 2011

The Financial Implications of Alzheimer's Disease

Search out the deadliest diseases that have plagued mankind and you will likely turn up such unsavory candidates as Small Pox (considered to have killed more people than any other infectious disease), Spanish Flu (some experts put the death toll for that single year as high as 50 million people worldwide), the Black Plague (thought to have killed 25 million people in Europe—about a third of the population—from 1347 to 1350), Tuberculosis (still kills nearly 2 million people a year and is ranked as the eighth leading cause of death worldwide by the WHO), Malaria (more than 1 million people die from it annually), Ebola (known to kill up to 90 percent of its victims), and Cholera (doesn't pose a problem when clean water and proper sanitation is available). Not on that list and not infectious as the previous maladies are but sure to be added to one of the deadliest disease is Alzheimers.

When you get Alzheimers, you will not recover. According to Harry Johns, president and CEO of the Alzheimer’s Association. "It is as much a thief as a killer. Alzheimer’s will darken the long-awaited retirement years of the one out of eight baby boomers who will develop it." Statistics suggest that over 10 million baby boomers will develop this affliction and at least as many of us will feel the emotional and financial repercussions of it.

Before we get to the financial implications of this problem, I thought I'd look at some of the information on this problem outlined on the Alzheimer's Association National Office website. Just because you are forgetful, doesn't mean that you have the disease. As one expert put it, it is not forgetting your keys that indicates the onset of this problem; it is forgetting what they are for. While memory plays a role in the gradual and always fatal disease, it is much more complicated.

These disruptions can impact what you do every day. More than just making yourself lists, asking for constant repetitive reminders for things that are consider part of your daily life - taking medication, getting dressed, even leaving the daily newspaper on the stoop might be qualifiers, if not to you to someone in your family. If you not only can't remember an appointment but can't recall why you made it, you might be in the initial stages.

You or a loved one might begin to forget certain aspects of their favorite activities, the rules to a game, what you went to the grocery store for or as one older woman I encountered on a grocery store aisle the other day. She had a list in her hand, a few odd items in her cart and was looking around at the overhead signs. Familiar with the store, I asked if I could help her. Seems I couldn't. She had written "dinner" and was searching for some sort of item to match her note. (I joked and suggested that my wife regularly wrote something just like that on lists she gave me. But you could tell she thought that there was just such an item somewhere in the store. She was dressed well which made me feel even more helpless, wondering if her family saw what I saw in just those brief seconds.)

Alzheimers manifests itself in other ways. At least this woman knew she was somewhere that might provide what she sought on her list. But not knowing where you are, having difficulty driving, or simply not understanding what was being said can also be additional signs that this cognitive slip has begun to take hold.

One of the easiest to spot signs are often the ones most often overlooked. Normally predictive reactions to every day events are no longer the ones you witness. In fact, if you are surprised by this frustration, perhaps the anger that accompanies it, you might be witnessing something worth your concern. These emotional disruptions go unnoticed with people living alone.

So what now? Your parent or relative is not acting as they always have. You show up to pick them up for a lunch date and they are still in their bedclothes without any recall of the event. You should be concerned. But simply writing it off as a sign of age is the easy way out. In fact, you are buying into one of the oldest myths. But don't be so quick to judge the older relations as the most prone. Alzheimers knows no age limit. And there is no cure.

As I mentioned there are some serious financial implications at play here. Our independence relies on our ability to take care of our financial well-being. While I regularly suggest that parents guide their children in their financial decisions, using their expertise and wisdom to help them, Alzheimers strips some of those abilities.

This can not only cost them in the short-term (losing a wallet, forgetting to pay the water bill) but in the long-term as well. They are quite often avid shopping channel customers, susceptible to scams and overly generous on a limited income.

While you may not at first witness these changes in their ability to handle money, some of their contacts often do and feel unable to do much of anything. According to the NYTimes: "The Financial Industry Regulatory

Authority, the largest nongovernmental regulator for securities firms doing business in the United States, recently met with individual financial services companies and the Alzheimer’s Association to formulate guidelines on how to deal with clients who have trouble remembering and reasoning, a problem that is not new but is increasing as the population ages."

Their doctors and attorneys have the same sort of problems in dealing with this situation. But there is something you can do and now is the time to begin to execute your plan.

Be sure their will is up-to-date. Lawyers will sometimes question whether their client is in the right state of mind when making decisions regarding this and other legal documents. And they wonder whether any changes made will be one day challenged. Your parents should include you in all of these appointments and if a living will needs to be created, now is the time to consider it. In fact, the attorney might feel as though the conversation would be worth having if you are present. (This, to the best of my knowledge, implies permission to discuss the client's issues or the lawyer's concern in front of you. Otherwise, they can't discuss the situation.)

A living will according to the National Institute of Aging "includes instructions and pages where you can specify your wishes for: (1) the person you want to make health care decisions for you when you can’t make them for yourself, (2) the kind of medical treatment you want or don’t want, (3) how comfortable you want to be, (4) how you want people to treat you, and (5) what you want your loved ones to know."

Also in the article written by Gina Kolota, she notes that "The bar association’s handbook for lawyers, written with the American Psychological Association, tries to provide some guidance. But the handbook acknowledges that it may not be easy to determine a client’s capacity to sign a will, execute a contract or transfer property."

Financial planners are also something that you should be in contact with. This is incredibly difficult from a distance. But often they can spot problems sooner rather than later. But not having one only amplifies the potential for problems. One of the easier remedies to this situation is to have your name placed on a to-call list. But by the time a landlord, bank or lender calls to suggest a discrepancy, the damage may be already done.

This conversation is a two way street. You need to be trustworthy enough to warrant their including you in what may among their most private affairs. Parents may appear open and honest about how they feel you should handle your finances. But the total opposite may be how they treat their own.

Your financial strength gives them greater reason to trust you in their affairs. And while you are at it, consider some of the following: Do the same for your loved ones who might be needed in the event something happens to you (living wills and wills are great start). Begin to plan for the cost their problems might have on you (without a doubt it will mean lost time at work, lost retirement contributions and lost insurance might also play a role in upsetting your financial apple cart.) Consider long-term care insurance before the symptoms begin. And lastly, realize now that your personal financial situation is so much more than just your immediate world and begin to plan for it now.

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