preparing for inability to make own decisions

[palomalou]

Dang, I posted a long reply on this to another thread, but it was too old. A well, here goes. Spouse and I have no children, or younger relatives whom we know or trust, or would have any reason to help us. This is probably a long time in the future, but dealing with Spouse's parent this weekend brought the question to the fore.
What do people in our position do when we are not competent to make our own decisions regarding finance or anything else, for that matter? We have visited an assisted living place in our new neighborhood, actually while we were looking for options for the in-laws (but now think that would be our place). We've been after them for a few years to look ahead which they adamantly refused to do. Now they MUST do something which they'd rather not, and are very argumentative. This is problem one, which is solved, and they have their two children who can help them. But do childless couples like us hire a CPA? An attorney? A CFP? It's not only financial, but in all ways. I suddenly don't like the look of this (doesn't matter, couldn't have had kids anyway) and just wonder--people have to do SOMETHING to allow for this eventuality, but what?

 

[Calico]

A couple of weeks ago there was a thread called "Planning for changes in mental acuity" which was/is about this exact issue. You might find the suggestions put forth in that thread helpful.

I don't know how to link to another thread (not that talented). Perhaps a moderator could combine the two threads?

 

[Tailgate]

Link is HERE

 

[Amethyst]

Summarizing that previous thread: Basically if you can't come up with a trusted family member, you pay somebody big bucks to do something (no one is quite sure exactly what).

I know a couple with a severely autistic child who will almost certainly outlive them. The father is in his late 60's, still working to fund a trust they hope will support their child once they die (actually, the child has a prospective guardian who is a relative, but the trust adminstrator is a lawyer). I wonder if people who lack trusted family could set up such a trust for themselves, with a lawyer as administrator. It wouldn't be cheap, but at that point, you aren't looking to spend money on anything else, anyway.

It's almost like depreciation recapture, isn't it....as if the money saved by not raising kids when you're younger, comes back as a future cost....

Amethyst

 

[timo2]

It's almost like depreciation recapture, isn't it....as if the money saved by not raising kids when you're younger, comes back as a future cost....

Amethyst

If a person raised responsible and successful children, maybe. That's a big IF, IMHO. DW and I do not have children, but not all of our nieces and nephews will in any way be able to assist in their parents care in needed.

 

[braumeister]

Cultivate honest and responsible friends who are much younger than you.

 

[Amethyst]

Good point. In such cases, it's back to the lawyer with the big retainer, I guess.

We've now had at least 3 threads on the subject of What To Do When I'm Demented and Don't Have Reliable Relatives, and nobody has taken it any farther, so it apparently will remain a Big Unanswered Question on this forum.

Amethyst

If a person raised responsible and successful children, maybe. That's a big IF, IMHO. DW and I do not have children, but not all of our nieces and nephews will in any way be able to assist in their parents care in needed.

 

[calmloki]

Cultivate honest and responsible friends who are much younger than you.

This is our tack. We have younger relatives, but I'm not counting on them, and in fact am not really counting on anyone. Still, there is a young man we've known pretty much his whole life, he has proven himself trustworthy over years of experience, and he has spoken of caring for his elders, including us. (Actually his expressed plan involves a multi-acre fenced parcel that the doddering old fogies can bumble about in). We are investing in his well-being with the thought being that if we lose our capabilities his sense of fairness will kick in.

 

[braumeister]

his expressed plan involves a multi-acre fenced parcel that the doddering old fogies can bumble about in

Ah, yes. I believe I've seen a place set up along those lines.

Upper Class Twit of the Year - YouTube

 

[powerplay]

The adult foster care home where my aunt lived had another resident who was dealing with dementia and had no family. This elderly lady had a professional care manager who looked after her well being. I have no details about how much this may have cost, but this lady always looked nice and had her hair done once a week by a beautician who came to the home. I think her quality of life was as good as could be expected given her severe dementia. She was in a lovely and quiet setting and received very good care.

Perhaps there are some professional care managers out there who could be contracted with to provide management and oversight when someone is no longer able.

 

[MBAustin]

A friend who is a CPA is handling this for one of her long-time clients. The client recently took ill and was taken to the hospital, and CPA friend has the medical power of attorney. It is clearly a burden on the CPA (whose mother is terminally ill also) but she is handling all kinds of arrangements for the client. Billable of course.

 

[MichaelB]

Dang, I posted a long reply on this to another thread, but it was too old. A well, here goes. Spouse and I have no children, or younger relatives whom we know or trust, or would have any reason to help us. This is probably a long time in the future, but dealing with Spouse's parent this weekend brought the question to the fore.
What do people in our position do when we are not competent to make our own decisions regarding finance or anything else, for that matter? We have visited an assisted living place in our new neighborhood, actually while we were looking for options for the in-laws (but now think that would be our place). We've been after them for a few years to look ahead which they adamantly refused to do. Now they MUST do something which they'd rather not, and are very argumentative. This is problem one, which is solved, and they have their two children who can help them. But do childless couples like us hire a CPA? An attorney? A CFP? It's not only financial, but in all ways. I suddenly don't like the look of this (doesn't matter, couldn't have had kids anyway) and just wonder--people have to do SOMETHING to allow for this eventuality, but what?

A tough set of questions. A few thoughts..

How do you want to be cared for if you have mild dementia and how should that care change if the disease progresses? Do you want to stay at home as long as possible or move to a retirement community with AL and memory care options? If you are married, how will your spouse live? Will you go together into a CCRC?

How will you pay for the care plan?

How will you decide when to begin implementing your plan? Dementia includes the loss of cognitive abilities, so when the moment arrives the mental capability to choose may be gone.

I'd say these questions need to be answered before thinking about who will help. A clear and viable plan will make it easier to identify and choose some key players. Hiring a financial planner to manage the financial assets and an care manager / advocate to follow the care instructions should help carry out your wishes and add some scrutiny.

 

[AllDone]

Cultivate honest and responsible friends who are much younger than you.

Probably the best advice. When my great-uncle died, my grandparents discovered that he had been stealing his mother blind. He probably assumed that he would outlive her and no one would know. He was a lawyer. We have one set of nephews raised by good, hard working parents and one set raised by a con-man. Scary

Here's an article which will give you the heebie-jeebies:
When a Family Matter Turns Into a Business - Los Angeles Times

 

[JoeWras]

The link AllDone points to is indeed chilling. And depressing. At least read the last page of the article to get an idea of what to do at a minimum to avoid some problems. What chilled me were all the people who actually had folks looking after them, but the "conservators" yanked out authority from under them. Some folks were getting their assets drained by the conservators and didn't even realize it was happening to them.

In any case, this topic comes up this time every year due to all the family visits and time together during the holidays. We catch up with our elders and siblings can talk. I brought it up last year on this forum. Last year was huge for my family as me and my siblings moved my dad and sold his place. It has been a difficult year, but we are grateful Dad is doing decently well. We have the papers we need - along with a trusted lawyer - but the article still wakes you up.

And of course me and DW are kidless and really need to get our stuff together. Dealing with Dad brings it to light. I can only think of one niece out of about 15 niece/nephews from both of our families that is trustworthy. We may have to have a talk with her. But frankly, I'm still not sure what to do.

This is scary stuff!

Oh, and for those with kids, read the article. In one case, estranged kid #1 got a court appointed conservator to take over the parents' affairs from kid #2. Very nasty stuff. Be careful out there!

 

[razztazz]

As long as there is money to be made there will not be any death with dignity. Even rich guys like Ronald Reagan. His last 10 yrs or so while more comfortable than ours will likely be and certainly more comfortable than most people's will be, I am not sure they were dignified. I am keeping the .45 caliber cure as a very serious option.

The larger problem has actually been ongoing for all of us all along. What if I get hit in the parking lot or have a stroke, or end up suddenly incapacitated for whatever reason? No warning time. Can't take any precautions. I'm 56 now and that has been on my mind for 30 yrs. Hopefully ALL I really have to worry about from here on in is Alzheimers...?

 

[MooreBonds]

One question on this topic that I'm dealing with currently with my parents (I'm the executor of their revocable living trusts) :

Does anyone know of standard 'tests' that people use or clauses they might reference on determining when they might be 'unfit' for managing their own finances? My parents are still with it, but I know my dad's the type that is sometimes difficult enough to get along with while he still has it all there - I can only imagine how he will be when he's more than started to slip and won't let me take over for his own good.

I realize that sometimes a doctor can diagnose official dementia.....but other than that (sort of as an unofficial way to help the effected person see for themselves) is anyone aware of some other sort of test or benchmark or other way that a person can kind of do themselves to supplement a doctor's evaluation to help convince them that maybe they aren't quite as able as they used to be and it's time to pass the responsibility?

 

[Meadbh]

Take a look at the Mini Mental State Examination (MMSE).

http://www.health.gov.bc.ca/pharmacare/adti/clinician/pdf/ADTI SMMSE-GDS Reference Card.pdf

The Mini Mental State Examination (MMSE) - Alzheimer's Society

Tests for Alzheimer's & Dementia | Alzheimer's Association

Detecting Dementia with the Mini-Mental State Examination (MMSE) in Highly Educated Individuals

 

[Khan]

This has been a concern all my life, more so now that I am over 60. I am in negotiations with two younger men.

 

[MRG]

One question on this topic that I'm dealing with currently with my parents (I'm the executor of their revocable living trusts) :

Does anyone know of standard 'tests' that people use or clauses they might reference on determining when they might be 'unfit' for managing their own finances? My parents are still with it, but I know my dad's the type that is sometimes difficult enough to get along with while he still has it all there - I can only imagine how he will be when he's more than started to slip and won't let me take over for his own good.

I realize that sometimes a doctor can diagnose official dementia.....but other than that (sort of as an unofficial way to help the effected person see for themselves) is anyone aware of some other sort of test or benchmark or other way that a person can kind of do themselves to supplement a doctor's evaluation to help convince them that maybe they aren't quite as able as they used to be and it's time to pass the responsibility?

Wow that's a tough situation. One our family has been dealing with. I wasn't aware of the MMSE tests. They seem a little better than what we've seen. The problem we had was DF was very good at faking and deception. He successfully hid his Dementia for 5 years. This lead my sister, his POA, into many problems. In the state he lives in even though she had POA, documentation from his DR. stating he was incapable of managing his own affairs, his attorney advised that DF could demonstrate a 'moment of clarity' and change his estate(he decided at age 96 he wanted to give his estate to the church).

We didn't want to force the preceding to have him legally declared incompetent. From what we learned that was very degrading to the elder. So we've walked on eggshells for 8 months. His condition has gotten to the point where his attorney now refuses to change anything. If you can get the elder to admit their issues, I think that's best.

Best wishes,
MRG

 

[imoldernu]

Am currently outlining my own "progress" toward that day in diary form, and can understand why capability to make decisions is such a difficult diagnosis. In my case, it's not an on-off situation, nor a good today, not-so-good tomorrow, thing.

So far, the biggest problem is frustration, short term memory, and declining ability to multi-task. The other part is just the nuisance of having DW and kids telling me that it's "normal"... when I know better.

Lots of unusual side effects, having to do with brain short circuits... popping up long forgotten life events, based on tiny stimulus bits... words, pictures, and really strange.. music.

With a genetic history, I have no qualms about accepting the situation, nor in sharing the "slide"... The process, all by itself, is quite fascinating. Have done the basics... Power of Attorney, Will, a preliminary listing of things that have to be done... and some sharing with the kids about major concerns... but have not gotten in too deep yet, because it's bit upsetting for the family.

The one thing I don't want to do is to have a medical diagnosis. You have to think this through yourself, to see if that would be your own choice.

That said... am encouraged that the "process" will take some time, and hoping that it will be more like a decade, than a year or two.

 

[braumeister]

So far, the biggest problem is frustration, short term memory, and declining ability to multi-task. The other part is just the nuisance of having DW and kids telling me that it's "normal"... when I know better.

Lots of unusual side effects, having to do with brain short circuits... popping up long forgotten life events, based on tiny stimulus bits... words, pictures, and really strange.. music.
ke some time, and hoping that it will be more like a decade, than a year or two.

All that sounds normal to me.

 

[spncity]

....to help convince them that maybe they aren't quite as able as they used to be and it's time to pass the responsibility?

Some of this testing can be done by a neuro-psychologist.

Once something like any type of dementia is setting in, many individuals have little insight into their own deficits as the deficits progress. They will believe that there is nothing wrong with them beyond, perhaps, the aggravation of a little short-term memory loss.

It will help you to know the results of your loved one's testing, but for some types of dementia, your loved one may discount, disbelieve, or revise the conclusions.