This is an addendum to Part 1. Over the weekend, there was an article in the New York Times that caught my attention:
Money Woes Can Be Early Clue to Alzheimer’s
New research shows that one of the first signs of impending dementia is an inability to understand money and credit, contracts and agreements.
It is not just families who are affected — financial advisers and lawyers say they are finding themselves in a bind when their clients’ minds seem to be slipping.
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.
The issue is far from simple. Dr. Jason Karlawish, an associate professor of medicine and medical ethics at the University of Pennsylvania, says it is generally agreed that decisions by a competent adult should be respected.
But, he said, “What do we mean when we say someone has enough decision-making capacity to be ‘competent’? The law, psychology and finance are all waking up to issue of decision-making capacity.”
Three people were profiled in the article:
For example, a lawyer has to make an independent determination that the client is competent. If the lawyer determines the client is incompetent but the client insists on executing a document, the rules say the lawyer should withdraw representation. However, Mr. Grant said, “one can question whether withdrawal from representation of an incompetent client is actually in the client’s best interest.”
Bruce Wampler of Glenwood Springs, Colo., said the law was of limited help in dealing with his father, who lived alone in Casper, Wyo., and, in his dementia, had forbidden his son to visit him.
Concerned about his father’s capacity to make decisions, Mr. Wampler went to court and won guardianship, angering his father so much that he refused to speak to Mr. Wampler for nearly a year.
Meanwhile, a neighbor who believed that the elderly Mr. Wampler was being ignored by his family found a lawyer who arranged to have the guardianship rescinded. The neighbor also encouraged the father to change his will, leaving much of his money to organizations he had never supported, his son said. At the same time, the elder Mr. Wampler was sending substantial amounts to lottery schemes.
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.
“The law wants a yes-or-no answer,” Mr. Sabatino said.
But medical evaluations come in shades of gray, discussing strengths and weakness in reasoning and mental abilities. The assessments place patients on a continuum. “They don’t like to give a yes-or-no answer,” Mr. Sabatino said.
And persuading clients to have medical evaluations can be difficult, as the law association’s handbook acknowledges.
“A referral to a clinician requires client consent, and can be quite traumatic for the client, as well as unsettling for the lawyer-client relationship,” the handbook states, adding, “Also, it is expensive.”
This is not new news; what is new is the world has never experienced such a large cohort set to pass into old age. To complicate matters, the signs and symptoms are not apparent to the afflicted person. It could be years before the problem is obvious to everyone. The last time I saw my mother, she was angrily screaming, “I have RIGHTS!”
Back in the 1990s, people were stunned by the contents of Ronald Reagan’s deposition on the Iran Contra Affair. We all found out later that President Reagan suffered from Alzheimer’s disease. While the official diagnosis was made after he left office, it was apparent things were not well during his second term. Since no one wants to rock the boat, I imagine we will hear many more stories like these over the next decade.
What if this is the tip of the iceberg? Lots of people write about demographics and social trends, but nobody wants to talk about this. Yet we must ask ourselves, what if the early symptoms are already manifest all around us? Aren’t young people the ones who are supposed to riot yet who is doing the stomping now? Wouldn’t dementia explain a lot of the anger, fear and paranoia that we’ve recently seen on the news?
Suddenly, a world driven by groupthink where facts don’t matter and Fox = news makes total sense. And with this understanding, we can calmly redirect our focus to what matters — looking out for number one — and withdraw from nonsensical political discourse with a clear conscience.
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21 CommentsSubmit a comment
It is difficult for a 60 year old “Child” to take control of an 80 or 90 something parent with dimentia. I faced this problem with my mother. She was nice about it most of the time but I understand the “I have rights” cry and the determination to hold on after fighting to survive for 90 years. Thankfully, she was not prone to giving away much except to the “Save Social Security” cons. I can say it takes years of careful preparation and a lot of love and trust to be in the position to “take over”.
In the end there will be an “event” where you have to step in and use the controls that have been put in place. It is sad and very emotional but unavoidable if you care for your parent.
SO are you helping your kids be ready for this or are you determined to “survive”? A durable Power of Attourney put in motion by the signature of two MD’s is a start.
I don’t hold any property, and the kids have the passwords to my accounts, so in the event of my demise, they just have to press a few buttons.
My experience is that when you get to the end the “kids” need the power of attourney to be able to “speak” for you. If they don’t have it they are not in control at the places they need to be. If you are a renter and truely hold no assets that will be a plus. Downside is the kids own your stuff and then one marries and gets killed in a car accident and their spouse takes control of your assets as sole benificiary. It can get complicated without out a lot of discussion and legal help. My experience is that it requires some thought and is not as simple as giving passwords.
No worries. No one is married yet. By that time, trusts will be in place.
Good planning now get the powers of attourny in place.
Another comment. I don’t think that only people on the right have dementia. I would guess that it is distributed fairly equally. I also don’t think all the extrememist are on the right either. I think liberals would like to portrait it that way. So I am not buying dementia is responsible for the Tea Party or the current unrest in the electorate. Sorry T.
It would be preferable that one could chalk it up to dementia. Could it be that the extreme right appeals to those who are angry (for any reason)? But it won’t matter. There are 105 million Boomers and Matures while Gen X and Millennials number 152 million. The silent majority is sane, paying into the system and we will hear from them soon enough.
For all we know, the Tea Party gets what they want, a 40% cut to balance the budget which would entail huge cuts in Medicare, Medicaid and of course, Defense. That doesn’t hurt the poor because they already have nothing. It doesn’t hurt the young because they don’t need the services The people who would immediately shoulder the burden will be the people that voted them in. I can live with that.
What is it with the extereme left then? No dementia just princilples?
Are you referring to Greenpeace or PETA?
Both and Code Pink as well
AND Fox = News? How about MSNBC (CNN) = News???!!! Do you believe that? I didn’t think so So why FOX = News.
Is there any news or is it all spin including NBC, CBS, ABC, FOX, CNN and MSNBC not to mention CNBC/Bloomberg/BBC. Looks like FOX = one and the rest = five+. But maybe 1 = 5 and that in itself is causing some dementia.
I’ve watched them all, and correct me if I’m wrong, but I don’t recall anyone on the “left” talking about Second Amendment remedies or revolution. The good news is that the audience for any type of “news” is very small. Nobody really cares. Everyone is watching Dancing with the Stars, Jersey Shore or Keeping Up with the Kardashians.
Just folks like Stalin and Chavez. The ones that care vote. The ones that watch the Jersey Shore etc. never mattered any way. In 1984 they are the sheep not the pigs.
Sorry that was Animal Farm not 1984.
It’s Lord of the Flies.
I wasn’t aware they were on the ballot.
Ok but you get my point there is potential for far left issues. And as the gov’t takes over more and more the potential increases.
Left or right makes no difference. Two sides of one coin.
Agree so don’t go off on the right only. thats my point
Except we don’t see anyone on the “left” stomping or threatening Second Amendment solutions. Maybe it will come to that one day, but until then, you’ve just proven the point of this article.
And we believe in life, and in the strength of love; and we have found a joy being together.
And in our search for peace, maybe we’ll finally see: even to question truly is an answer.
– “We Laugh, We Cry” – Shelley Denham Jackson
As an Unitarian Universalist who has assessed people with memory and other cognitive problems for many years; I read the previous comments with interest. We need community or we fall into anarchy no matter what our faith. Whether the Zen of the Markets, or the paganism of the land, or the forgiving power of an angry God we still need each other. We all pray that it will end peacefully for us. We move to the left, we move to the right we move to the centre. Nothing wil put off the inevitable. When a new correlation comes out; I always say that the only correlation that I believe in is the one between life and death.
Which is why when my son and daughter come home at Christmas there will be an appointment made and an enduring power of attorney set out and a living will put in place.
Thank you for this blog.
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