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 Wampler was being ignored by his family found a lawyer who arranged to have the guardianship rescinded.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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