NYT Article: Sunday, October 31, 2010

When is the time right for an adult child to get involved in a parent’s finances? When should an accountant or a financial advisor call a close relative of a client whose judgment and decision making have changed? Is missing three months rent or mortgage payment adequate evidence to a family member of an elder’s memory impairment? Or should an adult child or niece/nephew resist involvement until a letter from the IRS informs the forgetful older adult of a huge penalty added to unpaid taxes?

A client of mine was hospitalized recently following a fall. He had memory problems for the past five years following a previous fall but valued his autonomy so adamantly that he insisted on managing his finances.  He paid his bills when he received them and his accountant did his taxes. Yet, sometime two years ago, his long term care policy lapsed and noone knew. When it was brought to his attention, he didn’t even remember having such a policy! His previous payments for premiums for five years went to naught. Now he has to pay privately for 12hour a day home health aides and hope his resources will cover future care.

A 63 year old female client began showing odd behaviors years ago like arriving late for family events, not dressing as immaculately as she always had and walking in a strange manner. Until she got fired from her job, her family kept arm’s distance despite finding her apartment cluttered and unkempt. When they finally got involved, they learned that the client had not paid taxes for 10 years and had been giving hundreds of thousands away in a scam!

An elder with moderate stage dementia maintained control over her credit card despite advice to her family to put a cap on the charge amount. One day, she insisted her caregiver drive her to Tiffany’s where she charged over $20,000 worth of jewelry. Her family tried to reason with her to return this despite the fact she no longer retained the ability to reason. They were unable to return the jewelry and still were reluctant to remove her charge card from her wallet even though she mixed it up with her insurance card.

A client with advanced macular degeneration (and mild dementia) but severe pride kept his out of town daughter away from his finances. Every day he would walk one block to the ATM using the building walls as support and withdraw $200 or $300 with the help of a “very friendly man” man he met in the street. The daughter began to observe his assets progressively decreasing but he denied reality. After three months, she assumed responsibility but not before $20,000 was gone.

A very lively and verbal gentleman came to be reassessed when I was a research associate at NYU Alzheimer’s Research Center. He had a moderate stage Alzheimer’s and during the meeting, he would get up, go to the phone, take a paper out of his pocket and call his broker. He would ask for an update and make recommendations to sell. I asked his spouse about this and she reported that although she explained to the stockbroker, he insisted on listening to him and their assets were dwindling away. Her children advised her to take control but she “couldn’t take that role away from him.”

In western society, and moreover in the world at large, control over ones monies is equated with control over one’s life. Older adults hold tightly on to this control and often become unaware (or deny) when they can no longer manage their finances adequately. Family members (or concerned friends) are challenged with identifying the ‘right time’ to jump in and assume responsibility. Unfortunately, there is no clear-cut rule to follow but there are red flags to alert an adult child or a significant other that the older adult has become more vulnerable and needs some level of protection. Now is the time to prepare a financial Advance Directive (Durable Power of Attorney) to prepare you for that time.

Helene Bergman

Helene Bergman, LMSW, MA, C-ASWCM is the founder and director of Elder Care Alternatives. She is a Certified Geriatric Care Manager (‘Fellow’) and on the Board of Directors of the National Association of Professional Geriatric Care Managers (NAPGCM). Following a career in public elementary school teaching and administration, Bergman received a Master’s degree in Social Work and embarked on a second career in geriatrics. Her initial work with Alzheimer’s was as a Social Worker in Adult Day Care followed by years as a Research Associate at the NYU Aging & Dementia Research Center. There she was a family counselor in a landmark longitudinal study on Spouse Caregiving and co-authored the book “Guiding the Alzheimer’s Caregiver: A Handbook for Counselors.” She has led many caregiver support groups for the Alzheimer’s Association and served as a consultant to nursing homes and day care programs to develop specialized environments for Alzheimer’s patients.

Helene frequently speaks on a wide range of eldercare topics for professional organizations, community agencies, EAP’s (employee assistance programs) and senior living facilities. She was interviewed on AARP cable TV about initiating Family Conversations and Assisted Living and presented ‘The Challenge of Caregiving for Aging Couples’ at ASA. Her article on Alcohol and the Elderly was recently published in “Inside GCM”, the journal for Geriatric Care Managers. She was on the advisory board of the Brookdale Center of Aging Certificate Program in Professional Care Management and taught the seminar on Home Care. She previously served as President of the Greater New York Chapter from 2000-2004.

Click here to view Helene Bergman’s resume

Click here to read Helene Bergman’s expert advice on Caring.com

Click here to read Helen Bergman’s advice on the Web MD Alzheimer’s Exchange

Jillian Gordon

Jillian Gordon, MA, CMC is a graduate of the University of South Florida’s School of Aging Studies.  Since receiving a Master’s Degree in Gerontology, she has earned a graduate certificate in Geriatric Care Management and has been designated as a Certified Geriatric Care Manager.

Jillian’s career in Care Management began in New Jersey where for the past few years she has provided comprehensive services to older adults in the Jersey Shore area. She has now relocated her infectious energy and passion for life to New York and will be enhancing the quality of life for older adults here. Jillian strives to advocate on behalf of her clients by promoting their independence, accessing and coordinating public and private services, seeking alternative living arrangements when needed, offering crisis intervention, and collaborating with family members and professionals. Her motto is ‘accent the positive’ and ‘eliminate the negative’.

Mousse Gordon

Mousse Gordon, AKA Miss Mousse, Chocolate Labrador with advanced degrees in fetching and frisbee.  Mousse is a gentle and obedient pup who aspires to be everyone’s companion dog. She spreads joy wherever she goes and loves spending quality time with the seniors she visits.

Elder Care Alternatives was created in 1994 to assist older adults and their families attain a Quality of Life in the face of acute or chronic challenges associated with aging. Their philosophy from the onset has been that given consistent and superior care and support, older adults can remain at home, in the community, throughout the entire aging continuum.

• Consultation/Referral for Employee Assistance Programs
• On-site workshops & lectures
• Caregiver Support & Counseling

• Interdisciplinary Collaboration
• Linkage & Support
• Training in Care Management

• Advocacy
• Care Management
• Assessment
• Comprehensive Care Planning
• Coordination of Resources & Care
• Crisis Intervention
• Daily financial oversight
• In-Home Care: Securing, Screening & Arranging
• On-going Care Management
• Referral & Linkage
• Coaching
• Entitlements
• Community Programs
• Insurances
• Medicaid
• Family Support & Counseling
• Long Term Care Consultation
• Relocation

Caregiving for an elder who is experiencing acute or chronic difficulties can be a demanding role. At times of crisis, you may be faced with the dilemma of making a decision that clashes with the elder’s sense of self-determination. At the same time, you may be in conflict over your own needs and those of your family.

Balancing everyone’s needs can be an overwhelming task.

With understanding and guidance from a Professional Geriatric Care Manager, you can meet the daily challenges of giving care with peace of mind. Elder Care Alternatives has the expertise and resources to preserve the dignity of elders while ensuring their security, safety and well-being. Our mission is to improve the Quality of Life for older adults while minimizing the stress on those who care.

Watch an interview with Helene Bergman, Founder and Director of Elder Care Alternatives, on Getting Your Money’s Worth with Judith West.

Elder Care Alternatives, LLC
11 Riverside Drive, Suite 8TE
New York, NY 10023

Phone: (212) 724-3170

Fax: (212) 799-3031

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