Dementia and Money Management: 10 Things You Need to Know

Dementia affects the memory and the ability to work things out. Coping with money is often an early difficulty. Later on, as the illness progresses, money and legal matters can become harder to manage.

At first, the changes are slight. The person becomes forgetful and likely to repeat things. She may behave in unusual ways. She may be inwardly worried that she is losing control. Some people may become withdrawn and depressed, or agitated. Some may lose interest in life and find it hard to make day-to-day plans, and some may have problems handling money. These early changes may be noticed only by close family and friends.

As the illness goes on, the changes are greater. Memory problems get worse. The person may begin to:

* forget names of family or friends
* repeat questions over and over again
* not eat properly
* neglect personal care
* find it hard to grasp what is said
* be hard to understand at times, losing track of what she is saying
* become angry or upset quickly
* see or hear things that are not there
* have difficulty managing housework, food preparation, activities, interests or work
* need help with everyday tasks such as bathing and dressing
* need help with handling money.

In the later stages of dementia they may be very confused. Often they may not recognize even close family members. They will need a great deal of help, for example with eating, washing, bathing and using the toilet. Her speech may make little sense and she may not understand other people. Their personality may have changed greatly, but they may remain physically well for a long time.

1. People with dementia often say that the ability to manage money is one of the first skills to go.

2. Making plans for your financial and personal welfare as soon as possible after your diagnosis is very important. Later on in your illness you may no longer be able to make certain arrangements.

3. You can use powers of attorney to appoint someone you trust to look after your financial affairs and/or your personal welfare.

4. If you want, you can have different people look after your financial affairs and your personal welfare. Many people prefer to use an attorney to draw up a power of attorney but you can 'do it yourself'. In the State of Texas the Department of State Health Services (DADS) has a Legal Planning web site (http://www.dshs.state.tx.us/alzheimers/legal.shtm) geared towards Alzheimer's disease and dementia patients.

5. Having a power of attorney in place doesn't mean you can no longer make any decisions for yourself.

6. You can also set out your wishes about your future care and medical treatment with a health care directive.

7. If you haven't made a will or it has been some time since you reviewed an existing will, it is a good idea to do it while you are able - no-one else can do that for you.

8. Many people worry about being forced to sell their house and other assets if they need care and run out of money. It can be possible to protect some assets for family but advanced planning is very important. An attorney can help you do this planning but you need to seek advice very early in the process. There is a five year look back period for financial transactions so you need to seek advice well before you may need services.

9. Before you consider giving away your house or other property you need to get professional advice as you may not be protecting anything as Medicaid has a 60 month look back period where your finances are analyzed and if assets have been disposed of it can be disqualifying. Again, see the advice of an attorney early in the process.

10. You can simplify your financial arrangements by paying bills by direct debit or standing order and getting benefits and pensions deposited directly into your bank account.

In the best of circumstances, loved ones can gently intervene before small financial mistakes escalate into a much bigger problems. But family members and other individuals who take on the role of financial guardians need to thoughtfully consider their approach.

If you want to stay in your home there are many services that can help.

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