How Can You Tell If Your Client Has Diminished Capacity?

How Can You Tell If Your Client Has Diminished Capacity?

How good are you at spotting the telltale signs of diminished capacity in an older client? Many older people have a bit of difficulty remembering. We often dismiss this when we see it, thinking it's "just getting old". It may be part of aging, as we do process things more slowly as we age and recall may take longer. But, there is a point when a problem recalling things should be a red flag for diminished capacity for you, the advisor.   What are those red flags anyway? How do we label them? There are numerous signs of diminished capacity, more extensive than this article allows, but we'll look at one category, which we call cognitive signs. Here's a breakdown of what you should look for when your client has a lot of difficulty remembering things.

What to note and document about memory loss

This is one of the first things most advisors may notice in a client that causes concern. Perhaps she does not remember important meetings, decisions and discussions. Here are some examples of what you may see:   Multiple telephone calls in one day that are repetitive and do not make sense. The client forgets that she has already talked with you and is calling about the same thing in another call to you. She repeats a question she already asked you and that you already answered.   Client forgets why he has an appointment with you. This can be by telephone or in person. Perhaps the client himself asked for the meeting but then he forgets why. Or perhaps you wanted to discuss a proposed transaction with him and told him that, but when you call or he comes into your office, he has no idea why he is there. Trying to refresh his memory about it does not help.   Complete forgetting of an event that just took place. You just spent a hour with your client telling her some important information about upcoming changes to her portfolio. She seemed to understand when you were talking but an hour later she asks you questions as if the meeting you just had never took place. She had totally forgotten about it.   No shows. You have arranged meetings, appointments with others or events that require your client's participation. He agrees on the pre-arranged date and time but then does not show up. When you call him, he has no recollection of the event, that others are involved nor that he had agreed to this.

If your client demonstrates any of these indicators you need to be paying close attention and make an effort to contact your client more often than you did before you noticed these problems. Any or all of them might be warnings of developing dementia. There could be other reasons for memory loss, but you won't know unless you are keeping good records. The only way to determine if you have a serious problem here is to track these signs over time and document each instance you see.   If the problem gets worse, it is time to take it to the next level. In your organization that might mean escalation, or having the documentation reviewed by a committee. Ideally, as we see it, the next step should include contacting the client's appointed trusted third party who would step in when the client became impaired.   To learn more about diminished capacity and just what you should do about it, click here. An hour of accredited learning on the course Best Practices for Clients With Diminished Capacity will make you a lot wiser in your approach.

By Carolyn Rosenblatt, RN, Elder Law Attorney, & Dr. Mikol Davis, Gerontologist co-founder of AgingInvestor.com

Is There A Test for An Aging Client’s Diminished Capacity?

Is There A Test for An Aging Client’s Diminished Capacity?

Diminished capacity is sort of a catchall term that can mean different things. A person can have the capacity, for example to create a will or a trust, but at the same time that person might not have the capacity to understand the risks of buying a complex financial investment. Capacity is on a continuum. The more sophisticated the decision needed the more capacity it takes.

Is there any way to measure capacity? Is there a blood test or any other test? We have a number of things in the medical field that help give us clues and data, but there is no one, single thing that tells us for sure. We can't see inside a person's thoughts. What we do have is testing of the various areas of the brain, with standardized instruments, that give us information about how a person thinks. We call it neuropsychological testing.

What is neuropsychological testing?

Neuropsychological testing (using groups of related paper and pencil and verbal question and answer tests) can provide useful information to take the question of capacity outside the realm of speculation. Test data provides numbers, scores, something specific.

This kind of testing can give useful information about which tested parts of a person's cognitive function do or do not compare normally with the tested function of people of similar age and education. When a person falls below a measure of what is normal, and we have test scores to tell us where and how, it can give us guidance about whether to allow a person to keep making financial decisions.

Testing is underused in helping us find out about a person's mental capacity for numerous kinds of things, such as memory, following verbal instructions, understanding information and learning a new task. Not enough families know about it and request it and not enough others refer clients to the right source for considering it as a tool to give us more information. Perhaps older people resist it out of fear not "passing the test". If clients secretly know that they are losing their memory and do not want to be found out, they will strongly resist any suggestion of testing.

What can the advisor do?

If you are worried about a client who seems to be "losing it" and you aren't sure you have enough information about that, you can suggest that the client get a medical checkup, and that he ask the doctor to check into his memory. This is not a sure path to neuropsychological testing, to be sure. Unfortunately, doctors spend very little time with patients these days and a brief visit may not result in the follow-up testing you would like to have done. But in some cases, clients are willing, particularly when encouraged to do so by a concerned spouse or other family member. In spite of obstacles, know that this objective way of measuring things does exist and it can help everyone involved in the senior's life.

The client's primary care doctor may refer your client to a neurologist. The neurologist may prescribe this testing which is done by a licensed psychologist or neuropsychologist, who gives the results back to the neurologist.

You're not a doctor. But you don't have to be one to see the red flags of diminished capacity. If you are not sure just what to look for, learn all you need to know in an hour by clicking here. Learning best practices for diminished capacity can help you right away.

 

By Carolyn Rosenblatt, RN, Elder Law Attorney & Dr. Mikol Davis, Gerontologist co-founders of AgingInvestor.com

What Should You Say To A Client With Diminished Capacity?

What Should You Say To A Client With Diminished Capacity?

We've all had them. Those clients who seem to be more and more forgetful. They're with it some of the time and other times, not so much. They call you multiple times asking the same questions. They repeat their stories to you. It gets scary is when they start wanting to do dumb things with their money.

Unfortunately most firms do not have clear and specific protocols for you to follow when a client begins to show those telltale signs that he's slipping mentally. Or that she is flat out vulnerable to manipulation by some unscrupulous person. You see it, but what can you say? You just carry on hoping it will get better or that family will take care of it. But that doesn't happen. Then what?

At AgingInvestor.com we think it is far too dangerous for you to simply ignore the problem, or expect someone else to take care of it for you. If a scammer takes Dad, you will know when those strange and unexplained large withdrawals start coming out of his account. Family can reasonably expect that you will do something to keep your client, their father safe financially. That's fair enough, but how do you start?

First, you need to document every instance of anything that you observe that shows you that your client's ability to make financial decisions is becoming impaired. You don't need to be an expert to see what's obvious. Multiple phone calls in one day with the same question is an example. When you explain something slowly and clearly enough for a high school kid to understand and your formerly sharp client doesn't get it at all, that's another example: easily confused. There are numerous signs.

When you have collected the signs over a period of say, six months or more, and you have carefully recorded them somewhere, it's time to bring your client in for a face-to-face conversation. If you are at a distance, this may have to be by phone but it has to happen.

Start with your concerns. For instance, you can say "Jack, I'm getting concerned about some things I've noticed with you over the last few months. I've heard you ask the same thing multiple times in the same day. I have noticed that you are forgetting some important things I've explained to you about your portfolio." Jack may push back and probably will. You follow up by calmly showing him or describing to him the dates and your documentations of instances. "See here's what I mean. This is worrisome to me Jack. My job is to be sure your money is safe and that no one tries to rip you off. When you forget a lot, predators are waiting to target you".

Then you bring the conversation to the ask. "Whom do you trust that we could involve in being a backup safety person with you, or just joining in on the decisions about your investments here that might be a reassurance for me that you are ok?"

If you were smart before the diminished capacity issue came up long ago, you would have had Jack identify two trusted others you could contact in this situation. You would have had Jack give you permission to disclose protected information with the trusted others and thus dispose of the barrier that stops so many: the privacy issue. All this would be in your client file.

People respond to this approach in various ways. If you know your client, you will know some words that may work best with him or her. The point here is that you need to have this conversation, which may initiate a series of steps to keep that vulnerable client with diminished capacity as safe from predators or his own foolish decisions as you can.

Here are some takeaways from AgingInvestor.com, where you can learn more on this subject.

  1. Face the issue that you have to address this, awkward or not. Diminished capacity must not be ignored.
  2. Document each and every sign of diminished capacity as you communicate with your client. Here's a checklist to help you.
  3. Open the conversation by making it your concern. You are worried about the client. You want to keep him/ her safe. You want to do your professional job.
  4. Have at the ready your trusted 3d party contacts for your client. Get your client's permission to involve the trusted others at the earliest opportunity.

Does this expand your role as a financial professional? You bet. But there is no escaping aging clients and the issues longevity brings. Be ready for them.

Carolyn Rosenblatt, R.N., Elder Law Attorney, & Dr. Mikol Davis, Gerontologist co-founder of  AgingInvestor.com

The Elephant In The Room: Financial Professionals With Diminished Capacity

The Elephant In The Room: Financial Professionals With Diminished Capacity

Every profession is facing a common dilemma: what to do about your own impaired colleagues. When there is no mandatory retirement age, there is no one to say, it's time to quit. Do you think a colleague has dementia?

People are living longer than ever, continuing in their work longer than ever and sometimes they start to "lose it" before they decide to retire. As none of us are absolutely immune from Alzheimer's or other dementia, or anything that causes cognitive decline, we all need to consider what we would want if it happened to us.

Would you want a friend or colleague to tell you that you've got a problem with memory and maybe it's time to hang it up and rest? Would you want your legal department to embarrass you and tell you to stop handling other people's money because everyone knows you're no longer competent? It's a frightening thought.

Longevity can be great, but not when you are impaired. As a consultant with expertise in aging, I have seen cognitive impairment to a dangerous level in numerous professionals. One was a trial lawyer colleague, high profile and famous. No one stopped him from practicing law until he had nearly destroyed things. I have seen it in a business owner who founded his company and had been going to the office for 50 years. He was kicked out of his favorite restaurant and was physically harassing employees, his Alzheimer's had gotten so bad. No one made him stop until outsiders (myself and my partner, Dr. Davis) came in and created a plan to prevent him from entering the office again.

I have seen a judge with dementia fall asleep on the bench in the middle of lawyerly argument in court.

I spoke with the sister of a former bank president who had become a financial advisor. He had lost most of his wealth because he could no longer keep track of it and he was being taken advantage of. He was living in squalor before family intervened. During that time, he was still working as a wealth manager.

These are real cases. The message is that we need a strategy and a policy in any office with advisors who work into their senior years, to address the possible impairment that might occur.

There is a way to do this so as not to needlessly embarrass the affected person. There is a way to require that a person with memory loss confirmed by colleagues should step down and give up managing anyone's assets. This should thought out in every office. Clients need protection. It takes construction of a reasoned policy to address the impaired advisor confidentially by first requesting retirement and then mandating retirement if the advisor refuses to go along.

Pilots have a mandatory retirement age of 65. That would not work for many other kinds of professionals. But something has to be done. If you want some concrete action steps to put in place in your office, you will find them in our book, Succeed With Senior Clients, A Financial Advisor's Guide to Best Practices. Get your copy today by clicking here.

By Carolyn Rosenblatt, RN, elder Law Attorney, & Dr. Mikol Davis, Gerontologist co-founder of AgingInvestor.com

The Myth of That “Nice Long Life Ahead” at Age 65

The Myth of That “Nice Long Life Ahead” at Age 65

Probably I'm not the only one who has seen the deluge of ads on TV for Medicare supplement insurance. One that really bothers me though is the bit with the actress saying she's only in her 60s and "I've got a nice long life ahead." She's so smug and so sure she's just fine and will stay that way.

 

The ad taps into the belief most people cherish, which is that impairments happen to other people and that they will just keep being fine, at any age. People say they want to live to be 100. Their imagination is that they will be perfectly capable in all ways and will not need any help at 100. That is belief, not truth.

 

What makes a "nice long life" anyway? No one ever wants to think about infirmity and cognitive decline. And yet, by the time we reach that nice old age of 85 at least one in three of us, and maybe even one in two will have Alzheimer's disease. Not so nice. And oh, by the way, that supplement insurance the actress is promoting doesn't pay for care if you need it at home long term. Neither does Medicare.

 

Every financial planner who has a client over age 65 needs to be considering that the "nice long life" that is part of our cultural fantasy is indeed dreaming for most people. It's not about longevity. That we've probably got. It's about good health in old age. That, we have definitely not totally figured out. As 10,000 people a day are now turning 70, it's time to get past fantasy and consider how to make that long life a lot safer financially.

 

Are your client's assets enough to pay for the care they are likely to need? If not, you, the client and her family must engage in the essential discussion about who will care for the client as she ages and how much it will likely cost. One must do the math. The cost of caring for someone with dementia at home is staggering. And the advisor needs to calculate it. This is not considering the usual figures thrown around about "the average couple at age 65 will spend "x" dollars on out of pocket medical expenses for their lifetimes". None of those commonly used figures consider what it may cost to pay for a person with Alzheimer's disease who lives for 7-20 years with the disease. Help from someone will be absolutely necessary for anyone with dementia.

 

Your portfolio review with a client at retirement is a good time to talk it over and bring up the actual, not fantasy prospects for the future. And here's hoping you will not be influenced by stupid TV commercials about what the future may look like. Longevity can be wonderful, yes, and you can help make it financially safer for your older clients. A nice long life is certainly possible. And a long life with accessible assets to cover long term home care near the last phase of life is ideal.

 

Carolyn Rosenblatt, RN, elder law attorney, AgingInvestor.com