Podcast Interview: Common Challenges in Helping Aging Parents

Podcast Interview: Common Challenges in Helping Aging Parents

Nov 15, 2016 | aging, elderly, financial capacity, handling money for seniors, seniors finances

Interview: Common Challenges in Helping Aging Parents

Hello everyone. Welcome to better health while aging, a podcast that gives you strategies and tips about improving the health and well-being of older adults. We discuss common health problems that affect people over age 60, the best ways to prevent and manage those problems and we also often address common concerns and dilemmas that come up with aging parents and other older loved ones, like what to do if you're worried about falls or safety or memory or even the quality of a seniors healthcare.

I'm your host Dr. Leslie Kernisan. I'm a practicing geriatrician, so that means I'm a medical doctor specialized in geriatrics, which is the art and science of modifying healthcare so that it works better for older people, and for their families.

Today’s episode features a special guest and we are going to be talking about common challenges related to aging parents. My guest is Carolyn Rosenblatt. She is an attorney and a registered nurse, and for the past several years she and her husband Dr. Mikol Davis, who is a geriatric psychologist, have specialized in helping families resolve difficult issues related to older parents. They have a website at AgingParents.com.

Carolyn is the author of “The Family Guide to Aging Parents” and several other books about assisting older adults with legal, financial, and life issues. She also write a column about aging for Forbes.com.

I have read many of Carolyn’s Forbes columns over the past few years and also read her book recently as I was writing one of my own articles about advance planning for legal and financial issues. So I’m thrilled that she was able to join me today to share some of her insights on how to manage some of the common challenges and dilemmas that families often struggle with.

Carolyn, welcome to the show.

Questions:

  • Tell us about your practice and how did you come to specialize in families and aging parents?
  • What are the most common types of problems that people ask you to help them with?
  • Some common scenarios we can discuss:
    • People are sometimes concerned that their parent is losing mental abilities, or becoming “incompetent.” They also often complain that their parent is refusing to talk about the issues and refusing to go see a doctor. What are some of your suggestions to help families resolve this?
    • People worried about how their parents are spending money, and/or worried that someone else is influencing the spending (e.g. a sibling)
    • People worried about their parents driving
    • People who want their parents to plan for decline in the future but the parents refuse or avoid the subject
  • How can older adults and their adult children plan ahead to avoid many of these difficult situations? Can you share some favorite resources that are effective in helping people through this?
  • For families that have set up springing powers of attorney, there is often a requirement that a doctor or other clinician say the older person no longer has capacity to manage finances or whatever power is in question. But families often say they can’t get the person to the doctor/psychologist to obtain this assessment. Suggestions?
  • There is really a lot that families could and should do to plan ahead. If people are feeling really limited in time and energy, what do you think are the most important or high-value things to do, when it comes to older parents who are doing ok now.
    • Another angle on this: what are the things that people end up regretting not doing the most often?
  • You’ve written a lot about preventing financial abuse of older adults. What are some useful steps you recommend to prevent this from happening, or from causing serious financial losses?
  • You have a chapter on helping older parents from a distance, and you write about how you and your husband eventually hired a care manager, in order to have someone close to your mother-in-law. What do you recommend for people who feel they can’t afford to hire a care manager?
  • How can families deal with declining abilities, dementia, and physical dependency if there isn’t family to provide care or money to hire someone?
  • How have you and your husband planned for your own future? (We can skip this if it’s too personal.)

At the end I will tell people they can learn more about you and your special consultation practice at AgingParents.com.

Proving Value to Retired Clients: Creating a Financial & Personal Checklist

Proving Value to Retired Clients: Creating a Financial & Personal Checklist

Oct 28, 2016 | aging, aging investor, elder investor, elderly, finances for elders, financial advisors, handling money for seniors, investor, senior investor, seniors finances

Proving Value to Retired Clients: Creating a Financial Checklist

Many of us in this society have a very negative image about aging in general. We don't want to be "old". It is fueled by advertising on TV, movies, print media and other outlets with a consistent message: aging is bad, being younger and turning back the clock is good.  We are a work ethic driven culture. When we are older and no longer "productive" we are generally seen as less valuable.

Then there is the fear and denial about dying and death.  Our culture has been called the only one in the world that thinks of death as something optional.  Note how we talk about it to family--"in case anything ever happens to me... Besides it being a fantasy that maybe something" won't happen to us, it keeps us from planning, from preparing our loved ones and from being responsible about our older years, possible declining health and the burden ignoring these things can put on our families.  Reaching retirement age is a time to do planning about more than money.

Financial advisors are in the planning business.  You look ahead, analyze, budget and calculate. But your clients may not be on the same page in your view of the future.  They are busy being in denial that they may ever get ill and die.  You can help them.  In doing so, it may also make your job of talking about such issues as long term care, budgeting and spending easier.

Most people do not want to burden their loved ones. Most of them do not want to trouble adult children unnecessarily as they age. That is your best selling point for bringing up the personal matters.  These include how every senior and every retiree needs to plan for things in their own lives that go beyond how much money they've saved and how it will be spent having a great retirement.

Here at AgingInvestor.com we see the messes people leave behind when they nurture the Great American Fantasy that losing independence won't happen to them and that they will live happily to age 100 and die peacefully in their sleep.  Family members can spend years cleaning up the disaster their older loved ones leave because of failure to plan and take care of business.  It is truly not fair to anyone.  It leads to anger, resentment, family conflicts and sometimes to loss of wealth through ignorance. We've heard it and seen it countless times.  We put a checklist together to help people avoid these disasters created by the fantasy.

What Can You Do About It?

You can give your clients this checklist next time you sit with them and review the portfolio.  You can gently urge them to do what the list says is needed. We've broken down the essentials into 10 points, a "to do" list if you will. You can encourage them to take care of the items on the list, if they haven't already.  In general, the to do list includes updating the estate plan, having critical documents in the right hands, providing necessary financial, computer and account information to trusted family and having a family meeting to educate one's heirs about the older person's affairs. This is how your client gets a family ready. This is how they avoid unduly burdening anyone. This is how they free their loved ones from distress and unnecessary work when they have to take action as an aging parent declines and passes away.

Some of your clients will brush off your suggestion. They love that Great American Fantasy and aren't about to give it up. Others will thank you as they have thanked us and will go forward.  Their families will be forever grateful.  You'll look like the caring, smart and responsible planner that you are.

Get your free Ebook and the Financial & Personal Checklist For Smart Retirees, click HERE.

By Carolyn Rosenblatt, RN, Elder Law Attorney, AgingInvestor.comclick-here

The Inner Workings of Clients’ Financial Decision-Making Ability

The Inner Workings of Clients’ Financial Decision-Making Ability

Sep 28, 2016 | aging, aging investor, Alzheimer's disease, diminished cognition, elder investor, elderly, finances for elders, financial advisors, financial capacity, handling money for aging parents, handling money for seniors, senior citizen investor, senior investor, seniors finances

The Inner Workings of Clients' Financial Decision-Making Ability

Whether you have a lot of older clients or just an occasional one, it's critical for every financial professional to understand whether a client can safely make decisions about money. It might seem straightforward when your client is able to carry on a conversation, talk about current events or make a joke. You assume she's fine, but it's not that simple. Conversational ability can mask a true disabling brain condition we call dementia. It does not reveal itself easily, particularly at the earliest stage.

The insidious onset of Alzheimer's disease or other dementia can sneak up on a client and affect the ability to exercise judgment about finances. To help your clients, you need to know the red flags of diminished capacity, a basic skill anyone can learn. You can get a free checklist to help your do that at AgingInvestor.com. But beyond that, it is critical to understand just how complex our capacity to make safe financial decisions is.

Research shows us that with the most common form of dementia, Alzheimer's disease, financial capacity is moderately impaired even at the very beginning of the disease process. By the time a client gets to the middle stage when symptoms are more obvious she is already severely impaired in her financial capacity. No one should be making independent decisions about finances with severe impairment of this capacity.

This financial ability is defined as "the capacity to manage money and financial assets in ways that meet a person's needs and which are consistent with his/her values and self interest." It is broken down into nine areas or "domains". These include cash management, basic money skills, bill payment, and financial conceptual knowledge. The ones an advisor is most likely to see and assess are knowledge of personal assets and estate and investment decision-making.

You may not discuss with your client whether he understands what a money market is but you will be ethically obligated to discuss the pros and cons of various suggested investments and the effect they will have on your client's overall financial picture. This is the area where older clients with impairment will not be able to process the information you are offering them. When they are affected by brain disease like Alzheimer's (over 5.5 million people are diagnosed now, with that number expected to rise dramatically) they will not be able to "get it". You are on dangerous ground if you proceed to recommend or sell any financial product in the face of serious doubt about a client's financial capacity.

Granted, many financial products are complicated and the average person may not grasp all the nuances. But when you believe your client is probably impaired and cannot understand any carefully worded explanation you give, you are exposing yourself to liability by going ahead with transactions for that person.

How could this get you in trouble? All of the regulatory agencies want you to keep your older clients safer and they have issued guidelines for how to do that. All of them want you to know the red flags of diminished capacity. Financial capacity is the most complex of the kinds of capacity a person can have. If you do not involve a third party to assist the client with financial decisions, you risk a bad outcome and regulatory prosecution. You also risk the heirs coming after you in civil lawsuits, charging that you should have known what everyone else knew at the time, that their mother/father was impaired and you should never have sold that, done that or caused the bad outcome.

This is a very real problem among financial professionals-- the failure to recognize and act on the warning signs of diminished capacity. If you are managing a retirement account for that client, beware even more. Acting in the client's best interest means that you need to understand when the client's financial decision-making capacity is going downhill.

This article just touches on the complexity of financial capacity. Everyone deserves to have a deeper understanding so you can avoid prosecution or questionable accusations about your recommendations or the client's investments. When the investment an impaired client went for at your suggestion loses money, you can bet someone will blame you if they can. Don't set yourself up. Don't make it easy for them to attack you.

The way around this risk of working with an impaired client is to have your client's permission to involve a trusted third party as a surrogate decision maker for all financial transactions. How you get that permission is the subject of another article and it needs discussion. In the meantime, take a deeper dive into the nuts and bolts of financial capacity in Succeed With Senior Clients: A Financial Advisor's Guide to Best Practices, available here. Chapter Two explains all you need to understand about the components of financial capacity. And the privacy question and how to get that trusted other involved is answered in the book too.

By Carolyn Rosenblatt, RN, Attorney, AgingInvestor.com

Attention Financial Advisors: Do You Have A Colleague With Cognitive Impairment ?

Attention Financial Advisors: Do You Have A Colleague With Cognitive Impairment ?

Sep 22, 2016 | aging investor, elder investor, finances for elders, financial advisors, handling money for aging parents, handling money for seniors, investor, senior citizen investor, senior investor, seniors finances

Attention Financial Advisors:Do You Have A Colleague With Cognitive Impairment?

The financial services industry frequently shows concern about the problems of longevity and aging clients. Cognitive impairment, diminished capacity and dementia get air time with various solutions, mostly vague, offered by industry insiders. But one problem is not being addressed: the professional herself with cognitive impairment.

It's time to look at this as a real risk, not some unlikely possibility that can easily be taken care of by a succession plan for the professional's business. Dementia is a complicated disease. It sneaks up on people, with the early warning signs of short-term memory loss, followed by increasing difficulty with reasoning and judgment. If we had not witnessed this at AgingInvestor.com with impaired professionals ourselves, we might be fooled into thinking that professionals had figured out how to address it. Simply put, they haven't.

Let's look at the notion that all you need is a succession plan for your business and there will be no problem if you develop cognitive impairment yourself, or someone in your organization does. What's the flaw in this? It is that many people with early Alzheimer's or other dementia do not recognize that they are impaired. This phenomenon is called anosagnosia, an inability or refusal to recognize a defect or disorder that is clinically evident. Ironically, the part of the brain that reasons and analyzes is so affected by the disease that it is not able to process the information about one's own impairment.

How this plays out is that as a person ages and becomes more at risk for dementia, some will surely fall victim to brain disease. The odds are at least one in three by the time we reach age 85. The risk doubles about every 5 years starting at age 65. So some financial professionals are going to develop dementia and some will not know that they have any impairment. So they keep working. Others around them are afraid to raise the topic when alarming signs first appear. No protocol exists to ease a person out of the role to which they are accustomed, particularly when they tell you they're feeling just fine, thank you.

Busting The Myths

Myths exist. The first is that a financial professional, whether managing money for clients, selling products or addressing their taxes and accounting, will know that he or she needs to retire when the time comes. This is not what occurs. Many folks who have a good book of business and enjoy what they do will not look to retire by a certain age. They keep working, and consequently when they are impaired they put every client at risk.

Another myth is that somehow the doctor, the family or someone else will advise you when you have dementia and you will of course agree with their assessment. Denial is a frequent component of cognitive impairment, rooted deeply in fear of losing control over one's life. Even those who start to see and fear their own early difficulties with memory will cover it up, avoid facing it and carry on as if everything is fine. Even an annual physical checkup with the doctor is very unlikely to reveal the early warning signs of dementia unless the patient mentions cognitive problems to the examining doctor.

What Can Professionals Do?

As described in detail in Succeed With Senior Clients: A Financial Advisor's Guide to Best Practices, every organization needs a protocol to address the risk of diminished capacity in an impaired colleague. Few firms have a mandatory retirement age, but this option exists.

A protocol for advisors and others can look similar to the protocol every professional needs for aging clients. First, one needs a standardized way to spot the red flags of diminished capacity. Next, these must be regularly documented and contact with the potentially impaired client must increase. Third, a standard way to escalate the issue to knowledgeable others in the firm should exist. For clients who demonstrate the red flags, the organization must have a next step, which means contacting an appointed third party to become a surrogate decision maker. For professionals, a mandatory way to ease the person out of the job on a specific timeline should be in place, and this should become office policy.

It is time for every professional to look at the reality of the risk we all face with impaired cognition. It can happen to anyone. Your professional skill does not protect you from dementia. Wise planning for how you or your colleague would exit your job when you can't see why you need to must be on everyone's agenda.

By Carolyn Rosenblatt, RN, Attorney,  & Dr. Mikol Davis Geriatric Psychologist

AgingInvestor.com

Aging Clients and What Regulators Urge You To Do With Them

Aging Clients and What Regulators Urge You To Do With Them

Jun 14, 2016 | aging, aging investor, elder investor, finances for elders, senior investor

Industry regulators are always coming out with recommendations. And those have a way of eventually becoming mandates. When it comes to seniors, the regulators are very concerned about financial professionals keeping aging clients safer financially. We’re not talking about the DOL rule here. We’re talking about a lot of other recommendations they’ve made. One of these is increased communication with your older clients, 65+. What’s the big deal? These clients are more at risk of financial abuse from every direction. Regulators want you to do what you can to protect senior investors.

Here are two ways they suggest you do that.

First, increase the frequency of your communication with these older clients. That means reviewing their portfolios more often. It means calling or writing more often. It means paying attention to what is going on in their lives that may increase their risk of being manipulated financially.

Second, discuss with your clients the issues that affect seniors. One of these issues is the possibility of becoming impaired. You can present the idea in terms of having a stroke or heart attack. That’s a lot easier a concept for an older person to swallow than the idea of becoming cognitively impaired, everyone’s great fear. So you suggest that your client be sure to have an appointed agent on a durable power of attorney.

Another important piece of the picture of improved communication with aging clients is for you to encourage them to discuss their financial affairs with their heirs. You can be the catalyst in this process. Such discussions provide a forum for you to recommend that the client appoint a trusted other to serve as agent on a durable power of attorney document. Knowing that your client has done that essential thing, you have the potential to work with the appointed person in the event that your client becomes incapacitated for any reason, including dementia.

Without a DPOA, it is generally a messy legal problem for those who must take responsibility for an impaired elder. They may have to undertake the expense of seeking a guardianship in court to even have legal permission to make a bank withdrawal or sell a stock for the elder. If you know who the appointed person is, suggest a conversation with your client and that agent. Lay the groundwork for communication, should the need arise to have the DPOA step in at a later time and act on behalf of your client.

(Incidentally, from a legal point of view there should not be a conflict in appointments of the agent on a DPOA and an appointed successor trustee for the family trust. That begs for later fights. Encourage your client to consider this!)

We are touching on just a bit of what the SEC, FINRA and NASAA have jointly recommended for you and indeed urged you to consider in working with your aging clients. They want you do to business with this population in your book differently than the way it goes with younger clients.

You will absolutely benefit by being informed of what the regulatory agencies want from you when it comes to seniors. It is spelled out in some detail in our book, Succeed With Senior Clients: A Financial Advisor’s Guide to Best Practices. Check out the chapter “Pre-Emptive Strike: Hit the Aging Client Problem Before It Hits You“. Click HERE to get your book today. You will develop expertise you’ll appreciate soon.

By Carolyn Rosenblatt, RN, Elder law attorney, AgingInvestor.com