Financial planning a key but neglected component of Alzheimer's care, say researchers

Feb 16, 2011

Patients newly diagnosed with Alzheimer's disease or other dementias, and their families, need better guidance from their physicians on how to plan for the patient's progressive loss of ability to handle finances, according to a study led by a physician at the San Francisco VA Medical Center and the University of California, San Francisco.

"When a patient is diagnosed with Alzheimer's disease or , the chance that their physician will discuss advance planning for finances is miniscule," said lead author Eric Widera, MD, a geriatrician at SFVAMC. "And yet when family members and are asked what's important to them, finances are near the top of the list."

Writing in the February 16, 2011 issue of the , the authors use a case study of an Alzheimer's patient who progressively lost the ability to handle finances as a springboard for a review of medical literature on the topic of dementia and financial impairment.

"The literature tells us that financial incapacity occurs very early and very rapidly in Alzheimer's disease and other dementias," said Widera, who is also an assistant clinical professor of medicine in the Division of at UCSF. "Patients start having difficulty managing bank statements and paying bills in the pre-dementia phase – mild cognitive impairment – and then, often within a year, lose more basic financial skills like counting coins and paying with cash."

This rapid progression of financial incapacity, said Widera, makes it "essential" that physicians proactively counsel patients and their families on financial planning "early in the disease, while the patient still has the capacity to make the decisions" that will allow trusted caregivers to take over finances.

"This is about giving patients with dementia a choice, respecting them as individuals, and working to maintain their autonomy even beyond the point where they can't make decisions anymore," Widera said. "Proper financial planning will leave both the patient and the caregiver with more financial resources to deal with the consequences of the disease."

As a first step in financial planning, the authors recommend that early in the course of the disease, the patient sign a durable power of attorney authorizing a family member or other trusted caregiver to make financial decisions on the patient's behalf. "If you wait until it's too late for the patient to be involved in the decision-making, you have to go to court, which makes it much more difficult and expensive" for the caregiver to take over financial responsibilities for the patient, warned Widera.

Another strategy is for the patient and a trusted caregiver to open joint financial accounts. "The caregiver can go online and see where the money is going," noted Widera. "This can protect the patient's autonomy while giving the caregiver a bit of oversight, and provide an early warning system as the disease progresses."

Explore further: Off-season doesn't allow brain to recover from football hits, study says

Provided by University of California - San Francisco

5 /5 (1 vote)
add to favorites email to friend print save as pdf

Related Stories

When the patient can't decide

Aug 18, 2008

Family members are often called upon to make medical choices for patients who are unable to do so themselves. Researchers led by Alexia Torke, M.D., of the Indiana University School of Medicine and the Regenstrief Institute, ...

Recommended for you

US judge overturns state's abortion law (Update)

7 hours ago

A federal judge on Wednesday overturned a North Dakota law banning abortions when a fetal heartbeat can be detected, as early as six weeks into pregnancy and before many women know they're pregnant.

User comments : 0

More news stories

Down's chromosome cause genome-wide disruption

The extra copy of Chromosome 21 that causes Down's syndrome throws a spanner into the workings of all the other chromosomes as well, said a study published Wednesday that surprised its authors.

How kids' brain structures grow as memory develops

Our ability to store memories improves during childhood, associated with structural changes in the hippocampus and its connections with prefrontal and parietal cortices. New research from UC Davis is exploring ...

Ebola virus in Africa outbreak is a new strain

The Ebola virus that has killed scores of people in Guinea this year is a new strain—evidence that the disease did not spread there from outbreaks in some other African nations, scientists report.