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Old 05-23-2012, 12:18 PM   #1
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Not so hidden costs of "But She Seemed Really Fine"

The not-so-hidden cost of "But She Seemed Really Fine"

So often we as family do not realize the extent of AD or dementia until it has alredy begun to take its toll.

One of the first clues that my Aunt was in trouble came to light when I started "helping" her with her finances. I noticed she had a lot of cash withdrawals - a few thousand every few weeks, every month, for several years. I suspected all sorts of nefarious things and to make a very long, torturous story short, we finally discovered that she was buying hundreds of dollars worth of lottery tickets each week!

She could no longer tell if she had won or lost and was relying on the vendor to check her tickets. Who knows how much the poor woman won and got cheated out of.

Bad enough that she had gambled away thousands of dollars. The worst news was yet to come.

The elder care attorney has informed me that these cash transactions would most likely cause her Medicaid applicaton to be rejected! Even though the checks were written to herself or to cash, because of the large amounts they would be suspected gifts or asset transfers, and she has not one shred of documentation about how she spent the money - no receipts, no old lottery tickets, nothing. He said even if they were legitimate purchases like groceries or clothing, she cannot prove how she spent it and large amounts of missing cash would likely be a huge red flag.

Based on how much she spent on these lottery tickets, she could be disqualified for over a year!!!

This means that she is going to have to stretch her money for the entire lookback period, and not have the possibility of switching to an even slightly more expensive facility, or be in trouble if the prices go up significantly.

This is a cautionary tale for two reasons.

First, because the elderly who "seem fine" are often starting to make really bad judgments, such as gambling away thousands of dollars in small increments. A thousand little bad judgments can be ultimately just as disastrous as one or two really bad ones! How I wish we became involved much earlier on to try to get the gambling under control sooner and stem the flow of money!

But secondly, because even legitimate, legal and innocent cash transactions can come back to haunt you. It is not illegal to spend cash nor is it "required" to keep your receipts - but if you need to make a Medicaid application within 5 years, it can be your ruination. The attorney said anyone 65 or older who might eventually need to make an application should start keeping paper trails.

People are increasingly becoming aware of the limits on large asset transfers and the other "big" things.

But I think most people do not think about the impact of many simple cash transactions - and a lot of older adults find cash simpler to use and start using it more and more as they start to get a bit confused.

Older adults - keep a paper trail of how your cash is spent. And helpers should know this too along with guidelines to keep the receipts for any purchases the elder might reimburse you for along the way.

Knowing what I know now, I am really becoming an advocate of estate and elder planning but in the absence of that, of helping to get the word out to document cash transacations for their own protection.

Probably too late for any of us posting here already, but something to keep in mind as we advocate with others!

Last edited by Suzy0513; 05-23-2012 at 12:55 PM.

 
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Old 05-23-2012, 01:27 PM   #2
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Re: Not so hidden costs of "But She Seemed Really Fine"

Suzy,

My FIL had not got that far. However, he did use his debit card on the phone. Whenever a salesman called, he would answer and if he likes it, he would order it. e.g., Changing the phone co., buying the vitamins and ordering some subscription such as computer CDs for tutorials. He did all these 3 things and I had to cancel them or change the payment channel to the phone co. which he changed twice. I had to hide this vitamin booklet that comes every month or quarter. I had to call the co. to cancel the subscription but he already paid for some months. When we asked my FIL about these CDs, he had no idea!!
Although the loss may not be so much, it is still some damage in terms of financial controls. It should not have happened.
The worst part is actually when he almost wanted to spend his lifetime saving on this "research grant" for research on his own!! He asked my husband whose money is it (a statement from the mail) and wanted to use it for research!! Thank God my husband has POA and told him off. He literally forgot the difference between work and home. We set up everything online later so he would not see anything.

But: we could not stop him from doing these as he was not diagnosed yet and he was stubborn and still on his own. We found it out later. Yes he forgot a lot but we didn't realize he was forgetting all these things on top of AD! The fatal disease that causes this! We still thought he was a poor widower who didn't know how to handle his money.

We actually waited until he got worse to get him off the debit/credit cards and etc. There was nothing you could do since he was on his own and it was his house.

Indeed it would be a great loss if he paid too much for anything.
I still don't know what we would have done. The only thing we could have done was to take away his power of paying with his money. We could not stop the phone calls and mail...


A friend of mine actually changed the mail to her MIL because the MIL was paying lots of money to a company which was cheating on her. The son changed the address to a PO Box and thus stopped her from looking into the mail and calling the bad guys.

All I can say is, make sure you keep an eye on the finances. For sure, hire someone ASAP. Do not wait for reasoning and etc. Yes, we hired the home care later and saved the money for home care early on but it was not worth saving given the craziness.

Hugs,
Nina

Last edited by ninamarc; 05-24-2012 at 10:14 AM.

 
Old 05-23-2012, 04:45 PM   #3
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Re: Not so hidden costs of "But She Seemed Really Fine"

I'm with you Suzy and I have told my tale here a number of times. Mom is "not that bad" but one look at her financial statement brought raised eyebrows. Yes, money seemed to be slipping away. Much of it was used based on poor judgment. Some was given away. Some... who knows. Then she approved the transfer of $250,000 out of long held stock with capital gains and her IRA with it's penalties and taxes. There is no way she would have ever recouped her loss from the B rated insurance annuity. I stopped it once and she approved it again. It cost us the capital gains taxes but I stopped it again.

I heard the "Mom's not that bad" statement but grabbed control of her money. Many say they can't do it but there is no choice. As you said, you can't let them squander away the money they have and then expect Medicaid to show up. There has to be that paper trail. Yes, my Mom is stubborn. She is known for her stubbornness and she had no inclination to cooperate. Much of what I had to do was without her approval or help. Actually she fought me every step of the way... but it had to be done. By the time it is "that bad" it is probably way past time to take action.

It is not only the money but their reactions to emergency situations as well. They don't have the judgement and awareness to respond in an appropriate way to a situation out of the ordinary. They can also get lost. Not know the difference between left overs that are appropriate and those with fuzzy growth. The pitfalls are endless.

You don't want to wait until it is too late and the catastrophe is upon you to respond.

Love, deb

 
Old 05-24-2012, 05:21 AM   #4
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Re: Not so hidden costs of "But She Seemed Really Fine"

Quote:
Originally Posted by Gabriel View Post
It is not only the money but their reactions to emergency situations as well. They don't have the judgement and awareness to respond in an appropriate way to a situation out of the ordinary. They can also get lost. Not know the difference between left overs that are appropriate and those with fuzzy growth. The pitfalls are endless.
The pitfalls. The pitfalls. You mean like my close call with funny bacon bits on the salad?

Whatever is really happening to my wife, my rude awakening to this whole world of twilight zone was her inability to handle money. I used to simply hand over my paychecks, and she was in charge of family finances. For a year or two, I was increasingly concerned about how loosely she used to spend the money, and overdraws and duplicate payments were common occurances. Then the fog hit fast and hard; it was like driving from a clear night straight into a fog bank. She had managed to spend an entire's month's money in the first 10 days. She was in a panic, very upset, but couldn't explained how it happened. Then it happened again the next month. She was complaining that I wasn't giving her enough. She seemed confused when I explained that was all the money, because my pay has always been direct deposited, and she could see every cent. Funny.... this episode seemed a long time ago, but it was only January and February of this year. Lucy seemed relieved when I took over finances in March, and I began to unravel what happened to the budget. For us, it was not anything out of the ordinary like falling for scams or excessive lottery tickets. Lucy was simply spending more money on everyday things. So, instead of sushi and shrimp for dinner or appetizer every once in a while, it became almost every night. She was shopping for "special treats" for us, almost each and every night. So that explains the extra $30-40 grocery debits each and every day. For her dogs, instead of generic collars, she got them all designer Coach collars. She found great bargains on ebay for her clothes, but there were instances where she took her $10 ebay sweatpants to the tailor to be fitted. So now her sweatpants really cost $75. It has been exceeding hard to explain to someone with little concept of time except the immediate, why it was not okay to celebrate with special treats and an extra nice bottle of wine tonight. The only reason I have to give is that while it is okay to do this once in a while, it is not okay to do this each and every night.

Strange, this twilight zone, fog bank world.

 
Old 05-24-2012, 09:19 AM   #5
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Re: Not so hidden costs of "But She Seemed Really Fine"

My theory is my FIL was also bored. When he had nothing else to do, spending money on his health care or vitamins or phone bills is nothing unusual. He never handled his finances because his late wife did everything. Now he was free to use his money as he wishes. He is still stingy but he would spend if he feels like it.

Nina

 
Old 05-24-2012, 10:04 AM   #6
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Re: Not so hidden costs of "But She Seemed Really Fine"

Laua, like you the money was my first clue. But the other pitfalls were there as well.... and yeah like the funny bacon bits Imagine my face when I watched Mom pour spoiled lumpy milk on her cereal and begin to eat it!! Or the day she opened Dad's pill box and popped his heart meds in her mouth. Dad walked by later and assumed he had taken his meds. I still have no clue how she broke her right arm just below her shoulder.... but Dad (who had not been allowed to drive for years) took her to the hospital. I shiver when I think of that call from a neighbor who explained that the fireman came and everything was ok but he was concerned because he couldn't get Mom or Dad out of the house when it was filled with smoke. Mom had laid a wash cloth over a bedside lamp and left the light on. Or Mom confusing her antiviral medication with her pain meds. She didn't take the antiviral and was looped out on the pain meds... then drove two hours round trip, in a hurricane, to a doctor's appointment. Oh and got angry because the doctor's office was closed and the fast food establishment wouldn't give her anything to eat!! Maybe it was because they had no power? ..... I can go on and on related to the pit calls but it is something you have to look for along with the money

Love, deb

 
Old 05-24-2012, 10:38 AM   #7
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Re: Not so hidden costs of "But She Seemed Really Fine"

This thread offers exceptionally good advice!

I've posted in the past about DH's spending too. When we were just at the beginning of our long road, it was very hard to recognize that DH could no longer be trusted with money. He was an adult and looked the same, after all. I'd point out that he shouldn't be charging so much, that the car had been to the garage for service three times that month, or that we didn't need something. Then the bills would come, and I'd discover another few thousand dollars had been spent on things I couldn't cancel or return (like custom fur coats for me or service calls for items in the house that were "broken"). When I was traveling on business, he'd tell the kids that I told them all to go out for all of their meals at costly restaurants. He'd buy the kids anything they wanted -- and that was a video game every few days.

I'd tell him not to do it again, and of course he did it again the next month. I had been trying to treat him normally despite the diagnosis, so that he wouldn't get any more depressed, but I finally had to take his credit cards away, cut long-distance service off on the house phone, and tell all the kids to help me prevent him from spending money. I still ended up with an extraordinary amount of debt because I didn't control the situation fast enough.

It's a good suggestion to keep bank records and other financial records in a file by year, and to make a note in a checkbook register of large expenditures or deposits. I work with a lady who had a terrible time collecting her parent's bank records when her parent needed to file for Medicaid. This woman ended up having to pay a bank by the page to get several years of her parents' bank records, along with having to hunt down all of the other financial information required for the Medicaid application. If the bank statements just showed a payment but not what the payment was for, she was stymied since they had to explain any income or expenditure in excess of $500.

 
Old 05-24-2012, 11:20 AM   #8
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Re: Not so hidden costs of "But She Seemed Really Fine"

Gross bacon bits may be funny, but there was nothing funny at all about receiving bank overdrawn notices by the 10th of the month! In a rather twisted way, Lucy's rapid downturn at the beginning of this year may have saved us from financial ruin, because it forced me into rapid action. Moreover, this is a quantifiable issue that was easily understood by her kids, who I needed to get on the same page with me. Like Nina's FIL and Beginnings' husband, I think my DW was also bored. She sat home all day with nothing to do except buy stuff online, and then go to her dress maker to have her sweatpants altered. Interesting my DW's desire to find work plummeted to zero, and I still have no idea why. You guys have any ideas? Not that I think she can work now, of course, but she once was a high powered executive level recruiter. I think the jul of our financial problem has always been that she still thinks she can spend at a level of what she used to make.

You know, that's the other thing. My DW has not worked in 6 years. Right now, she is maxed out on one of her credit cards, and a second one half way there. And every day more credit card offers come in the mail for her. I don't get it. Obviously, since I am not home and so far she is not yet watched 24/7 (yeah yeah… I should soon….) I have not the foggiest idea of how many new credit cards she is getting in her name only. I have managed to cancel or to severely cap our joint credit cards, and I have taken pains to separate my income so that she cannot directly access. The house is in my name only. My investments, from before we were married, are in a safe place out of reach. Her personal savings has disappeared… no surprise there. I am working hard to quadrant off our joint holdings. Yet…. those credit card companies are still offering her new credit! How do you stop that????

PS to Gabriel Deb….. I am so glad you seem to be having so much fun with my name.
fondly, Lala Lauau

 
Old 05-24-2012, 11:54 AM   #9
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Re: Not so hidden costs of "But She Seemed Really Fine"

You may want to use other addresses for the mail. Usually the house mail will continue with the bank credit card advertisement and so on. I don't know if you pay her credit card now - you can also change that address on her card.
Well I am not sure if you can change hers as she will notice.
Anyway, try to stop the mail or transfer the mail to a P.O. BOx or your work address. At least get the important mail out of her eyes and you will check the important mail when you have a chance. Even forward some mail to another address such as the son's and etc.

It is hard for a 52 years-old. I am in the same age range so I can see that she needs to be acting or shopping. Probably she knows she has a hard time at work given her problems.

Sure hope there is a way to stop the junk mail. Strangely when we changed the address for my FIL after we sold his house in the winter, no more junk mail as they knew no one was there until the buyer came along.

Good luck,
Nina

Last edited by ninamarc; 05-24-2012 at 11:55 AM.

 
Old 05-25-2012, 07:50 AM   #10
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Re: Not so hidden costs of "But She Seemed Really Fine"

At the lawyers and accountant's suggestion, in preparation for possibly having to file an application, I keep all the bank statements and each month add a sheet of explanation of every expenditure and I attach all receipts and paperwork to it.

I may never need it but if I wait, then years from now I would never be able to put it all together.

What truly shocked me in all of this was the fact that perfectly NORMAL behavior could get a peson disqualified for several months!

And after all who would think of having to track their every penny for years. It is a very counter intuitive thing for most people to do!

He used the example of an extra $500 cashed check used for spending money - dinner out, movie, parking or cab fare, a trip to the Kmart or Walgreens for makeup, a visit to the hair salon, a cup of coffee and donut on the road.

But if they do that every month for 5 years, that amounts to $30,000 which cannot be accounted for and could disqualify them for up to 4 months in our state.

Granted that he said our state is one of the worst (or best, depending on your point of view) for going after every single penny that cannot be shown to have purchased fair value.

He said here they are draconian and even people who have the right assistance completing applications almost always get zocked for a few months.

Hopefully it will never come to that but I wanted to get the word out about tracking everyday cash expenditures.

Quote:
It's a good suggestion to keep bank records and other financial records in a file by year, and to make a note in a checkbook register of large expenditures or deposits. I work with a lady who had a terrible time collecting her parent's bank records when her parent needed to file for Medicaid. This woman ended up having to pay a bank by the page to get several years of her parents' bank records, along with having to hunt down all of the other financial information required for the Medicaid application. If the bank statements just showed a payment but not what the payment was for, she was stymied since they had to explain any income or expenditure in excess of $500.

 
Old 05-25-2012, 09:12 AM   #11
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Re: Not so hidden costs of "But She Seemed Really Fine"

Thank you Suzy for all this information. I knew somewhat about worrying about the family making big expeditures but never even thought how detrimental not keeping track to that extent can be! I've mentioned to my husband's family my concern when their mother with AZ bought (the sons bought, she paid) a LARGE screen tv when her tv broke. I was concerned that that sort of expenditure was bad and that she went to JC Penney and bought $1000 worth of clothes (the caregiver took her shopping!). These things are concerning to me and I guess I don't know enough about how detailed they get about finances on the look back. Your post really brings to light how diligent we need to be in the care of our loved ones. Thank you for your insight!

 
Old 05-25-2012, 01:07 PM   #12
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Re: Not so hidden costs of "But She Seemed Really Fine"

I have a few comments with regard to your post.

With big expenditures, you first want to be sure they person isn't just squandering money especially if they don't have enough of it!

But mostly the lawyer said they will then look to make sure that item is still accounted for. For example, if they bought a $40000 car - but then don't list it or the proceeds of its sale as an asset. They want to make sure that they did not buy it and then give it away.

He also said, it varies by STATE. He said some state are downright lax, some are feasibly fair, and others, like my state of NJ, are rather draconian.

He also said that in cases where there are few assets, low income and never were assets, the applications are pretty simple. It is when there were assets and a meaningful lincome that things get dicey.

Generally an elder care attorney can prepare applications or recommend you to someone who does.

I consulted with him because I have taken control of the finances and wanted to make sure I am doing everything right and not overlooking things that might come back to bite us!!!

If you have concerns I think it is a good idea to meet with someone in your state who knows the drill and can make recommendations.

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Originally Posted by mitsy View Post
Thank you Suzy for all this information. I knew somewhat about worrying about the family making big expeditures but never even thought how detrimental not keeping track to that extent can be! I've mentioned to my husband's family my concern when their mother with AZ bought (the sons bought, she paid) a LARGE screen tv when her tv broke. I was concerned that that sort of expenditure was bad and that she went to JC Penney and bought $1000 worth of clothes (the caregiver took her shopping!). These things are concerning to me and I guess I don't know enough about how detailed they get about finances on the look back. Your post really brings to light how diligent we need to be in the care of our loved ones. Thank you for your insight!

 
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Old 05-25-2012, 01:57 PM   #13
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Re: Not so hidden costs of "But She Seemed Really Fine"

Suzy, this is great info. Thanks!

 
Old 05-26-2012, 04:20 AM   #14
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Re: Not so hidden costs of "But She Seemed Really Fine"

The saddest thing about all this is how many people (corporations) are willing and quick to take advantage of a person's confusion to make money for themselves. Mom was 94 when a bank employee noticed she had an unusual amount in her checking account, and suggested she buy a long term care insurance for a lump sum. Sounds great! The catch: the money was to be paid in full today, the benefits woud not kick in for TEN (10) years .... when Mom was 104. Mom died at 99 a few years ago. Luckily my brother was a cosigner on her bank account and had to be informed of the new wonderful policy she was buying ... of course he said no. The bank representative would have received a wonderful commission on the sale. Mom would have received nothing.

Last edited by Martha H; 05-26-2012 at 04:21 AM.

 
Old 05-26-2012, 01:44 PM   #15
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Re: Not so hidden costs of "But She Seemed Really Fine"

You are doing good things about Lucy's access to money Luau Got it right that time hehe!! There is a way to opt out of much of the "junk" mail. Your local post office can give you that information. The bank card applications usually come in the junk mail. I had the addresses changed on important mail. Mom and Dad's came to me, you can have yours sent to work or a post office box. I also talked to the mail carrier and ask him not to put any mail made out to occupant ect in the box. Later I just had all mail forwarded to me. As I worked on eliminating bit by bit Mom got used to less and less mail... until there was none and she didn't check it any more.

I agree with all Suzy said about expenditures. You have to keep records of all expenditures and any other assets that are sold or given away. I pay for everything with a check or debit card and attach receipts to the bank statement. This is year 6 of doing that so I am covered. Any assets disposed of are noted. I have the deposit slip where the money from their van was put in the checking account etc. I did it because of the siblings, but it applies to medicaid applications as well. It's just a good idea when you are dealing with somebody else monies.

Martha, you are so very right. There are those that search out the elderly to take advantage of. Their product may be legit but not appropriate as in your Mom's case and in Mom's case with the Annuity. You definitely have to be on your toes to stay ahead of what is going on.

Mitsy, if the TV is still in your Mom's possession and the clothes are being worn by her.... and you have the information regarding the purchases... it is probably ok.... as long as it does not happen repeatedly. It is when they can not determine where the money went and to whom that you create a problem.

I remember in the beginning it all seems so very overwhelming. But once you get some safeguards in place, handle the mail issue, start the monthly book keeping process, change addresses and all the other stuff that seems to overwhelm you.... it become part of the routine and not so overwhelming

Love, deb

 
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