Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Alzheimer’s inevitably leads to loss of financial capacity

Alex Smith, MD
Conditions
August 14, 2011
Share
Tweet
Share

“Mom’s been writing goofy checks…”
“Dad stopped paying his bills….”
“Grandma wired her savings to Nigeria…”

Have you heard these phrases from the family caregivers of your elderly patients?  Have you ever been concerned that your patient may lack capacity for financial decision making?  How do you decide if they lack capacity?  What is the clinician’s role in making these decisions?  What is their responsibility?

These important questions are addressed in a terrific new article in JAMA by GeriPal co-founder Eric Widera (first author) and contributor Rebecca Sudore (senior author), with co-authors Veronika Steenpass (former UCSF Geriatrics fellow) and Daniel Marson (from UAB).  This is an in the JAMA Care of the Aging Patient series.

The take home points from the article as I see them:

  • Alzheimer’s inevitably leads to loss of financial capacity
  • Loss of financial capacity occurs early in the spectrum of Alzheimer’s disease, far earlier than loss of physical function
  • Clinicians have the opportunity to intervene early, when patients have normal memory or are first showing signs of mild cognitive impairment and can still designate a Durable Power of Attorney for Finance
  • Waiting until the disease has progressed has consequences – waiting leaves patients at risk for elder financial abuse, and conservatorship is expensive and can take months
  • Clinicians don’t have to be financial advisers; they should be attentive to warning signs that the patient may have lost financial capacity, know when to refer for assessment of financial capacity, and educate and prepare patients and family members

Speaking about the need to engage elders in advance planning for finances, Eric Widera says,

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.  Proper financial planning will leave both the patient and caregiver with more financial resources to deal with the consequences of the disease.

This paper was primarily aimed at primary care clinicians. Working in geriatrics and palliative care, we are fortunate to work in teams with others – principally social workers – who are often more attuned to these issues and have a better sense of the options for protecting finances. Nonetheless, none of us should “pass the buck” on learning the basic skills in recognizing, assessing, and responding to financial incapacity. As Charles Sanatino, a lawyer for the American Bar Association’s Commision on Law and Aging stated in the commentary accompanying this paper:

In an aging society, all professionals serving older adults have an obligation to understand diminished decisional capacity, especially with respect to financial issues, and to acquire the basic skills to identify it and respond constructively to it. Failure to meet the challenge will only increase the potential for financial abuse and exploitation.

Alex Smith is an Assistant Professor of Medicine, Department of Medicine, Division of Geriatrics at the University of California, San Francisco who blogs at GeriPal.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

Female doctors and the physician shortage

August 13, 2011 Kevin 23
…
Next

Why developing trust with your doctor is important

August 14, 2011 Kevin 6
…

Tagged as: Patients, Primary Care

Post navigation

< Previous Post
Female doctors and the physician shortage
Next Post >
Why developing trust with your doctor is important

ADVERTISEMENT

More by Alex Smith, MD

  • Do you know what your staff is saying about palliative care?

    Alex Smith, MD
  • We are morally scarring our future physicians

    Alex Smith, MD
  • Let’s celebrate nurses by reining in patient satisfaction

    Alex Smith, MD

More in Conditions

  • Clinical ghosts and why they haunt our exam rooms

    Kara Wada, MD
  • High blood pressure’s hidden impact on kidney health in older adults

    Edmond Kubi Appiah, MPH
  • How declining MMR vaccination rates put future generations at risk

    Ambika Sharma, Onyi Oligbo, and Katrina Green, MD
  • How one unforgettable ER patient taught a nurse about resilience

    Kristen Cline, BSN, RN
  • Why regular exercise is the best prescription for lifelong health

    George F. Smith, MD
  • When the weight won’t budge: the hidden physiology of grief, stress, and set point

    Sarah White, APRN
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...