<p>Once again I’m asking for some advice from the wise folks here on cc for a friend. My friend lives in the bay area and has an aunt who is in her 90’s. The aunt lives near Miami, FL in a condo. My friend is worried that the aunt is being taken advantage of by strangers and has perhaps been scammed. It has been reported that the aunt has written several large checks to complete strangers. My friend will be traveling to Florida in the next week or two to check in and find out what the real situation is and hopefully figure out how to keep her aunt safe. While the aunt is physically able to get around, she’s seems to be beginning to have difficulty remembering things. But mostly my friend is worried about her aunt’s financial safety - and wondering who she might turn to to look out for her aunt’s financial affairs. Any other suggestions for looking after an elderly relative from such a distance would also be appreciated. Thanks in advance for your help!</p>
<p>Google up “miami eldercare financial” and you’ll see that in that part of the country, this situation is so common that there are CPA’s and other professional practices specializing in exactly that. So many elders in retirement areas are there without their own adult children to watch out on a daily basis for money choices. It’s not even easy from close-range, but the distance makes it even harder. The aunt lives where there’s a market for professional helpers. Choose carefully…</p>
<p>Of course the visit will help determine if it’s only the financial or other larger losses that require a change to assisted living, perhaps. Some memory loss isn’t at all unusual at that age; it’s the overall picture the niece will see.</p>
<p>Your friend may also need to consider whether it makes sense to move her aunt to an assisted living facility that’s licensed to care for dementia patients near her own home. The aunt may not be happy about the prospect, but she may not be any more pleased about moving to a similar facility in Miami. Otherwise your friend, if she’s the only close relative, may find that she has to fly back and forth pretty often. </p>
<p>Did the aunt prepare a Power of Attorney for your friend back when she was more lucid? Is there a chance that she’s clear enough to do that now so that your friend can take over her affairs soon? A sympathetic trust & estate lawyer can help a great deal. </p>
<p>We basically had to get a relative’s doctor to write a letter to her attorney stating that she was no longer competent in order to activate a clause in her Revocable Family Trust that laid out the succession of Trustees (who could serve & in what order.) That also activated a medical PoA. The trustee was actually able to recoup, with the help of the bank, some of the money that our relative had been scammed out of, too. Your friend might want to see if there’s an elder affairs office in the area that can help with laws regarding elder abuse. I wish her luck. It’s a tough job.</p>
<p>We dealt with a similar situation in our family. My H and I were primary caregivers for an elderly relative (now deceased) who lived a six-hour drive from us. When it became apparent that our relative could no longer care for himself properly, I called his primary care physician, who recommended a geriatric care manager who had experience working with elderly patients with long-distance caregivers.</p>
<p>I can’t even begin to tell you what a tremendous help the geriatric care manager was. After an initial assessment of our relative, she created a plan for his care that included home safety, diet, personal hygiene, personal finances, medications, doctor visits, and home healthcare. She then helped arrange appropriate services and monitored them, as necessary. She also visited our relative at his home at least once a week to assess his health and overall well-being, including his finances. She called me frequently to ask questions about his care and to let me know how he was doing. </p>
<p>When our relative’s health declined, the geriatric care manager arranged tours at several assisted care facilities and helped in the final selection. Since H and I knew nothing about assisted care facilities in that area, this was a lifesaver for us. Our relative ended up in what was probably the top facility in the area. </p>
<p>Having a geriatric care manager was simply wonderful. Not only did she allow our relative to maintain his independence as long as he was physically able, but she also became a trusted friend. The downside, unfortunately, is the cost. Geriatric care managers are expensive.</p>
<p>oaklandmom, I recommend that your friend call her aunt’s primary care physician and discuss the situation with him. He’s in the best position to recommend the proper course of action for your friend, especially since she doesn’t live in the area. If finances allow, perhaps your friend could ask her aunt’s doctor to recommend a geriatric care manager. IMHO, GCMs are indispensable for long-distance caregivers.</p>
<p>
</p>
<p>I agree this is a good idea…but unless the aunt has signed a release to allow the physician to talk with the niece, the doctor will not probably not talk to her. We were in a similar position…we wanted information and could not get it…the aging parent would NOT sign a release, and all the doctor would say is “you need to come up with a plan for your mom’s safety and health” but the doctor would not discuss it further.</p>
<p>If this aunt is really safe physically, and finances are the only concern…is it possible for someone to take over the financials…do the bill paying, and also be certain that the aunt cannot write checks to others? This would mean that someone (the niece or someone other trusted person) would need to be added to the checking account so they could pay bills (maybe even online if distance is a factor). When my mom could no longer manage her checkbook, I was already on the account and took it home with me. That way I didn’t have to worry that she would lose it or write a check to someone who really shouldn’t have it.</p>
<p>Is there a council on aging the niece can contact? They often have community resources for families. They can be very helpful.</p>
<p>I’d like to note that caregivers don’t need a release to discuss a relative’s situation in general terms with a primary care physician. For example: “Mary Smith is your patient, and I’m her niece and primary caregiver. I’m really worried about her for X reasons. Can you direct me to some local resources that might be of help to us?”</p>
<p>I agree with thumper1 that it’s a good idea to have someone help with paying bills (a durable general power of attorney is necessary), but that won’t be of much help if the aunt still has access to her checkbook and can write checks to whomever she pleases. That’s what happened in our case before we hired the geriatric care manager. Although I paid all of our relative’s bills online at the time, he was still able to write checks for thousands of dollars for bogus charges by a home healthcare aide. It’s one of the reasons I decided to call his primary care physician. </p>
<p>The PCP was happy to provide us with a list of local geriatric resources. In our case, he recommended a geriatric care manager for the express reason that we were long-distance caregivers trying to deal with a multitude of problems.</p>
<p>Thank you all for the information. As far as I know if the aunt had a power of attorney, it was given to my friend’s mother who died last year and who’s estate is a mess right now. Which makes this situation more difficult. I will pass on your suggestions. Hopefully the aunt’s primary care physician will be helpful. Thanks again.</p>
<p>
I do not believe this is correct. Anyone could call up and say they are a caregiver and ask for information, without documentation that they have the authority to speak/act on the family member’s behalf. HIPAA laws would likely preclude this communication without a release signed. That said, if the aunt is not competent to sign a release, thats another issue. The aunt may need a competency evaluation. Is there no other more immediate family member (no children?) who can/should be involved? </p>
<p>Agree that geriatric case managers are wonderful (some better than others) and FL should have tons of geriatric services. But someone has to have legal authority (POA, healthcare proxy, etc) to act on the aunt’s behalf. Does your friend have this?</p>
<p>I think that any one can call and talk to a physician and he/she can listen and make notes of what was said and investigate at the next appointment, but the doctor cannot tell the caller anything without permission.</p>
<p>If you were concerned about competency you could talk to the doctor and ask him to check that out.</p>
<p>It is a real catch 22 in that interval of time after some one has begun to ‘lose it’ mentally, but before they are undeniably incompetent, especially from afar. How can you take over a make decisions for some one is is somewhat competent against their will. I wonder what will happen with my FIL who is obstinate and independent and also has been getting quite anxious for a couple of years. He has an Rx for anti-anxiety meds, but does not like to take them. That makes him more likely to be afraid to give up any control.</p>
<p>somemom, it is an interesting question - “how do you take over for someone who is somewhat competent against their will” when that person is beginning to lose their ability to take care of themselves. I think that is some of what my friend is facing. My friend reports that her aunt seems paranoid. I’ve tried to remind my friend that suggesting the the aunts finances be taken over by someone else might be very threatening and frightening to the aunt. It is something that needs be done thoughtfully and carefully. I’m also wondering if its also better to be doing this in person rather than via the phone.</p>
<p>Face to face is the way to go. When she gets there she will be able to judge for herself if the aunt is able to manage her personal as well as financial affairs (these are 2 distinctions in competency questions). The aunt’s house may be in disarray, she may be wearing the same clothes repeatedly, mail may be piling up, bills overdue, checkbook in a mess, etc. </p>
<p>If she can get the aunt to go to the dr with her and get a referral to a neurologist and neuropsychologist, she can get a better assessment of the aunt’s ability to live independently. Many people in their 90’s have some form of dementia. Many do not take their medications properly. Lots of things can be going on. Is there no other immediate family member involved?</p>
<p>Our mom’s checking account was JOINTLY owned by my mom and me. I did not need a power of attorney to pay her bills. The accounts were in MY name too. This was much more palatable to my mom who would not give us power of attorney…but was happy to have our names as joint owners on the accounts.</p>
<p>It also helped when she died as these accounts were not subject to probate because they were already in my name (I’m an only child to my mom).</p>
<p>Another thread for your friend to follow is to go and talk further to the person who reported to her about the aunt’s recent missteps with the checkbook. </p>
<p>Worst case end of the spectrum: There are many other stories this concerned person has to tell the niece. </p>
<p>Best case scenario: the reporter is addled and a busybody; the “complete strangers” who received the checks were just people collecting for charity and the amounts were reasonable…</p>
<p>The friendship circle of the elders can be a story in itself. The niece should go in without a lot of presuppositions. It could be that the 90-year-old aunt is amazingly sharp but her friends aren’t.</p>
<p>Good luck.</p>
<p>I am on all my mother’s accounts, too, and she is content to have me deal with everything; she really does not even want to know the details. I used to have her file everything, but stopped that as she still did not look at anything. She only pays for charitable contributions & gifts.</p>
<p>I do tell my sister what I am doing pretty regularly so that I have some one else who knows what I am thinking and who can make sure I am doing the right things.</p>
<p>FIL is so independent that unless he feels horrible, physically, he could not stand to give up an ounce of control.</p>
<p>A question for those who have joined onto a parent’s bank account, if you know: Are there any gift tax implications for doing this, either at the time you are added or when the parent dies?</p>
<p>
</p>
<p>Consult a lawyer. The very best time to do this is when the person still can make their own decisions…and can give you a power of attorney. The worst time is when they have become incompetent. We had to do an involuntary conservatorship with a parent who was not competent and had previously refused to give a power of attorney.</p>
<p>
</p>
<p>No…you are a joint holder of the account with your parent as the primary (so the 1098I is sent to the parent for tax purposes). When the person dies, this account is already yours. It’s not a gift. We did this with a parent…I was a joint holder on ALL bank accounts. When the parent died, these accounts were already mine…didn’t have to be even listed for probate purposes. This was good…prior to death, bills were paid. After death…bills could still be paid!!</p>
<p>Ok. thanks for info.</p>
<p>There could be estate tax implications to a joint account, I have read that when you are on a joint account and some one dies, it is incumbent on the living person to prove that those funds are really not the property of the dead person.</p>
<p>If your parent has an estate likely to be liable for estate taxes and you put their name on YOUR account, be sure to keep records or YOUR money could be counted for estate taxes.</p>