Patients and their relatives often to look to their physicians for guidance involving medical matters. This includes guidance involving cognitive impairment. Because even mild cognitive impairment can lead to difficulties with managing bank statements, paying bills and exercising good financial judgment, primary care clinicians are in a position to assist patients and their families with avoiding serious financial problems.

The Journal of the American Medical Association (JAMA) lists five specific steps physicians can take, which can also work well for starting a conversation with your or your parents’ doctor.

1. Educate on financial planning: Physicians should discuss the importance of having a durable power of attorney and suggest the Alzheimer’s Association, state agencies on aging and state bar associations as resources for legal assistance.
2. Recognize signs of possible impaired financial capacity: Diagnoses of mild cognitive impairment, Alzheimer’s disease, stroke or other ailments impacting cognitive or functional abilities should be viewed as warning signs about potential current or future financial problems. Physicians should use these diagnoses to discuss the potential for financial impairment with the patient and his or her family.
3. Assess financial impairment, financial abuse or both: Physicians should ask patients about who manages their money, who has access to their accounts, when the last time they were late paying a bill was and whether they have been a victim of theft or a financial scam. Responses should be compared with information from family members. Physicians should also be alert for comments about not being able to afford food or medications, especially if the patient didn’t mention these problems before.
4. Suggest practical interventions: Physicians can suggest automatically depositing checks, automatic bill payment and overdraft protection as methods to protect a patient’s finances.
5. Carefully determine when to make medical and legal referrals: Since a clinical judgment of incapacity may result in the loss of independence and autonomy, physicians should have a high level of confidence in their diagnosis. A referral to a neuropsychologist, a geropyschologist or a forensic psychologist may be warranted.

Source: “Finances in the Older Patient With Cognitive Impairment,” Eric Widera, Veronika Steenpass, Daniel Marson, and Rebecca Sudore, JAMA, February 16, 2011.

Related

Dispatches

Protecting Elders From Financial Abuse

Financial Planning

Aging and Investing: The Risk of Cognitive Impairment

Retired Investor

Aging’s Adverse Impact on Decision Making