Early Signs of Cognitive Impairment

A Psychiatric and Neuroscientist’s Perspective on Aging Parents:


Going home for a visit can sometimes bring unexpected surprises, especially if you haven’t seen loved ones in a while. As we all know, time can be tricky and seem to move at warp speed as we age. The problem with this is that sometimes, aging loved ones seem to change rapidly, even though memory loss and physical health decline are relatively gradual.

Clinical Professor of Psychiatry and Behavioral Sciences, Wes Ashford, MD, PhD, provides insight into why awareness and early detection of cognitive impairment can be beneficial to your family. Visits with family are a prime time to evaluate senior loved ones, do screenings and discuss options for the future.

“You need to be aware that there is an issue. How is your loved one acting? Do they seem themselves? People have a way of compensating and covering up for memory loss, so it helps if you know them really well and can discern a change. It’s the subtle changes or problems that might give you a clue, and consulting an expert is always helpful in these instances.”


Dr. Ashford discusses that the Alzheimer’s Association has published their 10 Warning Signs of Alzheimer’s and cognitive impairment. The problem with this is that once someone reaches these stages, they are often fairly far along. “Ten percent of people over 60 have significant memory problems. Look at the family’s genetics for an indication of when problems may arise. There are screenings that can be done these days, and 65 is a pretty good age to have a loved one screened. Also, having a family member who is very supportive and understanding attend doctor’s visits can be helpful.”

Here are a few signs Dr. Ashford discusses may be indicators that your loved one may be suffering from cognitive impairment:

  • Difficulty doing the more familiar things in their life. Having problems with activities of daily living (ADLs), or any activity that is part of your loved ones’ normal routine, such as cooking, cleaning, or performing regular job skills, could signal an issue.
  • Difficulty remembering things that happened in the last day. Alzheimer’s and dementia affects recent memory, so memory problems within the past 24 hours could be a red flag.
  • Sudden behavioral changes. If your loved one is suddenly depressed, quiet, agitated, or acting out of the norm, this could be a problem.
  • Having trouble keeping a conversation. The following problems in conversation could be an indication of memory impairment:
    • Asking the same questions repeatedly, without remembering the answer
    • Not referring to people by name
    • Vagueness and lack of details in conversation

People have a way of compensating for memory loss. Some people may realize they have a problem and try to cover it up, and others may not even recognize there is a problem. Dr. Ashford provides insight:

“I’ve seen over 1,000 patients, and only one came in by himself because he was worried about his memory. Usually when asked, ‘Have you been having any difficulty with memory lately?’ – Half the people say, ‘no’ and the other half say, ‘no more than anyone else my age.’ This is exactly why early detection is important.”

Sometimes it may be difficult to notice when there is a problem, but spending quality time with your loved one, having conversations and doing screenings can all help determine whether they suffer from memory loss, or may be at risk for Alzheimer’s or dementia.


Ashford has spent his career researching the process of memory loss associated with aging. He and the other members of the group at the Stanford Aging Clinical Research Center are involved in a variety of studies to measure the effectiveness of medications, mood, sleep and other factors on disease progression. He has developed a simple memory test that can help track changes over time, using colorful images to detect early signs of memory loss.

The test, MemTrax, is an online memory test that helps to measure and monitor the memory, and can be very helpful for families to determine whether their loved one is suffering from a cognitive problem. Dr. Ashford discusses:

“The problem is that it is difficult to recognize when people have a problem. People with a memory problem often try to cover it up, and as much as 90% of patients are misdiagnosed early in the disease course. After a certain point they don’t recognize that they have a memory problem and by then they need to be in a nursing home. Screening and tests can provide insight into memory problems.”

MemTrax is meant to be a fun way to test memory, without causing unease. “My family played MemTrax one Thanksgiving, and it was actually fun. We were in rural Kentucky and we decided to test our memory. It was meant to be fun, so it was not anxiety provoking. This simple game is a great way to give families insight into measuring memory and cognitive awareness.”


While mild forgetfulness affects most people as they age, serious memory problems affect peoples’ ability to participate in everyday activities. This is another reason it’s so important to be in tune to and observe your loved in their activities of daily living (ADLs), in addition to memory screening and/or attending a doctor’s visit. When you’re home, observe how your elderly loved one is doing the following:

  • Walking and getting around
  • Dressing
  • Bathing
  • Using the toilet
  • Grooming
  • Feeding

Dr. Ashford stresses that the cognitive decline associated with dementia and Alzheimer’s disease is an issue not only for affected individuals, but also for society. New understanding, improved treatments, and viable preventive strategies are becoming more crucial since more than 5 million Americans are already living with Alzheimer’s disease, and its prevalence is expected to double by 2020. Ashford notes the two most important things to pay attention to as people get older are:

  • Exercise
  • Cognitive Engagement

In other words, how is your loved one ‘walking and talking’ and are they doing well enough to live in their home without help? Ashford comments, “There is genetic testing available and families need to be proactive about getting tested and understanding their genotype. For one common genotype, which equates to about 20% of the population, there is a 40% chance of developing Alzheimer’s by age 76. Another genotype – one that affects only 2% of the population – has 10 times greater chance of having the disease by age 67; and another group appears to develop Alzheimer’s only after age 95. Looking at your family genetics and getting yourself and loved ones tested can help you determine what you’re up against.”


Whether you notice that your aging family member is in great shape or that he or she may need additional care, it’s never too soon to have a conversation. If your elderly loved one can participate in the discussion and provide you with all the necessary information to execute their retirement and end-of-life wishes when the times comes, your family will be in better shape, both emotionally and financially. Dr. Ashford comments,

“Help your loved one prepare for their future, proactively. Be helpful and supportive, and let them participate in the decision-making, if possible. If needed, get educated. I highly recommend “The 36-Hour Day, by Nancy L. Mace.” The Alzheimer’s Association also has great information, and provides local support groups. It’s also never a bad idea to seek an expert’s help; whether that’s a family doctor, geriatrician, psychologist or eldercare attorney.”

About Wes Ashford, MD, PhD

Dr. J. Wesson Ashford, a psychiatrist and neuroscientist, has dedicated his career to understanding the way Alzheimer’s disease affects memory. Dr. Ashford is Chair of the Memory Screening Advisory Board of the Alzheimer’s Foundation of America as well as a Senior Editor of the Journal of Alzheimer’s Disease. He also holds the positions of Clinical Professor, Psychiatry and Behavioral Sciences; Senior Research Scientist, Stanford; and Director of the War Related Illness and Injury Study Center in the VA Palo Alto Health Care System.

Download a summary of this article to take with you:

A Place for Mom Assessing Cognitive Ability Guide
Reprinted from A Place for Mom

New Medicare and Social Security Scams

How the Scam Works

Medicare and Social Security beneficiaries across the country report receiving calls from scam operators (frequently with foreign accents), who claim to represent Medicare, Social Security, or an insurance company. These callers claim that new Medicare, Social Security, supplemental insurance benefits cards are being issued or that the beneficiary’s file must be updated. The scam artist asks the citizen to verify or provide their personal banking information, which is then used to commit theft.

Callers involved in this crime ring may be extremely aggressive, calling over and over, and at all times of the day, in an attempt to wear down the potential victim. These criminals will say anything to try to gain a person’s trust. In some cases, the criminals may have already obtained some limited personal information about the citizen, such as his or her name, address, or even Social Security number, which the criminal then uses to try to make the call seem legitimate. In other cases, the callers may claim that they can improve the benefits. Do not believe these claims, and do not carry on a conversation with the caller. Instead, if you receive a call asking you to disclose your bank account or other financial information, hang up immediately. These are criminals, and by speaking with the callers, even to ask them to stop calling, they may be encouraged to continue calling your telephone number.

If you are a Medicare or Social Security beneficiary, the Center for Medicare and Medicaid Services and the Social Security Administration do not call you to ask you to disclose financial information in order to get a new card. If you receive such a call, you should report it to these two agencies as follows:

Centers for Medicare and Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244

Social Security Administration
Office of Public Inquiries
1100 West High Rise
6401 Security Boulevard
Baltimore, MD 21235
(800) 772-1213



These three tips should help you avoid falling victim to this scam:

  1. Remember, the Center for Medicare and Medicaid Services and the Social Security Administration will not call you to update your information or give you a new card.
  2. If someone who calls you asks for your personal information, do not provide it.
  3. If calls persist, you may wish to speak to your phone company about calling features that would enable you to be selective in the calls that you accept or receive.

If you have already disclosed personal financial information to an unknown party, you may be at risk of identity theft. There are certain steps that you can take to further protect yourself including:

  1. Call the three major credit bureaus and place a one-call fraud alert on your credit report:
    • Equifax: Call 800-525-6285, and write P.O. Box 105069, Atlanta, GA 30348-5069.
    • Experian: Call 888-397-3742, and write P.O. Box 9532, Allen, TX 75013.
    • TransUnion: Call 800-680-7289, and write Fraud Victim Assistance Division, P.O. Box 6790 Fullerton, CA 92834-6790.
  2. Consider placing a security freeze on your credit reports. In most instances, the freeze prohibits a credit reporting agency from releasing any information from your credit report without your written authorization. To place a security freeze on your credit report, you should send a written request to each of the three nationwide consumer reporting agencies by regular, certified or overnight mail at the addresses below:

    Experian Security Freeze
    P.O. Box 9554
    Allen, TX 75013
    (888) 397-3742 

    Equifax Security Freeze
    P.O. Box 105788
    Atlanta, GA 30348
    (800) 685-1111

    TransUnion Security Freeze
    P.O. Box 2000
    Chester, PA 19016
    (888) 909-8872

  3. Order a free copy of your credit report and look for unauthorized activity. Many consumers first find out that they are victims of identity theft by discovering inaccuracies on their credit report. The federal Fair Credit Reporting Act (“FCRA”) allows consumers to obtain a free copy of their credit report each year from the three major credit bureaus as follows:
    • Logging on to www.AnnualCreditReport.com;
    • Calling: 877-322-8228; or
    • Writing: Annual Credit Report Request Service, P.O. Box 105281, Atlanta GA 30348-5281
  4. Monitor your financial accounts for suspicious activity. Look carefully for unexplained activity on your bank and other financial statements. If you detect unexplained activity, you may want to contact the fraud department of your financial institution.


Related Posts:

The Do Not Call Registry and Unwanted Calls

Many people are bombarded by unwanted telephone calls – even though they are on the Do Not Call Registry. The problem is difficult to stop because the scam artists increasingly use modern technology – including caller ID spoofing and throw-away cell phones – to conceal their identity and location and evade law enforcement.

When in Doubt, Don’t Give it Out

Scams and crooked deals are everywhere today, often where we least expect it. At every turn you can protect yourself by following one easy principle. If someone contacts you and claims to need your private information, think twice and remember: when in doubt, don’t give it out.


Gifts for Seniors

Still looking for gifts for seniors? Stretch your imagination! Sometimes gifts for seniors are waiting at the grocery store, in the sewing aisle at your local home goods store, or even on-line.

gifts for seniors can include flowering bulbsFirst, check out your local garden center, grocery store or a place like Reny’s for bulbs. Amaryllis bulbs make great gift gifts for seniors when you plant them in a nice pot. Put three of a kind in a small window box for a fabulous display. They don’t take up much room, can survive a wide temperature variation (but not freezing), don’t need much watering, and grow slowly and reliably, giving weeks of pleasure. And the blooms last for several weeks. Or make a calendar garden. Start with narcissus in a clear pot with gravel for January. Get a hyacinth or two in little water jars for February. The amaryllis will bloom by March. Add a pot of daffodils kept in a cool location and your senior will have early spring flowers.

While pets can sometimes make great gifts for seniors, they require a financial commitment and care. If a cat, dog or bird is too much for your senior, consider Beta (Siamese fighting fish). They don’t require much care, live in a regular sized fish bowl (rather than an aquarium) and come in a striking array of colors. They do best in a fairly warm house. Make sure you include fish food.

Gifts for Seniors Can Include Services

Give a service. Gifts for seniors could include time with a loved one doing something special. Make up a little manicure kit with clear nail polish and other necessities, and supply a gift card for monthly manicures and a nice visit. Mark it on the calendar so you’ll both remember. Home made gift cards for snow shoveling, foot massages or specific household tasks are appreciated. Or supply an event: movie tickets, theater tickets, a trip to the Gray animal farm, or a lighthouse tour with lunch might be a great gift for someone who wants companionship and time with you. Or offer garden tilling with some seeds, or car washes with a new sponge.

Check out senior gifts for more ideas.

Reprinted with permission from Maine Senior Guide.

18 Signs your aging parent needs help

Whether mail is stacking up, food is spoiled or something just seems out of the ordinary, it’s important to be aware of the signs that your aging parents may need help.18 Signs Your Elderly Parent Needs Help

Sometimes age sneaks up on everyone. Mom and dad may have seemed themselves last time you visited, whether a month—or even year—has passed. Physical and mental health decline often surprises family members, especially if aging parents seemed fine on the last visit. The key is to be aware of the small signs or problems that something may be wrong, so that your family has an inkling of health decline and can properly prepare for the future.

A Place for Mom expert and geriatric psychologist Dr. Melissa Henston provides some guidance on how to not only spot common problems, but tips on how to deal with any issues to get your elderly loved one the help they need.

How to Notice There’s A Problem With Your Aging Parents

Aging parents and their children are often in denial that there is a problem. “It’s often hard for parents to admit that they need help, and no one wants to lose their independence,” notes Henston. “But daily living tasks sometimes get to be too much as we age, and it’s important for family members and loved ones to step up and address the problem when this happens—even if it is painful. The problems will not go away and usually need to be addressed in a timely manner.”

The burden often falls on the family to recognize the signs that an aging parent might need help with daily living tasks. This doesn’t necessarily mean that your loved one has to go to assisted living or a nursing home, but they may need some extra help in their home environment. And if they’re not willing to admit it, there are signs that your elderly parent needs help.

According to Henston, you can spot problems the minute you drive up to your loved one’s house:

“There are a whole bunch of warning signs that are easy to spot. For example, the exterior of the house has peeling paint, or the driveway isn’t shoveled or the walkway isn’t treated. Once you enter the home, newspapers are still in plastic wrap and mail is piled up. Maybe the house isn’t as clean as normal or has an odor. You can usually tell when something is ‘off’.”

Since a health crisis in the elderly can escalate quickly and catch everyone involved off guard, it’s important to not ignore signs that something may be wrong. Ideally, families will have conversations with their children or loved ones about getting their affairs in order and end of life care well in advance of having any issues, but here are some signs to be cognizant of when visiting aging loved ones for the holidays:

  1. House and yard need care / maintenance
  2. Disheveled clothing
  3. Broken appliances
  4. Changes in mood or extreme mood swings
  5. Spoiled / expired groceries that don’t get thrown away
  6. Poor personal hygiene
  7. Cluttered, dirty and/or disorganized house
  8. Depressed or low energy temperament
  9. Unexplained bruising
  10. Trouble getting up from a seated position
  11. Missing important appointments
  12. Uncertainty and confusion when performing once-familiar tasks
  13. Forgetfulness
  14. Poor diet or weight loss
  15. Late payment notices, bounced checks and calls from collections
  16. Loss of interest in hobbies and activities
  17. Forgetting to take medications
  18. Unexplained dents or scratches on car

If health or happiness seems to be compromised, it’s time to have a conversation and address problems, whether it’s finding in-home care, a retirement community or a senior living community. It’s important to find the right care options for each unique family situation.

Henston emphasizes the importance of noting anything out of character or outside of normal behavior as there are ways to improve quality of life if independent living in the family home is no longer working. 

Reprinted from A Place for Mom

An Elder Law Attorney Perspective on Aging Parents


Sometimes joyful occasions visiting family can illuminate health or cognitive issues in our older loved ones.

Mom and Dad may have aged more than expected, or suddenly seem to need more assistance with daily tasks. Or maybe your elderly loved ones are doing fine, but you recognize that they are getting older, and the reality is that you need to discuss important topics and decisions for their retirement, their advanced years and end-of-life wishes.

These tough conversations can be uncomfortable, but they are necessary. A Place for Mom expert and elder law attorney, Stuart Furman, Esq., shares his opinion on how families can position themselves to help their aging loved ones prepare for the future.

“You need to shift perspective and think of these talks as a gift, both from the parent to the children as well as from the child to the parent. There has to be a trust relationship where the parent understands that you will not be taking control, but rather you are going to be carrying out the aging parent [or loved one’s] objectives. Help them understand why these conversations are crucial to help them prepare for the future.”


It’s no secret that the need to care for an aging family member tends to sneak up on everyone involved. Both adult children and their parents tend to avoid thinking about getting sick or old.

Furman, an estate planning eldercare attorney, got thrown into becoming a caregiver and the eldercare journey himself when his own parents began to need help. He realized how important it was to collect information and to have it available to make important life decisions. Through his own personal experience as well as professional experience helping other families, Furman has observed that it is more difficult to cope with the uncertainty, stress, and confusion of eldercare due to a lack of clear understanding and preparation.

“There used to be only two absolute truths. Death and taxes. But there is a third, and that’s eldercare. The only questions are: how long is it going to last, and how intense is it going to be? You need to be prepared while Mom and Dad are still competent. By anticipating what will be needed for your eldercare journey, you can make the trip much less stressful for everyone involved.”

Furman outlines three approaches to delicately handle the ‘tough conversation’ of senior care with your aging loved ones.


This is difficult on many levels, notes Furman. Most parents still feel they should be the ones in control. After all, they are the parent. However, as the parent’s mental competency wanes, the access to their information and desires is also lost. If you let them be in control while still allowing you to do what needs to be done, that will help ease their distress. Begin the conversation and preparation where they can control what their desires and wishes are for the future, so that you can work together with them to put the right plans in place. Let them know that their wishes are the only things that are important. You are there to assist them. You are“Partners-in-Care.”


There has to be a new trust relationship if you’re going to be carrying out your loved one’s objectives. The role reversal that most people have heard about is real. The parent now has become the cared-for person. But stating it that way tends to upset the parent and create many roadblocks. Look at this in a different way. You are not becoming the authority figure, but rather you are merely becoming the agent for the parents. “Just like with a power-of-attorney, look at it not as control, but that you are the troops helping deliver your parents’ wishes. This helps to soften the conversation,” notes Furman.


Making guesses about your parents’ wishes and their vital information during a crisis most often results in a bad situation, and potentially bad decisions, for everyone involved. Gathering the information ahead of time is the best way to prevent this problem. Furman says, “I can’t emphasize more how much information needs to be readily at hand and packed in your eldercare suitcase.”

Remember also that just because you are not yet a senior citizen does not make you exempt from dying or becoming mentally incapacitated earlier than expected. So this early preparation and packing your suitcase is for everyone.


Our life is bookended by essential documents, many of which are necessary for family members to successfully carry out end of life care and wishes. But which documents are the most important? Here is a quick rundown of the ones you will need and that should be discussed with your aging loved one.

Financial Information You Need

Financial information can be crucial in many instances for timely, efficient and more affordable care. Here is a list of some vital financial information:

  • List of all bank accounts
  • Pension documents, 401(k) information, and annuity contracts
  • Tax returns
  • Savings bonds, stock certificates or brokerage accounts
  • Partnership and corporate operating agreements
  • Deeds to all properties
  • Vehicle title
  • Documentation of loans and debts, including all credit accounts
  • Trust documents and durable financial power-of-attorney (financial proxy)

Also critical is access to the information. Just because you may know what the parents own, does not mean you can get access to information regarding the assets, or be able to transact on behalf of the parent. This is where having proper releases (or a power of attorney or trust) on file with the asset holders and having them accepted as being sufficient for the particular purpose is necessary.

Healthcare Documents You Need

If a senior becomes incapacitated or can’t communicate, it’s important that the senior’s wishes be stated in a living will or health care advance directive, and also that someone with the authority to represent the senior has been designated. Furman advises,

“Since you never know what healthcare problems will arise or when you’ll have to visit a hospital, being able to quickly grab official paperwork such as a healthcare power-of-attorney or an advanced healthcare directive can eliminate a lot of stress at the hospital. Doctors want proof that you are the decision-maker, and all of the decisions should already be made.”

Important healthcare documents include:

  • Healthcare proxy (durable health power-of-attorney)
  • Authorization to release healthcare information
  • Living will (healthcare directive)
  • Personal medical history
  • Insurance card (Medicare, Medicaid, Independent)
  • Long-term care insurance policy
  • Lists of current medication and health conditions

When it comes to healthcare decisions, remember that the agent is the proxy for the parent in carrying out these decisions in the same manner that they would have had they been able to. Parents or family members need to provide a lot of detail. A broad statement is not enough.“Many of my clients say they ‘don’t want to be hooked up on tubes,’ or they ‘don’t want life support,’ which really does not give much guidance when a specific healthcare decision needs to be made.

“If specific wishes are not clearly communicated, the family and kids have to step up and decide what to do based on their own idea, or best guess, of what Mom or Dad may have wanted in a specific healthcare situation. This fuels the flames of family battles as these decisions, albeit in good faith, are made subject to each child’s biases and life experiences. It is up to the parents to clearly state what they want, so that everyone can just focus on delivering those wishes.”

End-of-Life and Estate Planning Documents You Need

It’s emotionally challenging when a loved one dies. Family members don’t need to also feel overwhelmed trying to sort out end-of-life affairs. “We can save ourselves and our loved ones the burden of disorganization at this crucial time by making sure that documents related to estate planning and end-of-life have been drawn up, are up-to-date, and easily available,”Furman reminds us. Essential end-of-life documents include the following:

  • Will and trust
  • Life-insurance policies
  • End of life instructions letter (regarding wishes not covered in will, for example regarding memorial, or items not covered in the will)
  • Organ donor card or information

Appropriate estate planning documentation is also necessary if you’re in any situation where the ability to do estate planning is at risk. Get more detailed estate planning preparation information in Furman’s “Why Estate Planning Procrastination Kills Your Options” article.


When you are ready to begin the eldercare journey, Furman recommends that you evaluate your family’s legal capacity, or consult with an elder law attorney first, to ensure that there are not any misconceptions about your loved one’s care.

“Many prospective clients see me when something has happened to one of them, or something has progressed and they need to have control of assets,” he says. “The wife may have Alzheimer’s or dementia and the husband waited until he must act due to an external event forcing them to see me (such as a financial institution refusing to let the husband have information about an account in the wife’s name, for instance). At that point, the individual may have already lost capacity to execute documents which creates a much more challenging estate planning project.

“I have also had countless families tell me that they have had Mom or Dad declared incompetent so that they can sign the power of attorney or trust and another person can then take over. Although their intentions were in the right place, you must have mental capacity to sign, not lack mental capacity. So families are often mixed up on this issue.”


This type of planning must also take place well in advance to protect assets, Furman says. “One must be very proactive, not reactive. If families are reacting to events that occur without the planning in place, it is often too late, or it becomes much more challenging and consequently much more expensive.”

Furman concludes, “So, if you are headed home to visit, plan ahead. Even if your senior loved ones are in good health, start the conversation about end-of-life wishes early. It’s better to be prepared and to let your parents know you are their advocate, or their ‘troops.'”

Reprinted from A Place for Mom

Medical Aid Closet

The Carrabassett Valley network has a medical aid closet with items that can be loaned out for free.  Contact Sugarloaf Christian Ministry for more info at 207-237-2304 or Gerry Baril at 207-235-3782

Here is the most recent list of items available.


Valley Network

Medical Aid Closet Inventory


Non-folding – w/o wheels         3   (1 loaned out)

Fold-up with large wheels                     10 (1 loaned out)

Fold-up with small wheels                     1

Child’s walker                                      1

Clip on basket                                      1

Vinyl storage bag for walker                 1

Portable Toilet Chairs                                   2

Transfer Chairs                                              2 (1 loaned out)

Hospital Bed  (electric)                                   1

With mattress, cushions, rails

Recliner (electric lift-assist)                              1 (loaned out/Orchard Park Assisted Living)

Crutches                                                         Pairs

Wooden                                               1

French Cuffs                                         3

Metal   (assorted sizes)             8

Ergo-Cooler & cuff                                        3

Athletic Knee Brace                                      2



To donate any gently used and serviceable items or inquire for available use, contact Sugarloaf Christian Ministry at 207-237-2304.

Seniors Fearful of Reporting Fraud

Elderly scams are the most common form of fraud. Sadly, scam artists relentlessly prey on seniors because they are easy targets; they tend to be gullible, live alone and usually do not have someone watching over their finances regularly. Even though senior fraud is more prevalent than ever, most cases are never reported for a multitude of reasons.Seniors Fearful of Reporting Fraud

Learn more about how senior citizens lose billions, yet are fearful of reporting fraud.

Seniors Are Fearful of Reporting Fraud

Sadly many senior citizens are fearful of reporting fraud, even though they comprise 65% of fraud victims. Fraud can happen to wealthy seniors, and those of limited means; and most of them are embarrassed and don’t feel they have the resources to report the incident or try to get their money back.

In fact, even though an estimated $36 billion worth of financial exploitation a year towards seniors has been reported, according to a recent USA Today article, only one out of every 24 cases is reported. Sandy Markwood, CEO of the National Association of Area of Agencies on Aging says this is due to embarrassment, fear or lack of evidence. She notes,

“Seniors may be fearful that if they report they have been duped, somebody may say, ‘It is time for mom to move out of her house,’ and again, most older adults don’t want to move out of their house.”

Financial exploitation is the most frequently reported form of abuse against adults as one in five has been financially exploited, with the average victim losing $120,303, according to a study by the American Association of Retired Americans Bank Safe Initiative. Studies show con artists are more likely to target senior citizens than other age groups because they believe seniors are more susceptible to such scams.

The FTC reports that fraudulent telemarketers direct from 56-80% of their calls to seniors, making the need for senior fraud prevention greater than ever. There are ways to prevent senior fraud, though. Seniors, their families and their caregivers just need to be cognizant of how to avoid senior fraud.

Senior Fraud Prevention Tips

Education is king when it comes to avoiding fraud. Seniors are often vulnerable to cons and scammers for many reasons, including impaired judgment from cognitive impairment, financial ignorance and loneliness. Being aware of these scams can help you protect your elderly parents so that they do not fall victim to fraud and and can be spared not only heartache, but also financial duress.

Here are four ways seniors, their families and their caregivers can help protect the aging population from fraud:

1. Be aware that you are at risk from both strangers and those close to you.

Often times elder abuse is committed by the senior’s own family members as they are most familiar with their finances and personal information. Most often their adult children, followed by grandchildren, nieces and nephews, among others, according to the National Council on Aging. Tactics include the following:

  • Depleting a joint checking account
  • Forms of abuse
    • Physical
    • Threats
    • Intimidation
    • Neglect of basic care needs
  • Outright theft
  • Promising but not delivering care in exchange for money or property

Strangers also prey on seniors because of their vulnerability, so it’s important to be aware of the most common scams targeting seniors.

2. Avoid isolation by staying involved.

Isolation is a huge risk for elder abuse as most family violence occurs behind closed doors. Many seniors withdraw from their communities for a number of reasons, including depression, lack of transportation or a physical disability. Many seniors are simply fearful of leaving the comfort of their own homes. Visit your local senior center to learn about transportation and social services available to seniors, or view the Eldercare Locator to find services that can help your elderly loved one stay active.

3. Be forthright with solicitors.

Always tell solicitors: “I never buy from (or give to) anyone who calls or visits me unannounced. Send me something in writing.” Seeing written material about the fundraiser or charity helps to both validate that it’s legitimate, as well as avoids seniors providing personal banking information from their credit cards or checks to solicitors. Of course neighborhood children you know who are selling Girl Scout cookies or school fundraising forms are different, so just be discerning and help to educate your elderly loved ones.

It’s also a good practice to obtain the following from a salesperson:

  • Business identity
  • Business license number
  • Name
  • Street address
  • Telephone number

4. Shred all receipts with a credit card number.

Identity theft is a huge problem and shredding receipts and mail, such as bank and credit card statements, that have your credit card number is important. Monitor yours and your loved ones’ bank and credit card statements and never give out personal information over the phone to someone who initiates contact or seems suspicious.

5. Sign up for the “Do Not Call” list and remove yourself from mailing lists.

Visit “Do Not Call” to stop telemarketers from contacting you or your elderly loved one. Being careful with mail is also important. Do not let incoming mail sit in the mailbox for a long time, and when sending out sensitive mail, consider dropping it off at the post office. Regularly monitoring crediting ratings and /or incorrect information can also be helpful.

6. Use direct deposit.

Direct deposit is an easy way to ensure checks go directly into accounts and are protected so that you don’t need to worry about scammers or scrupulous loved ones who have been known to steal benefit checks out of mailboxes or even from seniors’ homes.

7. Never give banking, credit card, Medicare, social security or other personal info.

Misuse of Medicare dollars is one of the largest scams involving seniors. Common schemes include billing for services never delivered and selling unneeded devices or services to beneficiaries. Protect your Medicare number as you do your banking and social security numbers and do not allow anyone else to use it. Be wary of salespeople trying to sell you something they claim will be paid for by Medicare.

Review your Medicare statements to be sure you have in fact received the services billed, and report suspicious activities to 1-800-MEDICARE.

Stay Educated on the Latest Scams

Unfortunately, fraud against older Americans is a serious problem affecting thousands every year. Many senior centers are trying to educate the public about the growing problem by discussing signs of financial exploitation and equipping people with resources.

Many seniors grew up during a time when they trusted people. Mark Shea, director of York County Area Agency on Aging notes:

“The world is vastly different today. Scammers often acquire information about their victims by scouting neighborhoods and going through trash. Families should keep an open relationship with their loved ones and watch out for changes or anxiousness as these are all common signs there is a problem.”

If seniors don’t have a family to support them, educating themselves is also key. To stay on top of the very latest scams hitting seniors, sign up for scam alerts from the National Consumer Protection Bureau

Reprinted from A Place for Mom


Cancer Screening Timelines for Seniors

Cancer Screening Timelines for Seniors

Taking advantage of preventative health can make seniors less vulnerable to the various forms of cancer. According to the National Institute of Health, advancing age is a high risk factor for cancer, with persons over 65 accounting for 60% of newly diagnosed malignancies and 79% of all cancer deaths.

Furthermore, with people living longer these days, it is expected that by 2050, approximately 70 million individuals will reach age 65 and older, compared to half that — 35 million today—which will create both socioeconomic and political consequences, as more healthcare resources and personnel will be needed to care for the elderly, as reported by the U.S. National Library of Medicine.

These numbers show the importance of being proactively healthy through diet, exercise and other lifestyle habits; in addition to preventative health screenings and donations to help fund medical research.

Take Action Against Cancer

Seniors and their caregivers can help avoid complications from breast cancer, colon cancer and more by simply being motivated to lead healthy lifestyles and by getting the proper cancer screenings. Dr. Constance Lehman, professor of radiology at the University of Washington School of Medicine and director of breast imaging at the Seattle Cancer Care Alliance comments:

“I cannot stress enough the importance of early detection and screening. Unfortunately, there has been a disturbing decline in annual screenings, and people need to by proactive about working with their insurance and Medicare to get the recommended screenings.”

In order to help avoid the disease, the American Cancer Society recommends cancer screenings by age and gender. The recommendations are noted below.

Charitable donations are tax-deductible and can also help scientists find the next breakthrough cancer treatments.

Cancer Screenings for Men Age 65 or Older

Colon Cancer Testing

There are many colon cancer testing options. It’s important you talk with your health care provider about which tests are best for your unique situation and how often you should be tested. Medicare does cover testing.

Prostate Cancer Testing

It’s important to consider overall health status, not just age, when deciding about the best prostate cancer testing. Men who expect to live at least 10 more years should talk with a care provider about the uncertainties, risks and potential benefits of testing to determine whether they want to be tested. Medicare covers prostate cancer testing.

Lung Cancer Testing

Seniors who smoke are more at risk for lung cancer and should discuss with their health care provider whether they should get an annual low-dose CT scan to screen for early lung cancer. Screening may benefit seniors who are either active or former smokers, who quit within the past 15 years, have no signs of lung cancer, and have a 30 pack-year* smoking history. You should discuss the benefits, limitations, and risks of screening with a health care provider before testing is done. Medicare covers testing.

*A pack-year is 1 pack of cigarettes per day per year. One pack per day for 30 years or 2 packs per day for 15 years would both be 30 pack-years.

Cancer Screenings for Women Age 65 or Older

Breast Cancer Testing

It is important that women report any changes in the way their breasts look or feel to their caregiver and/or a healthcare provider right away. They should get a mammogram every 2 years, or can even choose to get one every year, if they fall in the risk category (breast cancer runs in their family or they’ve had breast tissue issues before). It’s important for seniors and their caregivers to understand the pros and cons of breast cancer screening.

It’s also important to know if a senior has a higher than average risk for breast cancer. Health care providers help you determine whether they senior needs to get other tests done along with mammograms.

Cervical Cancer Testing

No cervical cancer testing is needed if the senior has had regular cervical cancer testing with normal results during the previous 10 years.

No cervical testing is needed after a hysterectomy that removed the uterus and cervix as long as it was done for reasons not related to cervical cancer.

Senior women with a history of a serious cervical pre-cancer should continue testing for 20 years after that diagnosis, and the testing is covered by Medicare.

Colon Cancer Testing

Testing is recommended for colon cancer, and there are many testing options. It’s important to talk with a health care provider about which tests are best for you and how often testing should be done. Medicare covers colon cancer testing.

Lung Cancer Testing

If the senior has a history of smoking, talk to a health care provider about it and whether you should get an annual low-dose CT scan to screen for early lung cancer. Screening may benefit the senior if they are an active or former smoker who has quit within the past 15 years, have no signs of lung cancer, and have a 30 pack-year smoking history. It’s important to discuss the benefits, limitations, and risks of screening with a healthcare provider before testing is done. Medicare does cover lung cancer testing.

*A pack-year is 1 pack of cigarettes per day per year. One pack per day for 30 years or 2 packs per day for 15 years would both be 30 pack-years.

Reprinted from A Place for Mom

Dealing with Dementia Behavior

Dealing with Dementia Behavior

Communication difficulties can be one of the most upsetting aspects of caring for someone with Alzheimer’s or some other type of dementia — and it’s frustrating for those with the disease and for loved ones.

Although it can be hard to understand why people with dementia act the way they do, the explanation is attributable to their disease and the changes it causes in the brain.

Familiarize yourself with some of the common situations that arise when someone has dementia, so that if your loved one says something shocking, you’ll know how to respond calmly and effectively.

Common Situation #1: Aggressive Speech or Actions

Examples: Statements such as “I don’t want to take a shower!,” “I want to go home!,” or “I don’t want to eat that!” may escalate into aggressive behavior.

Explanation: The most important thing to remember about verbal or physical aggression, says the Alzheimer’s Association, is that your loved one is not doing it on purpose. Aggression is usually triggered by something—often physical discomfort, environmental factors such as being in an unfamiliar situation, or even poor communication. “A lot of times aggression is coming from pure fear,” says Tresa Mariotto, Family Ambassador at Silverado Senior Living in Bellingham, WA. “People with dementia are more apt to hit, kick or bite” in response to feeling helpless or afraid.

Ann Napoletan, who writes for Caregivers.com, is all too familiar with this situation.

“As my mom’s disease progressed, so did the mood swings. She could be perfectly fine one moment, and the next she was yelling and getting physical. Often, it remained a mystery as to what prompted the outburst. For her caregivers, it was often getting dressed or bathing that provoked aggression.”

DO: The key to responding to aggression caused by dementia is to try to identify the cause—what is the person feeling to make them behave aggressively? Once you’ve made sure they aren’t putting themselves (or anyone else) in danger, you can try to shift the focus to something else, speaking in a calm, reassuring manner.

“This is where truly knowing your loved one is so important,” says Napoletan. “In my mom’s case, she didn’t like to be fussed over. If she was upset, oftentimes trying to talk to her and calm her down only served to agitate her more. Likewise, touching her–even to try and hold her hand or gently rub her arm or leg–might result in her taking a swing. The best course of action in that case was to walk away and let her have the space she needed.”

DON’T: “The worst thing you can do is engage in an argument or force the issue that’s creating the aggression,” Napoletan says. “Don’t try to forcibly restrain the person unless there is absolutely no choice.” Mariotto agrees: “The biggest way to stop aggressive behavior is to remove the word ‘no’ from your vocabulary.”

Common Situation #2: Confusion About Time or Place

Examples: Statements such as “I want to go home!”, “This isn’t my house.”, “When are we leaving?  “Why are we here?”

Explanation: Wanting to go home is one of the most common reactions for an Alzheimer’s or dementia patient living in a memory care facility. Remember that Alzheimer’s causes progressive damage to cognitive functioning, and this is what creates the confusion and memory loss.

There’s also a psychological component, says Mariotto:

“Often people are trying to go back to a place where they had more control in their lives.”

DO: There are a few possible ways to respond to questions that indicate your loved one is confused about where he or she is. Simple explanations along with photos and other tangible reminders can help, suggests the Alzheimer’s Association. Sometimes, however, it can be better to redirect the person, particularly in cases where you’re in the process of moving your loved one to a facility or other location.

“The better solution is to say as little as possible about the fact that they have all of their belongings packed and instead try to redirect them–find another activity, go for a walk, get a snack, etc.,” says Napoletan. “If they ask specific questions such as ‘When are we leaving?’ you might respond with, ‘We can’t leave until later because…’ the traffic is terrible / the forecast is calling for bad weather / it’s too late to leave tonight.”

“You have to figure out what’s going to make the person feel the safest,” says Mariotto, even if that ends up being “a therapeutic lie.”

DON’T: Lengthy explanations or reasons are not the way to go. “You can’t reason with someone who hasAlzheimer’s or dementia,” says Ann. “It just can’t be done.” In fact, says Mariotto. “A lot of times we’re triggering the response that we’re getting because of the questions we’re asking.”

This was another familiar situation for Ann and her mother. “I learned this one the hard way. We went through a particularly long spell where every time I came to see my mom, she would have everything packed up ready to go–EVERYTHING! Too many times, I tried to reason with her and explain that she was home; this was her new home. Inevitably things would get progressively worse.”

Common Situation #3: Poor Judgment or Cognitive Problems

Examples: Unfounded accusations: “You stole my vacuum cleaner!” Trouble with math or finances: “I’m having trouble with the tip on this restaurant bill.” Other examples include unexplained hoarding or stockpiling and repetition of statements or tasks.

Explanation: The deterioration of brain cells caused by Alzheimer’s is a particular culprit in behaviors showing poor judgment or errors in thinking. These can contribute to delusions, or untrue beliefs. Some of these problems are obvious, such as when someone is hoarding household items, or accuses a family member of stealing something. Some are more subtle, however, and the person may not realize that they are having trouble with things that they never used to think twice about.

According to Napoletan,

“There came a time when I began to suspect my mom was having problems keeping financial records in order. At the time, she was living independently and was very adamant about remaining in her house. Any discussion to the contrary, or really any comment that eluded to the fact that she may be slipping, was met with either rage or tears. It was when she asked me to help with her taxes that I noticed the checking account was a mess.”

DO: First you’ll want to assess the extent of the problem. “If you’re curious and don’t want to ask, take a look at a heating bill,” suggests Mariotto. “Sometimes payments are delinquent or bills aren’t being paid at all.” You can also flip through their checkbook and look at the math, or have them figure out the tip at a restaurant.

The Alzheimer’s Association says to be encouraging and reassuring if you’re seeing these changes happen. Also, you can often minimize frustration and embarrassment by offering help in small ways with staying organized. This is what Napoletan did for her mother: “As I sifted through records to complete her tax return, I gently mentioned noticing a couple of overdraft fees and asked if the bank had perhaps made a mistake. As we talked through it, she volunteered that she was having more and more difficulty keeping things straight, knew she had made some errors, and asked if I would mind helping with the checkbook going forward. I remember her being so relieved after we talked about it.” From there, over time, Napoletan was gradually able to gain more control over her mother’s finances.

DON’T: What you shouldn’t do in these circumstances is blatantly question the person’s ability to handle the situation at hand, or try to argue with them. “Any response that can be interpreted as accusatory or doubting the person’s ability to handle their own affairs only serves to anger and put them on the defensive,” says Napoletan.

reprinted from A Place for Mom.

Caring for Elderly Parents’ Estates and Finances

It’s important that you have conversations with your parents and siblings about the plans that your parents have made for their estate after they pass away or should they become too ill to continue to handle their finances. Ideally this is a conversation that your parents initiate and it will take place when your parents are still healthy and in good mental capacity.Caring for Elderly Parents' Estate and Finances

If you’re concerned that your parents haven’t yet discussed their financial plans with you or your siblings, then you may want to raise your concerns with them. Individuals who are open with their family about their plans have the opportunity while they are still alive to diffuse future problems that may occur after their death.  Learn more about caring for your elderly parents’ estate and finances.

Essential Conversations to Have with Your Parents About Estate and Finances

Some of the most common problems that occur if you do not discuss your parents’ estate and finances can include:

  • Not having a will
  • Not having a power of attorney
  • Being unable to access funds from the estate to pay for essential expenses (like funeral costs)
  • Paying unnecessarily high taxes and probate fees
  • Secrecy surrounding last wishes which can cause tension and emotional stress for remaining family members
  • Falling prey to financial abuse.

Although every person’s situation is unique, the following tips are designed to help families avoid some of these concerns:

1. Ensure Your Parents Have a Will and Power of Attorney

It is critical that you have a will which clearly outlines your parents’ last wishes and plans for an estate. If you don’t have a will then the government will determine what will happen to the estate, a process which could take a significant amount of time. While the government is determining the future of the property and belongings, assets will be frozen, which means your family will not be able to access them.

It is also a good idea to have a living will and power of attorney. A power of attorney as a “legal document that you sign to give one person, or more than one person, the authority to manage your money and property on your behalf.” Although this person is called an attorney they do not need to be a lawyer.

There are pros and cons to having a POA. If your parent falls ill and is unable to pay bills or manage financial affairs, a POA can step in to access funds for these purposes. It is critical that the POA is someone you trust to handle finances with accuracy and care.

2. Designate Beneficiaries for Assets

When you set up your parents’ accounts for Registered Retirement Saving Plans (RRSPs), Tax Free Savings Accounts (TFSAs) and insurance policies it’s important to ensure that there is a named beneficiary for each policy or account so the title change happens seamlessly.  “With a named beneficiary these accounts roll over very quickly,”  which means that if one spouse passes away the surviving spouse [or family] will be able to access the money in these accounts almost immediately.

If the beneficiary of these registered accounts is a spouse then they won’t need to pay taxes on the additional income. . However, if the beneficiary is a child or other family member then the additional income will be taxable, which in some cases can be a major taxable event.

What happens if you don’t have a beneficiary on these accounts? Without a beneficiary in place these registered assets will go into the estate and will be frozen until the estate is settled, which could take some time, Travers warns.

It is important to note that this seamless transition of assets to the beneficiary only takes place on registered funds. Unregistered mutual funds, stocks and bonds will become part of the estate upon death, which means that they can’t be accessed immediately.

3. Discuss Joint Bank Accounts

If you are helping your parents by paying their bills and managing their finances then you may wonder if you should become a joint account holder for their bank accounts. The answer, of course, depends on the situation and the comfort level that you have with your parent, but generally Travers advises against it. If there is no financial living will (POA) then a benefit to a joint bank account is that you would have the ability to access your parents funds quickly should they become incapacitated.

However, there are risks associated to a joint account including opening your parent’s finances up to your creditors and of course, the risk of financial abuse. Siblings or other family members may question how and why money is being spent. “Parents need to be mindful of what they may set their children up for,” Travers says. If you are paying your parent’s bills or they live with you their finances “could appear to be misappropriated,” warns Travers. “A better way is to have the POA in place to minimize the risk.”

4. Consider Gifts to Help Avoid Probate Fees

One way to avoid probate fees is for parents to give away excess assets as gifts while living. Most gifts are non-taxable, so parents who give children and grandchildren gifts while they are still alive avoid probate fees and taxes. Another benefit of gifting is that your parents will know that their assets arrived to the intended person. We’ve all heard stories of people challenging wills. Parents who gift valuable assets that are no longer needed like extra cash, jewelry, artwork and property know that these valuables won’t cause stress or dissension amongst family after they are gone.

Providing financial gifts like cash can often help family members out now who could use help with a mortgage or student debt. Not only does gifting avoid probate and tax fees it also allows the parent to witness the joy their gift has brought to their loved ones.

5. Discuss Joint Tenancy

Wondering what will happen to the family cottage that has been in your family for generations? Is it a good idea to have joint tenancy on the cottage before a parent passes away to avoid probate and taxes? As with a joint bank account the risk of opening the cottage up to creditors is a major con for adding children to joint tenancy of property. Many people are also concerned about their child’s spouse, what happens to the family cottage if there is a future divorce? In large families, how can parents ensure that the family cottage remains in the family and is still accessible to all?

Although joint tenancy may avoid having the cottage enter probate as part of the parent’s estate, it opens the property up to a lot of risk and in large families there may be a highly charged emotional element to consider as well. Also, depending on the asset the Canadian Revenue Agency (CRA) may deem that tax does need to be paid on the gift.

Paying Tax on Joint Tenancy is Up to the CRA

For instance, if a mother and son are both on the title of a property then the property would automatically go to the son upon the mother’s death, skipping probate altogether. In a small family this may make sense. However, Travers explains that the CRA could deem a transaction like adding someone to a deed as a taxable event, but this decision is at their discretion.

In the case of a mother and son, if the mother has an investment portfolio which she is living on and she adds the son as a joint account owner the government might not tax this because the son is not benefiting directly from the portfolio. However, if the mother owned a business and office building and put the son (who runs the business) on the deed as a joint tenant then the government may choose to tax the transaction because the son benefits directly from the gift.

6. Consider Complexities for Business Owners

If your parents own a business, then their estate and assets have extra complexities involved. Most business owners need professional help to ensure that their finances are in order and their business remains in the family upon their death.

7. Read the Fine Print

Travers says it’s important to carefully read all the detailed paperwork that you sign. Many people trust that their financial institution has filled out paperwork correctly on their behalf, and in most cases this is the case, “but 99% of us don’t look through these documents in detail, some of which are 20-30 pages in length,” Travers points out. “People sometimes make mistakes so it’s good to read through in detail and double check that everything is filled out correctly,” he advises.

8. Ensure Funeral Expenses are Covered

When a parent passes away there is not only a huge emotional stress, but for many families, also a large financial stress. “The main thing is making sure bills are paid and if everything is locked up in probate then a child without the financial means may have difficulty paying for bills and funeral expenses,” Travers says. However, he adds that based on demographics more elderly people have a whole life insurance policy (rather than term life insurance or no life insurance) which is usually intended to cover funeral expenses. You should know whether your parent has an insurance policy and where that policy is located should you need it.

It’s important that your parents take the time to look at their finances, will and power of attorney now. Putting financial plans off for another day is never a good idea because a sudden illness or death can happen anytime. Make sure your parents have plans in place and that you and your family are aware of their plans so that you can help protect them, their wishes as well as your own interests when the time comes to rely on you for help.

Reprinted from A Place for Mom.