Caregiving and the Risk for Financial Exploitation

Charles is an 80-year-old Caucasian man who has been the caregiver for his wife, Helen, for about two years. Charles had a traditional “breadwinner” role, and Helen managed the day-to-day budgeting and finances. Charles reported that they always discussed major financial decisions in their marriage and had used the same broker for years for investments. After years of financial stability, Charles has grown anxious regarding the potential cost of in-home caregivers to assist with Helen. Charles and Helen have two adult sons who live about an hour away, David and Thomas. They are concerned about their parents’ financial well-being and call to check in about once per week. Helen had served as the social bridge for the couple and was an enormous source of emotional support for the whole family. When his sons call, Charles has a tendency to minimize their challenges, indicating, “We’ll manage,” and trying to deflect the conversation to other topics. He brought Helen to a free lunch seminar recently that discussed government entitlement programs that could help with the cost of care.

Charles and Helen are both experiencing transitions in financial autonomy. In Helen’s case, she is losing her cognitive abilities to dementia. She is likely experiencing this shift as a significant loss to her autonomy. Even in the mild stages of cognitive impairment, we know that individuals are at increased risk for financial exploitation. Financial management is a complex cognitive task that draws on working memory, executive functioning, and basic calculation abilities. These domains, along with new learning, are exactly what is impaired in early dementia (neurocognitive disorder).

However, Charles is also experiencing a major transition in financial decision-making. Charles has lost his sounding board and is now expected to manage caregiving as well as all other major decisions. Caregivers as a group report a greater incidence of depression, anxiety, and fatigue. Not surprisingly, individuals who are caregivers are depleted cognitively and emotionally. These individuals, while cognitively intact, are also in a period of psychological vulnerability. They may feel isolated and miss the red flags that at one time they would have noticed.

Adding to the challenging dynamic are the communication rules observed between aging parents and adult children. Typically, strong boundaries exist within the area of communication regarding finances when individuals are well. However, these rules need to be revisited when transitions occur in financial decision-making. In the next column, we will talk about suggestions for supporting older adults during these transitions.