"The Grey Zone": How to Handle Partially Incompetent Aging Parents

Your aging parent seems ok one day. The next day, he can’t find his way out the front door. Is he really losing it? Or is it just a temporary thing?
What we call “the grey zone” is that place between being competent and being incompetent for making decisions that is part of cognitive decline. The crazy-making part of it is that it is so unpredictable. The impairment that begins to affect the brain of a person with dementia very early in the process may be both hidden and subtle. But it’s real. And it can be dangerous.
Research tells us that with Alzheimer’s, the judgment needed for financial decisions is impaired even at the beginning of the disease, though you might not see it. The elder may look and feel fine. Perhaps he or she is completely appropriate socially. The problem is, he can’t see a scam coming. He can’t tell when something smells fishy about a proposal. She doesn’t know a ripoff from a good thing. This difficulty causes two things to happen quite often.
First, the family may argue and disagree that anything is wrong with the parent. He’s always been in charge. She always paid the bills on time. The insidious reach of the disease robs the parent of the necessary ability to handle money safely and the family doesn’t believe it or can’t understand how it works. No one wants to make a change in any way and they get stuck in their positions opposing each other.
Second, the elder with early cognitive impairment is very vulnerable to financial abuse from family, from unscrupulous financial professionals, from scam artists or from caregivers. The problem of financial elder abuse costs elders $2.9B a year and it is growing.
What can we do about this?
One useful thing is to understand that an elder, even in the early stages of cognitive decline needs to be making plans to allow others to take over the handling of financial matters. And then the authority needs to change. It is not smart to wait until some disaster happens or all the money in the bank disappears before transferring power over finances to another responsible person.
Next, one can make use of objective data to measure the extent of impairment. Get some testing done by a qualified psychologist or neuropsychologist. What will show up on psychological testing is often quite different from family’s casual impression of how Mom was at lunch last week. She seemed fine. Testing compares how Mom is doing with how others in Mom’s age group compare in terms of memory, ability to understand concepts, judgment and other functions. The data can help everyone make better decisions about what Mom needs.
Finally, we encourage using family meetings with a neutral person, a mediator, to keep family warfare from interfering with safe decisions about aging parents. The investment of time and resources into this step can save untold aggravation and can prevent the fighting from
escalating all the way to the courthouse.
We continue to offer you our help in raising the bar in family relationships.
Carolyn Rosenblatt, R.N., Elder Law Attorney & Mediator
AgingParents.com