Caring for someone with a long-term, progressive condition like Alzheimer’s can be overwhelming. It helps to have as many resources as possible – including the tools to manage the financial aspects of care.
Getting your financial ducks in a row sooner rather than later will make things easier on everyone. Talking about finances with your partner or family member as soon as possible after an Alzheimer’s diagnosis can be empowering as well as practical. And knowing a plan is in place takes some of the stress out of a situation in which there are many unknowns.
Some first steps you can take:
- Make a financial plan. An attorney or financial adviser can help. Online resources can also get you started. The Alzheimer’s Association website has articles, planning tools, and links. Your Area Agency on Aging may have information about what’s available near you.
- Take an inventory of assets and debts. The Alzheimer’s Association has a worksheet that can help you identify these and keep track of them.
- Make a list of monthly bills and income sources, as well as insurance information you’ll need for benefit claims.
- Try to anticipate costs. These will rise over time as the disease progresses. In addition to prescriptions and medical visits, you may need medical equipment, changes to your home, and maybe in-home or residential care services. If you hire a professional caregiver, you may be responsible for paying that person’s Social Security and unemployment taxes.
Paying for Care
Next, figure out what insurance you have and what it covers. You may be able to take advantage of one or more of these government benefits:
- Medicare is the primary insurer for most people 65 and older. Medicare Part A covers hospital bills, Part B covers outpatient care and some medical equipment, and Part D covers prescription drugs. It’s important to enroll in these programs 3 months before reaching age 65 if you want to avoid penalties. Your State Health Insurance Assistance Program (SHIP) can answer questions about Medicare eligibility and coverage.
- Medicaid benefits are available to people with low incomes and limited assets. Eligibility criteria vary by state.
- Veterans benefits are available to people who have served in the armed forces.
- Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) are additional government benefits given based on age, disability, and income or assets.
You may also have private insurance through a job, a retiree plan, or a personal policy. If so, review the policy and see what you can take advantage of now and in the future.
- Many people with Medicare have Medigap plans, private insurance policies offered that help with costs like deductibles and copays that Medicare generally doesn’t cover.
- Long-term care insurance usually needs to be in place before a diagnosis. If you have a long-term care policy, check to see if Alzheimer’s disease is covered, and if so, what benefits are available and when. Most policies specify a measure of physical or cognitive impairment, such as needing help with daily activities, before approving benefits. Some also have maximum daily or lifetime benefits, and some only cover certain kinds of care.
You may be able to tap other sources for funds.
- Life insurance policies sometimes offer ways to get cash, such as borrowing against the policy or accelerating benefits. Some also waive premiums for people with disabilities.
- Some states pay family caregivers for their services. There are also tax credits and deductions for caregivers to offset costs of things like medical equipment and nursing services.
- Community resources such as Meals on Wheels can provide free or low-cost meals or transportation assistance.
Money Management
It’s a good idea to talk to your partner or family member with Alzheimer’s early on about how they want their assets to be managed when they can no longer make decisions. You’ll also need to decide together who will be responsible for ongoing tasks like paying bills and filing taxes.
You can talk to an attorney – the National Academy of Elder Law Attorneys has a directory you can search about drafting documents that spell out responsibilities. You will want:
- A will to detail how the person’s assets will be divided after they die
- A durable power of attorney for finances naming a person to make financial decisions
- A living trust that appoints a trustee to manage money and property
All these documents can be updated as situations change.
People in the early stages of Alzheimer’s may be able to make simple financial decisions. But as the disease goes on, they’ll need help. In fact, difficulty with tasks like paying bills is often one of the early signs of Alzheimer’s. Some things to watch for are:
- Unopened bills
- Unusual or a lot of purchases on a credit card bill
- Money missing from bank accounts
It can be hard for a person to give up financial independence, and some people with Alzheimer’s can become suspicious about attempts to take over their finances. There are some things you can do to help them feel that they still have some power:
- Give the person small amounts of cash or voided checks to have on hand.
- Place limits on credit card accounts.
- Encourage working together to learn about finances.
People with Alzheimer’s can be especially vulnerable to financial scams and fraud. Be on the lookout for signs like these:
- Checks or documents with suspicious-looking signatures
- Items missing from the home
- Changes to the person’s will or other documents without your knowledge
Wayne State University’s Institute of Gerontology has a financial vulnerability survey that can show how at risk a person may be to fraud or exploitation.
As with all aspects of Alzheimer’s care, communication, respect, and compassion make life easier for everyone involved. Coming up with and following a financial plan – together, early on – makes for a smoother road ahead.
Show Sources
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SOURCES:
Alzheimer’s Association: “Money Matters: Making Financial Plans After a Diagnosis of Dementia,” “Legal and Financial Worksheet,” “Planning for Care Costs.”
Administration for Community Living: “Eldercare Locator.”
Medicare.gov: “How Does Medicare Work?”
State Health Insurance Assistance Program.
Veterans Administration.
National Council on Aging: “SSI vs. SSDI: The Differences, Benefits, and How to Apply.”
USA.gov: “Get Paid as a Caregiver for a Family Member.”
National Academy of Elder Law Attorneys: “Find a Lawyer.”
National Institute on Aging: “Managing Money Problems in Alzheimer’s Disease.”
Wayne State University Institute of Gerontology: “Financial Vulnerability Survey.”
Mayo Clinic: “Alzheimer’s and Dementia: Tips for Better Communication.”
