Presenter: Neal Howard
Guest: Stephanie Erickson
Guest Bio: Stephanie Erickson, Director of Erickson Resource Group, is a clinical social worker and Director and Founder of Erickson Resource Group based in Montreal, Quebec. She has over 20 years of experience as a geriatric social worker. She has worked with seniors living autonomously at home, placed in care facilities, at the hospital, and who are living with family.
Stephanie Erickson discusses how to protect aging parent / adults from financial exploitation. Stephanie stresses the importance of preparing proper documents for protection and information.
HPR – Health Professional Radio – Aging Adult Finances
Neal: Hello, you’re listening to Health Professional Radio. I’m your host Neal Howard, so glad that you could join us today. Those of us who may be Baby Boomers may find ourselves in the position to take care of Mom, Dad, or maybe Grandma and Grand Dad, and not to mention sometimes taking care of people that aren’t so old but maybe have some cognitive skill loss that is causing them problems. Our guest in studio today, Ms. Stephanie Erickson, Director of Erickson Resource Group and a clinical social worker with more than 20 years of experience working as a geriatric social worker. She’s here today to speak with us about some of the financial aspects of taking care of the aging. How are you doing today Stephanie?
S: I’m great, thank you for having me.
N: Thanks so much for coming back. Your area of expertise is in taking care and working with the aging. You’re a clinical social worker with years of experience as a geriatric social worker in particular. You’re also the founder and director of Erickson Resource Group. Could you tell us a little about what Erickson Resource Group does as it pertains to the aging?
S: Sure. We work with caregivers and their loved ones. Most of our clients are suffering with some sort of memory loss, they have a diagnosis of Dementia or Alzheimer’s. And myself as a social worker and my team, dietician, a couple of recreational therapists, occupational therapists – we help to provide support information and professional evaluation for those suffering with memory loss or other issues of aging.
N: Now, you’re located in Canada. Am I correct?
S: Yes, I’m in Montreal but I’m actually from California so I’m licensed there as well.
N: And if there’s more information available on the Erickson Resource Group, where can our listeners go and get more information?
S: To our website www.ericksonresource.com
N: Great, great. Now as I’ve said before, you know, the topic today is taking care of the aging and in any type of caregiving, there are costs involved. Some of those costs – physical, emotional, time constraints, financial – to be sure, we hear a lot in the news about people taking advantage of the aging. Let’s say, yard work, maintenance work around the home or with many other scams that target the aging mainly because of the proclivity for the aging to lose some of their cognitive skills. Now, when it comes to the real cost of caring for the aging, what are your thoughts on how some of these can be avoided or recognized at least?
S: Well, there’s two different issues you’re bringing up. One is about the vulnerability of seniors to be exploited financially and the second is the cost of aging financially. So if we split those and we look at the cost of aging, I can just say that for a caregiver, women lose more money over time than men, which is natural because women are mostly the caregivers. More women are caregivers than are men. So if you look at numbers over time with social security loses, pension loses – women on average lose about three hundred and twenty thousand dollars throughout their lifetime from caregiving and men lose about two hundred and eighty thousand dollars. And that’s just what they’re losing because of their impact on their work. But that does not even include any of the cost that they might be spending of out of pocket in addition to pay for care, more you know, drop by and pick up a new clock, or a new telephone, or a TV. I mean all of those other things that we do, that’s not even included.
N: I have heard, it is said that one of the first things that an aging parent or an aging adult will become defensive about is, say, the car keys. Once you start saying, “You know Mom, Dad you don’t really need to be driving today.” It seems that, for many, that is the point of which they say, “You know, my independence is being taken from me. My right to make my own decisions is being challenged here.” When is the right time to take over the decisions when you see, for yourself, maybe you’ve been told, or maybe your physician has had a little powwow with you. What’s the right time and how can you tell when is the right time?
S: Boy, driving. You’re really talking about a hot topic here now because taking away the keys, particularly for a man of the older generation in his 80’s, let’s say, it is devastating. It means so much for them and their identity as a person and their independence as well. If a physician has already talked to a family member about concerns of the person driving, obviously there needs to be some sort of a plan to put into place. But in terms of taking over and really forcing an issue, we cannot do that if a person is competent to make decisions. So, they might be driving poorly, they might be making poor decisions on the road, but if they’re still declared competent to make decisions for themselves, you really can’t force it and this is one of the issues. It’s usually an accident or a crisis, where then a person is hospitalized and then all of a sudden the keys are taken away. It kind of prompts people to step in and actually take over. They’re living autonomously there. Unfortunately, not a lot you can do.
N: Would you, in your opinion, say that the issue of competency is more objective with family members and more subjective with caregivers or professionals or vice versa or a mixture of these two?
S: It’s a mixture but I do tend to find that family members jump a bit quick, a bit quickly, to say that someone is not competent to make their own decisions. And I understand it, it’s not malicious. The intent is good. They’re concerned about, let’s say, their parents living in their home, they’ve had some falls, you know, they’re having trouble cooking or doing the grocery shopping etc. And so with all good intent, they want their parents to move and they feel they’re not capable anymore. Well, maybe they are capable because, you know, we have the right to make really bad decisions and I think family members sometimes have a hard time swallowing that. But really, I think that it’s important for the physician or the other healthcare professionals that are involved to step in and do some formal analysis in terms of judgment, let’s say, decision-making, planning, organization to really make that determination if now is the time for family members to step in.
N: Now we’re talking about having the right to make core decisions. As the person ages and possibly loses more and more of their cognitive abilities on maybe a weekly basis, you’re talking about, well, cooking or driving. A mistake in driving can cause thousands of dollars, maybe even life. A pot left on the stove can burn the house down or cause extensive damage. We’re talking about some, maybe, some deep financial issues here, once the family members maybe in conjunction with the healthcare provider or without the healthcare provider’s input, have determined that, “Hey, you know, something’s got to be done.” What’s the next step? When do you begin gathering documents or filling out power-of -attorney and things of that nature?
S: Well, power-of-attorney should be done much earlier on and there’s different types. There is, you know, banking power-of-attorney which gives a person permission to manage finances in just one institution. There is a more general power-of-attorney which can include, you know, paying for someone’s property, paying their taxes, all their investments etc. And then there is also healthcare documents – a living will or naming a healthcare surrogate. So there’s a variety of documents and all of those things should be completed when someone is younger. I mean, I’m 44 and I have mine done. You‘ll never know what could happen. I think everybody should be doing it, but particularly when someone hits about, you know, fifty five, sixty years old, those documents should be drafted.
N: Now what if the situation is not one of, say, cognitive loss or maybe even a physical degeneration but strictly a financial thing and your mom has been living in this five-bedroom house all her life and it’s just become too much. She’s maybe by herself with the dog and you have to maintain the house. You’re paying for rooms to be heated that nobody is in anymore and it’s time to talk about assisted living. What type of a conversation can that turn into and if it’s a negative outcome is the case, how can it be avoided?
S: Yeah, that’s a really hard discussion and it makes sense for adult children to be concerned about that kind of a thing. But, you know really, if this woman wants to stay in her home, I understand. And I think approaching it from a place of compassion instead of saying, “Mom this is such a waste of money,” but “Wow, you’ve been living in this house for thirty years. There’s a lot of memory here Mom. How do you think we can maybe transfer your memories to another location that’s just gonna be as satisfying for you?” Also, you can put numbers down on paper. But in the end, it’s that person’s decision and if they’re safe in their home, then they have the right to stay there. Another angle, I guess that you can look at too, I would want to know from that senior, “Mom what’s important to you? When you’re gone what do you want for me and what do you want for my kids? Do you want us to benefit from all of you and Dad’s hard work financially or do you want to use the money for yourself in your care? What are your values?” Because if she says, “Well, I want to leave everything to you.” Then you can say, “Okay, so then let’s talk about what’s the cost of the house is.”
N: Okay. Now, as we wrap up this segment, I’d like to ask you a question that I guess maybe kinda sensitive. We’re talking about cost. Obviously, you know – your mom, my mom – has a healthcare provider, a general practitioner and maybe several other physicians who’ve been caring for them over the years who are getting paid through Medicare, Medicaid or something. Once the person transitions to a point where, you know, it’s basically home healthcare, there might not be any need for further doctor visits unless there is an emergency situation. Is there a way to ask a physician to maybe have some input in this person’s life, although they are not being officially compensated for it?
S: Oh, you will have to have a pretty generous physician for that. I doubt it, because I’m sure according to code of ethics and professional obligations, they have to be documenting and billing for every visit that they make. I’m probably not the right person to ask. I mean, families come in, I will talk to them on the phone. But if someone wants me to make me a visit, I’m obligated to engage in a professional relationship with them and have them sign consents and things like that. I would imagine it would be the same for a physician.
N: Absolutely. So I guess it would be wise not to suggest to a person to compromise their own legal standards on behalf of someone who they would not normally do that for.
S: Yeah, they would have to look up to their own professional code of ethics.
N: It could create an uncomfortable situation. Okay, I understand. You’ve been listening to Health Professional Radio. As I said, our guest in studio today has been Stephanie Erickson, Director of Erickson Resource Group. She’s a clinical social worker and director and founder of the group. She’s got many many years of experience as a geriatric social worker, working with seniors that are living autonomously at home, placed in care facilities, at hospitals, and living with the family members often times. It’s been great having you here with us today Stephanie.
S: Thank you so much, anytime.
N: Thank you. Audio of this program is available at healthprofessionalradio.com.au and also at hpr.fm, and you can subscribe to our podcasts on iTunes.