paying late, or paying twice (If you are concerned, you can request a credit report.)
When in doubt, caregivers can begin small by offering to help pay bills and balance the checkbook, which may be welcomed by someone who has not been responsible for finances. The next step might be assisting a loved one with creating a budget, which can alleviate some financial stress. However, it’s important to keep the care recipient informed and involved with financial decisions whenever possible. For instance, you may review monthly bank statements together or have him or her sit with you while you pay the bills. Obviously, for those caring for a loved one with dementia, Alzheimer’s, or other cognitive disorders, handling the finances is a must.
Seeking Guardianship
Perhaps the most difficult caregiver situation results when a loved one loses the ability to think clearly and make decisions on his or her own, whether from dementia, Alzheimer’s, or other illness/trauma. When the person for whom you are caring is no longer able to make rational decisions about health care, safety, finances, or other aspects of life, it may be necessary to seek guardianship. Guardianship is an option when the person does not already have a power of attorney in place (yet another reason to prepare these documents before a crisis). It may also become necessary when there is disagreement among family members about how to care for a person.
When it comes to both financial and healthcare planning, the most important thing to remember is that a person must be “of sound mind” when preparing legal documents. Once a person becomes incapacitated, it is too late to specify wishes. Therefore, the best time to have these conversations and create the necessary documentation is before a health crisis occurs. When these documents are not in place, a caregiver may have to seek legal guardianship (see “Seeking Guardianship”).
To become someone’s legal guardian, you must have the care recipient declared incompetent in a court of law, usually based on expert testimony and evidence that the person is no longer able to make rational decisions. If the person is found mentally incompetent, the court transfers the responsibility for managing living arrangements, medical decisions, and finances to a legally appointed guardian. In some cases, more than one guardian may be appointed. For example, one person may handle finances, while another takes care of medical decisions.
The process can be lengthy and costly, especially if family members disagree about the need for guardianship or who should be appointed as guardian. Once appointed, a guardian has a legal duty to act in the best interests of the individual (referred to as a “ward”), but in many cases this action can create irreparable damage to relationships. Because guardianship takes away a person’s legal rights, it should only be done when absolutely necessary to protect a loved one. Guardians are typically required to provide the court with regular reports and financial accounting.
The bottom line—many times being a caregiver involves not only caring for a person’s personal and health needs, but also means being someone’s financial guide, legal aid, and voice when they are not able to speak for themselves.
Care for the Caregiver
Avoid the Guilt Trip
When Henry’s wife, Ann, had a stroke, he took on the role of caregiver with love and compassion. With time, they developed a comfortable routine, and Henry, who was a planner by nature, felt he had all the bases covered. He even scheduled a weekly poker night with his friends to get out of the house. While Ann still needed help with certain tasks, she was doing well enough to be home on her own for a few hours. In fact, she had developed a habit of watching various home shopping channels and was often still in front of the television when Henry returned.
“I thought she found these programs comforting,” said Henry. “Sometimes she didn’t even seem to be watching—it was background noise while she read.”
But Ann was doing more than just watching. Packages began arriving at the house that Henry didn’t order—including expensive luggage, a blender, and a pair of high-end tennis rackets.
“Well, it was a little strange, since we’ve never even played tennis,” Henry chuckled. “Ann was ordering things that we didn’t need and couldn’t really afford. When I asked her why, she couldn’t explain. Sometimes she didn’t even remember placing the order.”
It had never occurred to Henry to remove his wife’s credit card from her purse. She wasn’t able to drive after the stroke, and he never thought about placing orders over the phone. Unfortunately, he had no choice but to take the card away and explain to his wife.
“Initially, she was very angry with me,” said Henry “She saw it as another step in losing her independence, and I was considered the ‘bad guy’ for a long time. I can’t tell you how awful that felt.”
Taking things away from loved ones, such as car keys, credit cards, and financial freedom, is very difficult for most caregivers. Even when you know steps such as these are necessary, your actions can feel punitive and seem hurtful. Those feelings of guilt can cause a great deal of stress. In fact, guilt is so common among caregivers, the term “caregiver guilt’ is a widely used and recognizable term (see chapter 8 for more on handling emotions).
In Henry’s case, he felt so guilty that he canceled his weekly outings, along with his morning walks. However, after a few weeks, he began feeling irritable and cranky, and so was his wife. When he confided in Ann’s physician, he told Henry to lose the guilt and reclaim his personal time for both their sakes. Instead of focusing on what was being taken away, he suggested that Henry “give something back.”
“Our physician suggested that part of the problem for Ann may be boredom and not feeling useful,” said Henry. “So I taught Ann how to play some simple computer games, which she enjoyed, and also helped with her cognitive functions.”
Henry also identified some easy tasks for Ann to do around the house, which made her feel
