Calming a client, with dementia, when she has lost control over her finances and mail? Client can’t make appropriate choices.

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Calming a client, with dementia, when she has lost control over her finances and mail? Client can’t make appropriate choices.

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I have been working with a client who has Dementia. She is 79 years old and is pretty independent in basic needs. However, she isn’t able to make appropriate decisions in regards to money. ( In her earlier years, she was very organized and handled the family’s finances.) Since I started working for her, a year ago, the family and I felt it was best for her to have a Power of Attorney - because she would, continuously send checks to scams that came in the mail and even scammers that called her on the phone.

So, she now doesn’t have access to her checks and all her mail is going to a P.O. Box. I, as one of her caretakers, try not to bring her to the bank - which is something that my client did almost daily. In the days I don’t take her; my client gets furious with me! Telling me that I get paid to take her to the bank. During these moments; I remain calm and speak to her gently. Typically it takes about an hour for her to settle down. My client is also furious that all of mail doesn’t come to her house. She is still lucid at times and questions why the mail carriers can’t bring her mail up to her door instead of to a P.O. Box.

What is the best way to handle this when she is so mad?? I am not able to take her anywhere without her complaining to everyone at the bank and Post Office about what’s happening. She, currently, believes that her family is out to get her.

What should I do? Sometimes when I try to deflect or change the subject it makes my client even more mad. Any suggestions, please?

Activities of Daily Living Alzheimer's & Dementia Home Care

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Do not try to deflect her or change the subject. That will only make her angrier.
If she gets furious and starts telling you that your job is to take her to the bank tell her the truth. That she doesn't decide what your job is, your agency does. Then explain that the family (name them by name) gave you specific orders not to take her to the bank and if you do, you'll get in trouble with your agency. You will too because if the family told you not to take her to the bank, they will report you to your supervisor if you do.
When she starts up about the mail not coming to her house, tell her the truth on that too. Explain that her family (name them by name) is having her mail redirected to a P.O. box and that they sort it out for her to pay all of her bills.
Don't lie to her. Don't try to distract and deflect. Tell her the truth. You do not have to deal with her being furious at you. You didn't make these decisions for her. Her family did. Let them take the heat for it, not you.

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Thank you for your insight. I appreciate it! Actually, I don’t work for an agency. I work for her - technically I work for the family.

I will try your suggestions of naming family members and that they requested me not to take her to those places. Then brace for the tantrum…

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Wow, do I feel for you. My mom was EXACTLY like this. She was still driving at the time and was driving herself to the bank - and driving everyone crazy. The best thing we did was slowly remove all papers from her house -- we emptied files until absolutely nothing was left -- because the papers were triggers. We would leave a few things that couldn't get her into trouble. We did not tell her we were having her mail held and changing addresses on every account she had. This would have incited unrelenting anxiety and anger. We carefully sneaked out all reminders of her finances, bills, anything with phone numbers (all businesses and some personal), etc. We even removed paper and pens because she would constantly write notes (like "Go to bank") and these would trigger her. Each visit would include careful scouring and removal of all notes. Anything out of sight will eventually be out of mind -- but there may be some painful moments during the transition to forgetting. It is not cruel. It is the only way to curb the extreme anxiety and keep her safe. ...We ran around her house like crazy people when she was not looking because we had to remove any and all triggers, notes, and things that might get her in trouble. ...Last thing to go was her checkbook, which she obsessed over and a few remaining bank statements. As she grew frustrated looking for things, she would lose track of what she was looking for and eventually give up (especially if she couldn't write a note to remind herself because she couldn't find a pen and paper). This is not an easy process, but hope some of my experience will help. Hopefully, you can get her family members on board with this. Perhaps you can deflect certain requests, such as saying 'your daughter said she was taking you to the bank next time she is here, and she asked me not to take you today.' It doesn't matter if this is true. You are just trying to keep her calm and safe. This is truly the most frustrating thing, I know!

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Yes! This is such a similar experience!! I do hide some of her notes and bills - just so she can move on. Of course I feel terrible it; but, it is for the best. Unfortunately, my client isn’t happy with her family and when I say something like that; it makes my client angry. I try and say it calmly. Immediately I get a look of daggers! Then the tantrum starts.

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My Husband loved to go get the mail daily. I was afraid if he got the mail important things would be lost. I would go to the mailbox and pull out important items and leave the junk mail. He would go out get the mail and bring it in. There were days when I put junk mail in the box if there was no mail that day. So Sunday and holidays I would put stuff in the box.
What if you brought junk mail to her and said you picked it up on the way in. Would that relieve some of her anxiety about loosing control of that aspect?
As far as trying to deflect sometimes it works sometimes not so much. Maybe tell her that it is out of your control as well and you understand her frustration and she should discuss it with family.
I would probably avoid the places that upset her, the bank and post office. Would she get upset if you took her to a totally different bank, a different branch and use the drive through. Same with the post office, go to a different one or just use the outside postal box to mail items.

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Yes, those are places I am
not taking her because they are triggers. I bring her all of her personal mail

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Since you say she can't be redirected or distracted... does it occur during the afternoons? If so, she is Sundowning, in which case you may need to preempt this phenomenon and start distracting her before she devolves into this obsession. If this isn't the case then I would contact the PoA to let them know that you've tried many tactics to address this problem and now need their input and action. She may need meds to reduce her agitation (and the PoA needs to come to this conclusion, I wouldn't suggest it yourself).

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I am her caretaker during the week and I see her in the mornings. After I leave in the afternoon there isn’t anyone there until the next day. Someone comes on the weekends to see her too.

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She should have been told what's going on, when she signed the POA.

You could have some trash mail continue being delivered for her to look thru and you could take her to the Bank once a week and allow her to get a few dollars out to go out to lunch if that makes her happy.

You need to explain things to her.

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I am beginning to wonder if you Bev, have any experience with dementia, you can tell them every 5 minutes and they can not remember! I agree with redirecting/ distracting. I expect when the POA was put in place it was explained, but her brain is broken and can not process the information.

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Why would anyone tell her, her mail goes to a p.o. box now??? Of course she is going to hone in on that! Or tell her she can't go to the bank.
Could you tell her she already went to rhe bank that week and all her bills are paid up? Or the bank is closed due to covid? Or give her old checks that aren't associated with a bank any more. Let her fill them out and pretend to mail. I don't know if you could find fake checks online and print out.
What about saving up some some junk mail and putting it in her mailbox but hide the address.
There was a daughter on Next Door who asked if we could send her 95 yr old mother Christmas cards. She was used to getting them in her younger yrs and was disappointed she doesnt get them any more. People sent nice notes and cards. She is up to 185 and counting now. People are still sending them. The mom was thrilled. And enjoyed setting them up on a table to admire them all. Maybe you can do something like that. She gets to focus on something positive. Or get a cheap box of diff Christmas cards and put them 1 at a time in her mailbox. Not sure if she will notice no stamp. Get her to focus on that.
Id tell her if it's Friday, remember we went on Monday to the bank. They are closed now. All bills paid and up to date. Your very good about keeping up with them. It's lunch time, what are we doing for lunch. That kitchen sink needs a good shine, wanna help. It's laundry time, I got some new downy. Wanna help fold? Good luck.

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She used to get an enormous amount of mail, daily and she would write checks to all the charities and scammers. So, all her mail was then forwarded to a family member’s house. Then my client wasn’t receiving her mail on a regular basis which caused a huge source of stress for my client. Then the family and I thought if we got a PO Box then I could bring her the mail everyday - minus the junk mail. This is still a problem because she wants her mail coming to her house. My excuse has been the the Post Office won’t bring it up to her house. My client doesn’t believe me. I have been telling her that we went to the bank “yesterday “. The definitely has been working.

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This is common with people that suffer from moderate dementia. I mean, she is still able to process certain situations, but not all of them. First of all, trying to explain and expect her to comprehend, is useless. This is something that is not going to change for a while and you have to accept it for now. When her dementia becomes more pronounced, she won't even know what the word bank means. But also by then, she might not know who you are and what you're doing in her house. Her dementia will progress and appropriate plans need to be made in advance to deal with those future situations.

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Thank you.

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I'm the power of attorney for an elderly cousin with dementia. Like your client, she was always very careful and in control of her money. The situation was a little bit different in her case, because at the point at I was dealing with this (she's now in a memory unit), she was able to get herself to the bank, and I was worried about what she might do. I had a conversation with the bank manager and also the person in the branch assigned to her investment account, so they knew what was going on, and knew not to approve any of her requests without my being looped in on the conversation. Perhaps there's some variation of this that would help here? Could you and her family let the bank know what's going on, and then, say, take her once a week? You could tell her that because of covid, it's impossible to take her more often. (I don't know where you're located, but in my location, bank hours are reduced and so is staffing.) That way if she complains about you to the bank, it will be on the record as to what's really going on (though I suspect they know anyway). I was surprised about how willing the bank personnel in my cousin's bank were to help, especially because this was a large branch of a major bank.

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Good points, thank you very much! Yes, her POA has communicated with her bank and they are aware. Money has become a trigger for her for several months. If she sees a bill or even comes across an old bill; it sparks anger which lasts quite a long time! Even days! I have hidden them - out of sight, out of mind. (True; but, sad) She isn’t capable of making responsible choices. I don’t want to be involved in her finances; however, she has asked me to. There is a lot of mistrust among family members and I am uncomfortable knowing things that I have heard - but, that I keep to myself.

I don’t think she would believe me if I told her the bank is changing it’s hours. I will try that, tough. Thanks!

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A sweet husband told me he sat his wife at a table with various envelopes and papers and she happily shuffled them around and found it calming. Could you bring some of the mail from the post box to the house?

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Yes, I bring all of her personal mail to her. This causes an issue immediately because she sees the PO Box address instead of own address.

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Finances when these things must happen for the good of a senior OFTEN become an obsession. There is little that can be done about it but to explain over and over again that this is how it must now be, and you recognize how hard it is to feel such a loss of control over things but that this is for the good and everything is under control. That's about all you can do, but don't expect it to make thing OK. Not everything can be fixed. Do know that for MANY seniors, in fact in the experience of a lot of ALFs, the senior who trusts how things are being done is actually VERY RELIEVED.

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Sadly my client isn’t trusting of her POA and that is the biggest issue

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Good points. I would stand up to her and tell her not under any circumstances to rant and rave and go after you. YOU are under directions from whoever - tell her to talk to them - and YOU will not listen to her ranting and raving. Tell her very firmly to stop at once. Also seek medication to calm her down. I do not believe in allowing people to scream and rant because or whatever reason - I stop it at once or perhaps leave the room and don't go near them until they are calm. I cannot take this behavior and would never allow myself to be involved. Someone - not the caretaker - must make her understand and she is NEVER TO YELL AT THE CARETAKER.

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Thank you for your suggestions. Actually,I am working for my client. Not through an agency. This is a private arrangement. I have told her that I am
not driving her anywhere if she is yelling and swearing. The way she sees it; I am working for her; although, I am actually working for the family. Her POA pays me with one of my client’s checks.

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A person who was formerly very capable, used to having all their ducks in a row, can't change; and we all learn from this forum that dementia seems to only intensify these outstanding parts of a person's personality. And paranoia also comes with dementia. Kick the problem 'upstairs'...tell your client you've been instructed to just help her with basic needs, that finances are not your job. You can tell her that mail goes to the post office to Protect Her from mail theft, which we all know has increased lately, as with 'porch pirates' grabbing delivered boxes, etc. Tell her politely but very firmly, that her Raising Her Voice with you could make you not want to work for her, that if she wants your help she must remember her manners. Many elders were raised to be courtesy to some level or other, so fall back on That ingrained early training/memory. Let your client know that if she loses her temper with you that you have to leave the room. Then do it, at the drop of one harsh word, just don't give an inch. It's so much like training a small child, instant consequences, because sadly dementia has reduced these elders to a childlike stage again. All the best.

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Thank you for your input. I appreciate it. My client is very used to getting things the way she wants - especially when she was younger. When she yells at me ; I remain calm and say that I am not going to take her anywhere if she is yelling at me. Then she proceeds to say that I am fired or to leave her house. I tell her that I will keep sitting in the chair until it is the end of my shift. This causes lots of swearing. Eventually she calms down and interestingly as I am leaving for the day; she will break down and cry… apologizing.

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Tell her that COVID is still a problem. Most banks require appointments made in advance to see a banker in person. Tell her that having family "sanitize" her mail before she gets it also protects her against COVID. Make sure she gets some mail - like letters and cards from family and friends.

Ask family and friends to send her letters and cards throughout the year as their Christmas gifts to her.

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My client is unconcerned about Covid and is very familiar with her bank. She used to go there everyday. Yes, I bring her all of her personal mail. This really doesn’t help much because she is preoccupied with it coming to her house.

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CrushedLove18: Imho, you could state that your auto is broken/in the repair shop/you haven't money for a taxi - essentially no wheels to take your client to her financial institution.

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That is a good point; however, my client is aware that I drive to her house and I drive her to appointments.

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Brainstorming to see if there’s a way to diffuse.

Can you tell her she was making checkbook errors and payment mistakes so she asked her POA is doing the banking? Or be more direct and suggest that if she wants to go to the bank, she needs to ask her POA should take her.

Or ask the POA to have bank envelopes with money that you can give her? Then say banking day is Wednesday and make a ritual of getting the envelope? Even if you put the envelope in the bank drive through machine and take it out again? Ask the bank to change the denomination if they need a reason to see money going to them.

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How bout if your getting paid to do it, DO IT!

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get mail at the home keep everything like she remembers for as long as you can let her be at times , other times do puzzles or any kind of mind stimulation i find that caressing shoulders and scalp can be most beneficial please understand I'm extremely good at all of this and think my advice will work for many , yes I'm bragging and never will i stop trying any new thing that makes the patient feel the best for the longest . Attention avoid automobiles ,loud noises crowds keep it simple think of how you would want to be less burdened. Remember this person or patient deserves the utmost respect and the kind of care only a truly caring person can provide , Screen Applicants with Caution and Background Checks . No Fussy No Moodiness No Anxiety No Lack Of Attention like I see in so Many Situations sorry if any of you get offended Not About You Period. Thank You For Letting Me Be A Part Of Solutions Not Problems .

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If your " client" is paying you, then I suggest, EARN YOUR PAY AND TAKE HER! Maybe she needs to feel she still has some control of her spinning out of control life! It is wrong to hide her mail in a PO BOX. It's her money. You can easily explain, most of the time, oh, here's another org or person asking you to support them. In the end, she may want to send a donation to someone. If she handled the family finances, she still has some left to pay for care. Not too bad. Give her some credit and tell the children not to count their inheritance before she's gone. If she truly wants to spend her money, let her. Maybe she might want her kids to spend some of theirs and VISIT!!

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Under normal circumstances, I would say that she should be able to do whatever she wants, but it’s not that simple.

Dementia can be a horrible thing and my mother was answering phone calls from scammers saying that she owed them money from Amazon. She took her credit card out on numerous occasions and try to go online and pay them but thankfully she was not successful because she is not very computer savvy. My father was the one who always paid the bills, so she really does not have any knowledge of how to pay them (other than in person).

I am sure that her pre-dementia self would be mortified at the idea of sending money to scammers. There is a reason that she signed off on allowing a power of attorney to handle her affairs. I don’t think it would be responsible of a power of attorney to allow this woman who has a mind altering disease to make decisions that would put her in financial ruin.

Calming a client, with dementia, when she has lost control over her finances and mail? Client can’t make appropriate choices.

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