Effects of dementia on family can be gruelling

Jeff Sidel

April, 2011

My mother-in-law’s bills weren’t being paid on time. She felt she was losing control.

It was early 2007 and she was suffering from short-term memory loss as a result of progressive dementia. She had always been a formidable, take-charge woman and this was frightening for her and her family.

My wife and I realized we had become part of the “sandwich generation.” We were baby-boomers, caught between raising our teenagers and assisting my mother-in-law, who was in her 80s. When I was called on to help with her finances, I didn’t think it would take me far beyond the straightforward task of paying her bills.

But I was about to embark on a four-year odyssey that would plunge me into a labyrinthine world of lawyers, courts, financial advisers, rental boards, doctors, social workers, home care and assisted living and geriatric care institutions. Nothing had prepared me for this.

Quebec boasts an impressive collection of private and public services for the elderly and their caregivers, but I could not find an agency or group that would provide an overall roadmap for consultation.

Because of the memory loss, it was difficult for her remember which financial institutions she was dealing with, and after four days of sifting through documents I discovered her holdings were spread among four investment firms and three banks. I was surprised by the size of her portfolio. She had been her family’s breadwinner and had earned a modest salary as a bookkeeper. Family folklore would have it that $5 was pinned to the butcher’s bill on the fridge, and slated for payment every Sunday morning.

She had made some astute business decisions, particularly in real estate. She accumulated a sizeable nest egg for retirement. But there was no global strategy to manage her investments. Instead, the investment houses competed against each other and duplicated each other’s efforts. She was spending thousands annually in management fees and generating very little return.

After acquiring a bank’s power of attorney, I designed a plan that met her financial needs. Her medical expenses had grown exponentially and would continue to grow. The plan eliminated her risky and expensive investments and consolidated her holdings into a fixed income portfolio designed to protect her capital and generate a monthly income.

Eight months had passed and I believed that the worst was behind us. I was wrong.

My mother-in-law, in the company of her caregiver, went to her bank. She was agitated, confused and aggressive. A manager informed me that the bank was going to freeze her assets, on the advice of a lawyer. While the manager appreciated the role I had played and asked that I remain as liaison with an account manager, I had to obtain a court order to execute her mandate. The court was petitioned to grant protective supervision through a council made up of three family members. The public curator of Quebec provides oversight of this structure and reviews an annual financial report.

As her dementia progressed, so did her need for extensive home care. She became the employer of four independent home-care providers.

An accountant established the payroll system and it became her most important tax deduction, ensuring that she would not have to pay income taxes again.

By mid-2009, living at home was no longer an option, and she moved to Maimonides.

I did not log my hours or keep a diary of the hours I spent managing her affairs. My best estimate is that I spent 1,400 hours over four years.

I am not alone: Many of us are sandwiched between the needs of our children and our parents. We have reached the point where we are “club-sandwiched” as our children have children.

My experience has shown me that you can’t go it alone. A multi-pronged approach including such institutions as trust companies is important.

Jeff Sidel is the managing director and architect of BGK Seniors Advisory Group Inc., a division of Bessner Galley Kreisman accountants.