Horror stories of families who discovered a loved one’s dementia only after payments were missed, a family business was lost or a home was foreclosed motivates a University of Colorado health economist’s research to understand the financial symptoms of dementia.
Lauren H. Nicholas, PhD, MPP, professor in the Division of Geriatric Medicine at the CU Anschutz School of Medicine and the Center for Bioethics and Humanities, who studies the intersection of finances and dementia, said damaging financial impacts often appear ahead of clinical diagnoses, making them particularly ruinous.
“On average, we see a number of adverse financial events including missed bill payments, deteriorating credit scores, and dwindling assets beginning six years before other clinical symptoms of dementia are recognized,” Nicholas said.
Her research looks at two traditional methods used for health and finance planning: advanced directives and surrogate decision makers. Advanced directives – also known as living wills – are legal documents that specify what healthcare actions to take if a person is no longer able to make decisions personally. A surrogate – or durable power of attorney – is someone designated to make treatment decisions for a patient who is unable to do so.
Both are complex and having a complementary personal match when assigning a surrogate or writing advanced directives is imperative, Nicholas said.
“There can be a difference in preference between you and a surrogate in terms of what makes life meaningful to you and at what point to transition to palliative care,” said Nicholas. “It’s important to have conversations with someone who would make those care and financial decisions.”
In the following Q&A, Nicholas discusses her research on what to consider around finances and dementia and why planning early and finding a good surrogate match is important.