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For older adults, competence and cognitive capacity override age

This week, Carol Bradley Bursack explains ways to assess if an older relative's cognitive abilities are starting to decline or staying strong.

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Dear Carol: In general, around what age should older people stop managing their own finances? When should they stop driving? Do doctors check older people for cognitive problems at checkups? My parents are in their late 70s and show no obvious signs of memory problems, driving issues or significant health challenges. Even so, I’m a planner. My brother says to forget about this and just let them enjoy life, but I’m the one who needs to figure out what to do if things go downhill. What red flags should I watch for with their health and cognition? – LR

Dear LR: You sound like a caring daughter. There are a few things you can do now to encourage your parents to plan but be careful to go about it gently.

Your priority at this time is to determine if either you or your brother is listed as at least an alternate Power of Attorney for both health and finances. Your parents may not have thought of this because they have each other, but older couples should consider adding an alternate in case both elders have setbacks. If you don’t know, then you should have a conversation with them. Don’t stress their age. Just suggest that this is the smart thing to do so that the family can assist with their health and finances if they need help in the future.

Many people are competent to handle their financial affairs and healthcare needs in their 70s and even far beyond. So, when considering red flags, think about competency and cognitive capacity.

Are bills going unpaid? Are they getting calls or mail from their bank due to mistakes? These are red flags that would indicate their financial competence is slipping. With driving, repeated fender benders or dents in the car can be a sign that they should limit or stop driving. Many people self-limit driving as they age because they realize that they may not be safe under high-speed or dense traffic conditions. This shows competence. If your parents seem to be having problems, try to ride with them to see how they do.

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There is a lot of planning you can do now that can help you feel more prepared. First, consider buying When Your Aging Parent Needs Help: A Geriatrician's Step-by-Step Guide to Memory Loss, Resistance, Safety Worries, & More , by Leslie Kernisan, MD. This modest investment will provide you with a ton of information as well as references and downloadable checklists. (I moderate a support group for Dr. Kernisan).

Dr. Kernisan’s YouTube channel, Better Health While Aging, is also helpful. Her free video entitled How to Know if your Aging Parent can still Make Decisions explains capacity or lack of capacity.

LR, your parents sound like a dream team, so enjoy knowing that they are doing well. Yes, plan for the basics so that you’re prepared for changes in their health and abilities, but that’s enough for now. Enjoy their company, while staying tuned to indications that your help might be needed.

Read more columns from Carol Bradley Bursack
Columnist Carol Bradley Bursack lists the various reason why some older adults may begin to shuffle as they age.

Carol Bradley Bursack is a veteran family caregiver and a nationally-recognized presence in caregiver support. She's the author of “Minding Our Elders: Caregivers Share Their Personal Stories,” a longtime newspaper columnist and host of her blog at mindingoureldersblog.com. Carol's an introverted book nerd, so you won't see her mugging in viral videos, but you can easily reach her using the contact form at mindingourelders.com.
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