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Financial Support & Dementia Care
1. Introduction & Context
Tom Dickson opened the webinar with a focus on the intersection of dementia care and financial decision-making, welcoming:
- Denise Brown, caregiving consultant and founder of the Certified Caregiving Consultant (CCC) program
- Dr. Eric Jutkowitz, Associate Professor at the University of Minnesota and co-founder of Plans for Care
Tom referenced a Wall Street Journal article highlighting the emotional and financial consequences of dementia on families, underscoring the urgency of early planning.
2. Denise Brown: Supporting Family Caregivers
Denise has supported caregivers since 1990 and created the Certified Caregiving Consultant (CCC) program in 2016, a 106-hour professional training to equip consultants to guide family caregivers.
Key points from Denise:
- Many caregivers struggle without structured guidance.
- Caregiving requires emotional support, planning, and financial vigilance.
- Consultants help families recognize declining abilities and develop personalized care plans.
Her coaching model often integrates financial review, stress management, and care execution planning.
3. Dr. Eric Jutkowitz: Research, CMS GUIDE Program & Plans for Care
Eric explained his research background in dementia care interventions and the difficulty of scaling evidence-based programs beyond university settings. To solve for this, he co-founded Plans for Care in 2023.
3.1 CMS GUIDE Model
The GUIDE Model (Guiding an Improved Dementia Experience) is a Medicare demonstration program that:
- Pays providers through Monthly Care Management Payments (MCMP)
- Supports care navigation, caregiver training, and respite care
- Applies only to Traditional Medicare (NOT Medicare Advantage)
External fact-check URL:
CMS GUIDE Model Overview
https://www.cms.gov/priorities/innovation/innovation-models/guide
4. The Everyday Function Scale (EFS)
The centerpiece of this webinar was Eric’s Everyday Function Scale (EFS) — a validated assessment tool based on the Allen Cognitive Disabilities Model, used to evaluate cognitive functioning for people with dementia.
4.1 Purpose of the EFS
- Helps caregivers understand what the person can still do
- Identifies where support is needed
- Flags financial management vulnerabilities
- Offers structured insight versus subjective judgment
4.2 Structure of EFS
- ~10 branching-logic questions (1–10 minutes completion time)
- Produces a score corresponding to one of 8 cognitive functioning levels (early → late stage)
Validated by occupational therapists
4.3 External Fact-Check URLs
Allen Cognitive Disabilities Model (ACDM)
https://research.aota.org/ajot/article/74/3/7403205120p1/6981
Overview of Functional Cognition Assessments (NIH)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376322/
5. EFS & Financial Management: How Cognitive Changes Show Up Early
Eric explained that money-management decline appears early in the dementia process, often before diagnosis.
Examples by Cognitive Level:
| Level | Function | Financial Implications |
|---|---|---|
| Early dementia | Lives independently | Needs help with complex tasks: online banking, withdrawing from retirement accounts |
| Moderate dementia | Needs weekly visits | May overspend (Amazon purchases, subscription renewals), cannot adjust budgets |
| Middle-stage | Needs daily visits | Understands physical cash but not balances in accounts |
| Advanced | Needs 24-hour oversight | Cannot manage change or understand denominations |
| End stage | Bedbound | No awareness of money |
6. Case Study: “Helen & Steve”
Denise shared a practical application:
- Helen believed her husband Steve (care recipient) was still managing finances well.
- EFS revealed he had actually declined two functional levels.
- Insight: Steve could still manage finances with help, but needed:
- Monthly review of statements
- Joint-access filing system
- Involvement of adult sons
This case showed the EFS can shift caregivers from "It seems fine" to objective clarity.
7. Financial Abuse & Scam Prevention
Denise and Tom emphasized how dementia increases vulnerability to:
- Online scams
- Check washing
- Bank account misuse
- Amazon/QVC-style compulsive ordering
- Family-member exploitation
Tom stressed:
- Credit freezes
- Power of attorney
- Surveillance systems like EverSafe (https://www.eversafe.com)
External Fact-Check URLs
Elder fraud statistics — FBI
https://www.fbi.gov/how-we-can-help-you/safety-resources/scams-and-safety/elder-fraud
FTC Elder Financial Exploitation Data
https://www.ftc.gov/news-events/data-visualizations/data-spotlight/older-adults-report-billions-losses-scams
AARP BankSafe Training for Advisors
https://banksafe.aarp.org/
8. Using EFS in Advisory Practice
Two access methods:
- Through Certified Caregiving Consultants (CCCs)
- CCCs use the EFS in care-planning sessions
- Can refer findings back to financial planners
- Direct Subscription
- EFS software costs $30 per staff member per month
- Larger organizations eligible for volume pricing
9. Regulatory & Ethical Guidance
Denise highlighted compliance reminders:
- Do not diagnose
- Document conversations
- Follow firm policy for diminished capacity
- Maintain privacy and confidentiality
- Recognize increased scam risk
External Fact-Check URLs
FINRA “Cognitive Decline & Diminished Capacity” Guidance
https://www.finra.org/investors/learn-to-invest/avoid-fraud/diminished-capacity
CFP Board Guidance on Diminished Capacity
https://www.cfp.net/ethics/compliance-resources/client-with-diminished-capacity
10. Q&A Highlights
Key questions included:
10.1 Alzheimer’s Hotline
Denise confirmed its value as a 24/7 emotional and practical support line.
External URLs:
Alzheimer’s Association 24/7 Helpline
https://www.alz.org/help-support/resources/helpline
Alzheimer’s Foundation of America Helpline
https://alzfdn.org/afa-helpline/
10.2 Progression of Dementia Stages
Eric explained that progression is not linear, varies by dementia type, comorbidities, and medications.
External URLs:
National Institute on Aging — Types & Progression of Dementia
https://www.nia.nih.gov/health/understanding-different-types-dementia
10.3 Using EFS Without a Diagnosis
EFS can be used even before clinical diagnosis when caregivers notice concerns.
11. Comprehensive Fact-Check URL List
Medicare & CMS
CMS GUIDE Model
https://www.cms.gov/priorities/innovation/innovation-models/guide
Medicare & Dementia Care Resources
https://www.medicare.gov/coverage/dementia-care
Dementia Care & Cognitive Assessment
NIH Functional Cognition
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376322/
Allen Cognitive Disabilities Model
https://research.aota.org/ajot/article/74/3/7403205120p1/6981
Caregiver Support
Alzheimer’s Association 24/7 Helpline
https://www.alz.org/help-support/resources/helpline
Alzheimer’s Foundation of America
https://alzfdn.org
Family Caregiver Alliance
https://www.caregiver.org
Financial Exploitation & Protection
FBI Elder Fraud
https://www.fbi.gov/how-we-can-help-you/safety-resources/scams-and-safety/elder-fraud
FTC Older Adult Scam Data
https://www.ftc.gov/news-events/data-visualizations/data-spotlight/older-adults-report-billions-losses-scams
AARP BankSafe for Advisors
https://banksafe.aarp.org
EverSafe Financial Monitoring
https://www.eversafe.com
Financial Advisory Compliance
FINRA Diminished Capacity Guidance
https://www.finra.org/investors/learn-to-invest/avoid-fraud/diminished-capacity
CFP Board – Clients with Diminished Capacity
https://www.cfp.net/ethics/compliance-resources/client-with-diminished-capacity
12. Action Items
☐ Provide information on subscribing to EFS software from Plans for Care
☐ Share details about Denise Brown’s Certified Caregiving Consultant training
☐ Consider integrating EFS into client intake for older clients
☐ Develop a workflow for detecting diminished capacity and caregiver stress
☐ Explore partnerships with caregiving coaches for high-need client households
☐ Share scam-prevention tools with vulnerable clients (EverSafe, credit freezes, etc.)
