IADL Handling Financial Affairs

Another IADL a geriatric care manager or aging professional assess ,is handling financial affairs

Can the older person plan, budget, manage investments, pay bills, balance a checkbook, and manage day-to-day purchases without assistance? Is the person at risk for scams, undue influence, credit problems, or other financial difficulties because of functional limitations? Does the person show good judgment in regard to finances? Has the person changed lifelong habits in how he or she manages money?

On first meeting a client, often it is difficult to gain enough trust to fully assess functioning in this area. As a first step, questions about who pays the bills and manages investments open up the topic. Based on responses to earlier less threatening questions, the geriatric care manager or aging professional may detect some clues that can shed light on functional capacity here.

For example, if someone has difficulty shopping because Alzheimer’s disease has affected his or her ability to make a shopping list and go through the market independently to shop, it is expected that this person will need assistance with bookkeeping and money matters. Because the Lawton IADL scale it is important to recall that the less demanding tasks are presented first and those requiring higher cognitive functioning are presented later. Thus, difficulties performing the easier tasks indicate the likelihood of difficulties performing the higher-order functions.

When the care manager tours the house, he or she can discreetly and with permission look for unpaid bills lying about or piles of mail that need attention. Stacks of solicitations for charities and/or contests should be noted. Enlisting information from key informants, such as adult children, is important to round out the evaluation of this area. Adult children may be able to review the older person’s checkbook to make sure things are in order. They may be aware of utilities or insurances that have threatened termination for nonpayment. They may know whether the older adult participates in “contests” or gives more money than ever before to charities. Financial advisors for the older person may also be a source of information for assistance in evaluating functional performance. Because finances are a very private topic in many families, this subject needs to be handled with delicacy and discretion.