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Sunday, July 4, 2010

I Can Pay My Own Bills!

How many of you are dealing with a loved one who is unable to pay bills or even figure out what is a bill and what is trash mail? This is a common problem, especially when the loved one has mild or moderate dementia. One of my more challenging clients is a good example:

Jane [not her real name] was referred to me by her family who lived a very long way away. Jane's daughter, Mary [not real], called explaining that Mom was having difficulty paying her bills but that she had always been very independent and proud. And by the way, Mom had some memory problems. I arranged for a date to visit Jane with Mary who assured me that she would talk with Jane shortly before I arrived to prime her for my visit.

When I arrived Jane let me in but was definitely reserved although polite. It was immediately evident to me that Jane had more than "some" memory problems. Her short term memory was very poor. We chatted a bit and when I brought up the subject of assisting her with paying her bills, I was politely but summarily excused.

This short visit told me several things: 1) Jane had moderate to severe short-term memory lose, 2) I could not approach Jane regarding her bills directly and 3) I was not going to be able to fix this problem quickly.

After thinking about the situation and talking with my other care manager, I decided on the following game plan: 1) I needed to visit Jane daily in order to get into her long-term memory (short-term memory becomes long-term memory with repetition) and 2) I needed to be patient and wait until she allows me to help with something "safe" [not related to bill paying]. In other words, I needed to build some trust with Jane.

It took several weeks of stopping in daily and shooting-the-breeze with Jane before she took that important step of trust and allowed me to purchase something at the store for her. Over time I was able to learn when her bills came and would show up. Our conversation would go something like this:

Me: Hi Jane! How are you doing today? I see that you're working on your bills. Could I write your checks out for you?

Jane: Thanks but no. I can take care of my bills.

[We would chat for a bit]

Me: Are you sure I couldn't help write out your bills? It would only take a moment.

Jane: No thank you. I know you want to help but this is my job and I can handle it.

[We would chat a bit more]

Me: Well, it's time for me to leave.

Jane: Before you go, would you write these checks out for me?

Me: Sure! Let's see, which one shall we do first?

Because of Jane's dementia, it took her a while to process the information [my offer of assistance] and develop a face-saving response. A little patience can really help.

You'll hear more about Jane. She was one of my first clients. She has since lost her resistance "gene" but I still delight in visiting her and seeing what a wonderful quality of life she still has despite severe dementia.

1 comment:

  1. That's an interesting story! I'm so excited that you have a blog!! I can't wait to hear more about your work! Love you!