Originally published in Money

By Melissa Montgomery-Fitzsimmons

The older woman, in her mid-80s, was one of my sharpest clients, always on top of her finances. Then, not long ago, some of her children told me they found several past-due mortgage statements in a pile of old mail. Worse, after we arranged to pay the past-due bills, the client thought she was through with the issue. She did not understand that she needed to continue making payments every month.

I see incidents like these – as tragic as they are alarming – more and more. Difficulty managing money is often one of the first symptoms of Alzheimer’s disease.

Last year, 5.2 million people 65 or older, or about one in nine Americans, suffered from Alzheimer’s disease and other dementias, according to the Alzheimer’s Association. Among those 85 or older, the figure was one in three.

The numbers will grow, too, as the United States ages. Already, the Baby Boom generation is in the midst of retiring. The leading edge of Generation X is in its early 50s.

For wealth managers, the diseases present several challenges and complications. Slow progression of the illnesses may make onset difficult to ascertain; often symptoms are similar to ordinary, age-related memory loss. Clients may be in denial of the disease or hide symptoms, too. They also can fall prey to scammers, perhaps family members, raising the specter of elder financial abuse.

So, what are a financial planner’s responsibilities if he or she sees behavior such as unusual donations to charities, hiding bills and other documents, payments to telemarketing schemes, frequently wanting to change beneficiaries on wills and retirement plans, confusion, or poor decisionmaking?

Ideally, the tasks are easier if the client has established a trust, or if someone already has the power of attorney to make decisions, or if family members or friends have the client’s best interests, rather than their own, at heart.

If not, it may be a financial planner who has to contact physicians and seek a judicial competency hearing to decide who will makes decisions about the client’s money.

My feeling is that such a path is a professional duty, as well as a moral obligation. It’s not always easy to do, however. Sometimes, the client will get suspicious or angry and intervene; sometimes, friends and family members take over with self-interest in mind.

I know of a son who has moved to be his mother’s power of attorney so he can sell her home, move her into assisted living and control her funds to support his lifestyle. We reported him to the division in the sheriff’s office that investigates elder financial abuse.

FINRA, a self-regulatory body for the brokerage industry, has moved to address the issue. It proposes requiring firms to make reasonable efforts to get a trusted contact person for each customer, and permitting firms to place temporary holds on withdrawals from a customer account if there is a reasonable suspicion of financial exploitation.

That contact person may not be those in the family or even those that are most proximate. A trusted contact might be an accountant or lawyer.

I tell my clients that anyone in such a role should be younger than themselves.

Discussing the possibility of dementia before it appears, making a plan, a trust or appointing someone as a power of attorney, and noting triggering events, are all helpful, of course. Another consideration is the possibility of long-term care insurance. Alzheimer’s can be a devastatingly expensive disease to manage, even for the wealthy, as some dementias can last 10 to 20 years.

Unfortunately, clients may not want to tackle the issue, even if they have had the disease in their family. Perhaps, to some degree, that’s human nature.

In the absence of such a conversation, however, your financial planner should have an eye out for problems as they arise. Good advisers will document all client conversations to protect themselves, and provide copies to their client — or to the courts, if necessary.

Other concrete steps that may be appropriate are to work with a care manager and a knowledgeable elder lawyer to petition the court to appoint a guardian and/or conservator. Once appointed, the guardian is responsible for making health care and legal decisions on behalf of the client. The conservator is responsible for managing finances on behalf of the client.

Additionally, it may be useful to set the client up on an automatic bill pay program. My preference is to utilize a revocable living trust, which is funded with the client’s assets The trustee then becomes responsible for managing the assets on the client’s behalf. The financial adviser fulfills an important role in making sure that the client’s assets are protected in the event of a gradual decline in the client’s mental capacity.

Melissa Montgomery-Fitzsimmons is Director of Wealth Planning at First Western Trust, based in Denver.