“Money Woes Can Be an Early Clue to Alzheimer’s.” This is an attention grabbing headline from the November 4th edition of the New York Times. The point of the article is to inform that complex decision-making may be the first sign of Alzheimer’s that catches attention. We often dismiss mild memory loss as another senior moment rather than a call to action. The changes are so small that complex problem solving is ignored. I once had a client who received attention only after he bought his plane ticket to pick up the $17 million he had won from the publisher’s clearing house.

The dilemma is to determine competency. This is a very complex legal issue that faces families, medical professional, financial advisors, and attorneys alike. Financial decisions have important impact on not only the person with Alzheimer’s disease but also their partners. Current legal and medical tests of competency are too insensitive to be of much use as they only become effective after a problem occurs. Some financial institutions are using the Min-Mental State Exam for screenings but the problems they are trying to head off may occur with perfect scores on this insensitive screening device.

It seems to me that we throw out the logic that we use to make financial decisions when it comes to memory. Financial planning requires us to make decisions based on long-term trends and needs. We have to decide early in life how long we will likely live, what life style we aspire to, our balance between present and future needs and desires, and how to best protect our family. We have to make informed guesses and periodically review and update the plan based on periodic assessments and consultations with financial experts. We even approach heath care with the same proactive periodic assessments, review, and alteration of plans based on data regarding how our bodies are working. Again we make informed decisions that are proactive in nature with our physician as our health expert.

But we don’t apply the same process to our memory and judgment. Most are not aware of the risks and what to do about them. Most don’t come close to doing what they need to do to protect their memory against possible cognitive decline. We miss so many opportunities to protect our future because we fear confronting the facts about memory and judgment. Our present philosophy is wait for memory to start failing before we do something about it. We hope that we can exercise or engage in challenging activities to ward off changes. We hope for a magic drug that will cure Alzheimer’s. We listen to those who continue to say there is nothing you can do.

This solution is to treat memory as you do your finances and health. Track your memory with the help of a memory expert as you do your retirement accounts and your physical health. Start when your memory works well and establish a baseline to track changes in memory and judgment over time. Start when you are in control and issues of competence have not changed. Make a plan for how major decisions will unfold given that your memory keeps working fine and an additional plan in case your memory starts declining. Include family in the assessments and planning. Next week we will focus on the outline of the time course of changes and how to plan at various stages of adequate as well as declining memory.