Financial files in disarray. Late payments and last-warning service-cutoff notices. Multiple daily bank withdrawals. Out-of-character purchases.
When a family member who has been fairly responsible with money all their lives becomes careless with their finances, it may be one sign of as-yet-undiagnosed dementia.
Researchers at the New York Federal Reserve who analyzed both U.S. credit reporting and Medicare data found that in the five years before a dementia diagnosis, a person’s average credit scores may start to weaken and their payment delinquencies rise.
“The harmful financial effects of undiagnosed memory disorders exacerbate the already substantial financial pressure households face upon diagnosis,” the researchers wrote. “Beyond susceptibility to payment delinquency, early stage [Alzheimer’s disease and related disorders] may affect new account openings and debt accumulation, credit utilization, and/or credit mix.”
‘Methodical’ military spouse’s record-keeping deteriorates
Marcey Tidwell, who lives in Bloomington, Ind., said those findings are “not remotely shocking.” Tidwell’s mother was diagnosed with a form of dementia in 2020 and has been living with her daughter ever since.
Tidwell said that for most of her life, her mother was an “outrageously methodical human being” who kept the bills paid and the family records organized across many moves as her husband pursued a career in the military.
After going through her mother’s papers this year, Tidwell surmises that her mother’s memory started faltering around 2015, because from that point forward her record-keeping became “less than pristine.”
For example, Tidwell said, her mom used to keep an immaculate record of checks written and deposits and withdrawals made in her checkbook register. But that register became a mess. “There was a bunch of stuff scratched out and she was obsessively adding and re-adding — she knew things weren’t all they could be. Later on, I saw that she took out large amounts of her savings, more than she needed for groceries.”
Former finance executive accrues piles of unpaid bills, finances new car he didn’t need
Karen Lemay, who lives in Ottawa, knew something was really wrong with her father in 2022 when she saw on his desk piles of late-payment notices and final-notification warnings from service providers and insurers.
Her father was a former finance executive who “was very conservative with his money, very smart about it and never reckless with it,” she said. And he had strongly impressed upon his daughter the importance of paying off her credit card in full every month to avoid interest.
Yet Lemay discovered he owed US$50,000 in charges, interest and late payment fees on a Visa card. He also financed the purchase of a new car he didn’t need, just months before police took away his driver’s licence. Normally, he would only buy high-end used cars with cash, she said.
What’s more, his daughter noted, he failed to pay his 2021 taxes. So he ended up owing the government roughly US$20,000, the bulk of which was for late payment and underpayment penalties.
“I spoke to him about some of his balances and he refused to believe he hadn’t paid them,” Lemay said.
Two parents with dementia, one daughter’s efforts to reduce financial worry
Jayne Sibley, who lives in the United Kingdom, knows the pain and stress of dealing with the financial behaviours that can signal dementia. Her father and mother were both diagnosed with different forms of it.
Her father moved into a nursing home years ago, but her now-deceased mother remained in her own home, albeit with live-in care.
“The most challenging thing we faced was managing mum’s everyday money as her condition progressed. She would overspend on things she didn’t need or want. Random items, cleaning equipment, luxury food. She also fell victim to scams over the phone — a fake insurance policy, those sorts of things,” Sibley said.
Her mother also would take money out of the cash machine two to three times a day and give it to anyone who asked.
Acutely aware of how high long-term care costs were, given her father’s situation, Sibley said she worried that her mother would run through the money that would be needed for her own care.
While her mother’s condition made her vulnerable with money, she initially was still able to walk and shop and go to yoga on her own. In other words, she was able to maintain a lot of her autonomy and social ties.
To try to stem the money outflow, Sibley and her brother tried doling out a week’s worth of cash for their mother “but she’d spend it all in one go,” she said. Ditto when they tried divvying the cash up into daily envelopes.
Eventually, they took away her cash card. But, soon after, her condition worsened, Sibley said. “She wasn’t able to maintain her familiar routines and social connections. That’s when we realized there has to be a better way.”
With her husband, she founded Sibstar, which offers a debit card in the U.K. that can be used by a person with dementia to maintain some sense of financial autonomy and social engagement. When needed, family caregivers can monitor their debit transactions via an app. As a person’s condition worsens, the caregiver can set limits on how much money can be spent on any given day or week, and where the card can be used (eg, at cash machines, online or at the grocery store).
Early planning lessens some stress
While there are few dementia-specific financial tools to reduce the odds that someone squanders their own hard-earned money, there are steps you can take to make it easier to assume control over another person’s finances when they become incapacitated.
In 2008, a year after her father died without a will and a dozen years before her mother was diagnosed with dementia, Tidwell said she and her siblings took their mother to a lawyer to make sure she had a will, named her medical proxy and named the person to whom she would give power of attorney to handle her financial affairs should the need arise.
That made it easier for Tidwell, among other things, to get online access in 2018 to her mother’s bank account to make sure nothing was amiss. By 2020, she had automated her mother’s bill paying online.
“The time to make plans is before you need to. It’s hard to overstate what a gift that trip to the lawyer in 2008 was to ‘future me,’” said Tidwell, who fully manages her mother’s finances now that her condition has worsened considerably.
Since dementia can worsen over time and because someone in the initial stages may not recognize they are more vulnerable to financial errors and scams, the U.S. National Institute on Aging recommends that a family take steps early on to alleviate those concerns, such as setting up automated bill payments for the person with dementia.
Of course, no amount of advanced financial planning can alleviate the heartbreak of watching a loved one with dementia decline. “I prepared as best as I could, but it’s still hard,” Tidwell said. That’s why she advises anyone potentially facing a similar situation to, in her words, “make the easy part easy.”
TORONTO – The Public Health Agency of Canada says it is not providing Novavax’s COVID-19 vaccine this respiratory virus season, citing low demand.
It says the manufacturer requires a minimum order of its updated protein-based vaccine, called Nuvaxovid, which far exceeds the uptake by Canadians last year.
The agency says a very small portion of the doses ordered in 2023 were used and that its decision reflects efforts to limit vaccine wastage.
It is distributing two mRNA vaccines — made by Pfizer-BioNTech and Moderna — that are approved for adults and children six months and older.
Both COVID-19 vaccines have been reformulated to target the recently circulating KP.2 subvariant of Omicron.
Novavax’s vaccine, which was approved by Health Canada last month for adults and children 12 years and older, has been touted as an alternative to the mRNA vaccines.
The public health agency says provinces and territories have the option of ordering the vaccine — which has been updated to target the JN.1 subvariant of Omicron — directly from the company.
As of Tuesday afternoon, several provinces – including Alberta, Saskatchewan, Ontario, Nova Scotia, P.E.I. and Newfoundland and Labrador – confirmed to The Canadian Press that they aren’t placing orders for Nuvaxovid.
The Public Health Agency of Canada said in an email that its contract with Novavax “only provides access to domestically manufactured vaccines, which Novavax has been unable to confirm for the 2024/25 season.”
The minimum order requirement was based on buying Novavax vaccines that were “internationally produced,” it said.
“Demand for Novavax’s COVID-19 vaccine in Canada has been very low in previous years,” the public health agency said. “In 2023, 125,000 doses of the Novavax XBB.1.5 vaccine were ordered and available in Canada, of which only 5,529 doses were administered.”
In emails to The Canadian Press, Novavax confirmed that it produced its updated vaccine outside of Canada.
It said the company “significantly depends on its supply agreement with Serum Institute of India Pvt. Ltd,” but would not elaborate further.
—With files from Hannah Alberga in Toronto.
This report by The Canadian Press was first published Oct. 1, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
Shopping season for Medicare coverage is about to begin. With it comes the annual onslaught of TV ads and choices to consider.
People eligible for the federal government’s Medicare program will have from Oct. 15 to Dec. 7 to sign up for 2025 Medicare Advantage plans, which are privately run versions of the program. They also can add a prescription drug plan to traditional Medicare coverage.
Many people on Medicare Advantage plans will probably have to find new coverage as major insurers cut costs and pull back from markets. Industry experts also predict some price increases for Medicare prescription drug plans.
Shoppers often have dozens of options during this sign-up period. Here are some things to consider.
Don’t put off shopping for Medicare coverage
Start thinking about next year’s coverage before the annual enrollment window begins. Insurers will usually preview their offerings or let customers know about any big changes. That makes anything arriving in the mail from your insurer important to read.
Insurance agents say many people wait until after Thanksgiving to decide coverage plans for the new year. That could be a mistake this year: The holiday falls on Nov. 28, leaving slightly more than a week to decide before the enrollment window closes.
Look beyond the premium
Many Medicare Advantage plans promote a $0 premium. That may sound attractive, but price is only one variable to consider.
Shoppers should look at whether their doctors are in the plan’s coverage network and how prescriptions would be covered. They also should know the maximum amount under the plan that they’d have to pay if a serious health issue emerges.
Plans offer many supplemental benefits, including help paying food or utility bills. Don’t let those distract from understanding the core coverage, said Danielle Roberts, co-founder of the Fort Worth, Texas, insurance agency Boomer Benefits.
“Remember that we buy health insurance for the big things, not the frills,” she said.
How to get help shopping for plans
The federal government operates a plan finder that lets people compare options. The State Health Insurance Assistance Program can be another resource. Insurance brokers or agents also guide customers through searches.
Sometimes a plan’s coverage doesn’t work as expected. If that happens, there’s another enrollment window in the first three-months of each year where some shoppers may be able to make a change.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
WASHINGTON (AP) — Americans can once again order COVID-19 tests, without being charged, sent straight to their homes.
The U.S. government reopened the program on Thursday, allowing any household to order up to four at-home COVID nasal swab kits through the website, covidtests.gov. The tests will begin shipping, via the United States Postal Service, as soon as next week.
The website has been reopened on the heels of a summer COVID-19 virus wave and heading into the fall and winter respiratory virus season, with health officials urging Americans to get an updated COVID-19 booster and their yearly flu shot.
“Before you visit with your family and friends this holiday season, take a quick test and help keep them safe from COVID-19,” U.S. Health and Human Services Assistant Secretary for Preparedness and Response Dawn O’Connell said in a statement.
U.S. regulators approved an updated COVID-19 vaccine that is designed to combat the recent virus strains and, they hope, forthcoming winter ones, too. Vaccine uptake is waning, however. Most Americans have some immunity from prior infections or vaccinations, but under a quarter of U.S. adults took last fall’s COVID-19 shot.
Using the swab, people can detect current virus strains ahead of the fall and winter respiratory virus season and the holidays. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year. Insurers are no longer required to cover the cost of the tests.
Before using any existing at-home COVID-19 tests, you should check the expiration date. Many of the tests have been given an extended expiration from the date listed on the box. You can check on the Food and Drug Administration’s website to see if that’s the case for any of your remaining tests at home.
Since COVID-19 first began its spread in 2020, U.S. taxpayers have poured billions of dollars into developing and purchasing COVID-19 tests as well as vaccines. The Biden administration has given out 1.8 billion COVID-19 tests, including half distributed to households by mail. It’s unclear how many tests the government still has on hand.
