cognitive decline in a customer
January 3, 2024 4:53 PM Subscribe
I work at a small bank and it's becoming clear to everyone at the branch that an elderly customer has had a sharp decline in cognitive abilities. It's worrisome because...
he lives alone (his wife died a few months ago) and has no family around (we know this because of the process of dealing with his wife's accounts--she was a customer as well.) What can we do, what should we do, and if it involves calling an agency that deals with elder affairs or "elder abuse," how might things play out for this man? I don't know what his internal experience is currently but he seems fairly cheerful and physically spry and able to cover his expenses and I don't want to possibly (in his view) ruin his life or decrease his happiness. (He does not drive, fwiw.) Is there a way to throw him a life raft to help him get whatever supportive assistance he wants/needs while respecting his autonomy? This is in Massachusetts.
he lives alone (his wife died a few months ago) and has no family around (we know this because of the process of dealing with his wife's accounts--she was a customer as well.) What can we do, what should we do, and if it involves calling an agency that deals with elder affairs or "elder abuse," how might things play out for this man? I don't know what his internal experience is currently but he seems fairly cheerful and physically spry and able to cover his expenses and I don't want to possibly (in his view) ruin his life or decrease his happiness. (He does not drive, fwiw.) Is there a way to throw him a life raft to help him get whatever supportive assistance he wants/needs while respecting his autonomy? This is in Massachusetts.
It isn't clear how close a relationship you and/or the bank have with him, but I think a good first step might be to have a conversation with him regarding your concerns.
posted by uncaken at 5:13 PM on January 3, 2024 [5 favorites]
posted by uncaken at 5:13 PM on January 3, 2024 [5 favorites]
I think it's wonderful and caring for you to be concerned about this customer. He likely IS struggling and may or may not realize it. HOWEVER, it looks super sus when, even if super well-intentioned, a bank employee who has privacy guidelines or, heck, even laws (not a lawyer so just a hunch) to uphold, tries to comment on or get involved with his personal life. I would definitely talk to higher ups who could advise you on what you could do and how you could proceed. I have an elderly neighbor who I (secretly) keep an eye out for -- we say hello but that's it -- and fortunately he has a younger relative, perhaps a niece, who visits every few weeks for fun outings. The difference is that I have absolutely no professional regulations or guidelines that would keep me from getting involved and really no conflict of interest (because he and I have no say on each other's rental situation in a huge managed complex.) I do know he's a veteran so, were to become concerned, I could call VA services and ask what resources I could share with him.
I think the appropriate thing to do, after checking bank guidelines for an ethical OK, is perhaps a mixture of what ReluctantViking and uncaken wisely suggest: look up the resources available to senior citizens in your area, then speak to him directly IF it's considered not a violation of trust or risk by the bank. Along those lines, some people with dementia become paranoid about the people around them, especially those with a hand in their finances, so you would not want to scare him away should he have those fears.
posted by smorgasbord at 6:02 PM on January 3, 2024 [5 favorites]
I think the appropriate thing to do, after checking bank guidelines for an ethical OK, is perhaps a mixture of what ReluctantViking and uncaken wisely suggest: look up the resources available to senior citizens in your area, then speak to him directly IF it's considered not a violation of trust or risk by the bank. Along those lines, some people with dementia become paranoid about the people around them, especially those with a hand in their finances, so you would not want to scare him away should he have those fears.
posted by smorgasbord at 6:02 PM on January 3, 2024 [5 favorites]
The parent bank of your branch may have guidelines for these sorts of situations. With cognitive decline comes the very real possibility of financial abuse, which I would certainly hope banks want to prevent.
I know cashiers at big chain grocery stores are trained to help prevent gift card fraud when they see it. Surely banks must have similar sorts of training/guidelines available?
You may also want to call elder services to ask a general question about what should be done in cases like these (not using any identifying info for this man in particular, but instead telling them you work for a bank and sometimes you see clients in XYZ type of situation etc.). They probably have a good idea of what can/should be done and what ethical considerations there are.
Thank you so much for caring about this man, by the way. I ended up being primary caregiver for a beloved elderly relative who lived alone, and I was honestly so grateful and moved by all the people who sounded the alarm to me and my family when she started slipping into cognitive decline.
posted by hurdy gurdy girl at 6:22 PM on January 3, 2024 [8 favorites]
I know cashiers at big chain grocery stores are trained to help prevent gift card fraud when they see it. Surely banks must have similar sorts of training/guidelines available?
You may also want to call elder services to ask a general question about what should be done in cases like these (not using any identifying info for this man in particular, but instead telling them you work for a bank and sometimes you see clients in XYZ type of situation etc.). They probably have a good idea of what can/should be done and what ethical considerations there are.
Thank you so much for caring about this man, by the way. I ended up being primary caregiver for a beloved elderly relative who lived alone, and I was honestly so grateful and moved by all the people who sounded the alarm to me and my family when she started slipping into cognitive decline.
posted by hurdy gurdy girl at 6:22 PM on January 3, 2024 [8 favorites]
Response by poster: I don't want to thread-sit, but: banking privacy/etc is absolutely a factor I'm aware of, and the advice about elder affairs/etc I am hoping to gather here is to share with higher-ups rather than to act on unilaterally.
posted by needs more cowbell at 6:23 PM on January 3, 2024 [8 favorites]
posted by needs more cowbell at 6:23 PM on January 3, 2024 [8 favorites]
You need to ask them to appoint a "trusted contact person" to their accounts. Really everyone should have one. This info is from the sec but look up "trusted contact person" for whatever agency regulates your bank and there should be a form. You should really be asking everyone to do this when the open an account. This is exactly one of the things it's for.
posted by If only I had a penguin... at 7:03 PM on January 3, 2024 [10 favorites]
posted by If only I had a penguin... at 7:03 PM on January 3, 2024 [10 favorites]
I appreciate your concern and desire to help, but the fact that you are asking this question here indicates a major failure by your bank. Staff at a specific branch should not have to figure this out on a case by case basis but should be able to refer to an existing, well researched and reviewed policy. If one doesn't exist, I hope you are able to demand that your bank create one.
posted by Mr.Know-it-some at 7:17 PM on January 3, 2024 [9 favorites]
posted by Mr.Know-it-some at 7:17 PM on January 3, 2024 [9 favorites]
Chiming in to say thanks for at least trying to think about what to do. A relative of mine had a tragic fall recently and in starting to over some of his affairs we have gone into the local bank and pharmacy and been truly touched by the kind folks in his small-town institutions who clearly knew him & appreciated him.
One thing that occurred to me is that they recently got a watch-out-for-scams type of brochure from their bank that is clearly targeted at the elderly. If your bank has something similar, maybe you could hand him that along with a brochure for the meals-on-wheels or similar senior services that you find out about from the town office for aging? Just a thought.
posted by wowenthusiast at 7:47 PM on January 3, 2024 [1 favorite]
One thing that occurred to me is that they recently got a watch-out-for-scams type of brochure from their bank that is clearly targeted at the elderly. If your bank has something similar, maybe you could hand him that along with a brochure for the meals-on-wheels or similar senior services that you find out about from the town office for aging? Just a thought.
posted by wowenthusiast at 7:47 PM on January 3, 2024 [1 favorite]
If he has a personal banker, that is the person who should ask him if he would like help being connected to resources.
Failing that, the branch manager (if company policy permits it).
Your concern is admirable; but, though this may be hard to swallow, people have a right to ruin themselves.
If it won't create additional problems and to the extent the branch handles it, you could be especially exacting about compliance and fraud provention, to protect the customer from any likely scams.
posted by snuffleupagus at 9:04 PM on January 3, 2024 [2 favorites]
Failing that, the branch manager (if company policy permits it).
Your concern is admirable; but, though this may be hard to swallow, people have a right to ruin themselves.
If it won't create additional problems and to the extent the branch handles it, you could be especially exacting about compliance and fraud provention, to protect the customer from any likely scams.
posted by snuffleupagus at 9:04 PM on January 3, 2024 [2 favorites]
Adult protective services is totally the call to investigate these things. In Healthcare it is common and even mandated by law to make these sorts of calls but banking isn't Healthcare and in wouldn't know the relevant law. I have made so many of these calls There is one in every state of you are in the US so googling your state + adult protective services should bring up the hotline. In most cases you can report anonymously. In general things you will need to report include: name, address, phone number if available. Short description of your concerns: general apperence, behaviors, what your concerns are.
An example report for dementia might look like: x has recently lost alot of weight, and it doesn't look like he is bathing himself. and has started to ask repetitive questions. He keeps trying to do the same things over and over even with redirection. He lives alone and I'm concerned that he is unable to care for self.
I'm assuming the bank has a policy of what they do if they suspect someone is a victim of financial exploitation in an elderly adult. There may be some guidance there to guide your decision based on workplace stuff.
posted by AlexiaSky at 5:08 AM on January 4, 2024
An example report for dementia might look like: x has recently lost alot of weight, and it doesn't look like he is bathing himself. and has started to ask repetitive questions. He keeps trying to do the same things over and over even with redirection. He lives alone and I'm concerned that he is unable to care for self.
I'm assuming the bank has a policy of what they do if they suspect someone is a victim of financial exploitation in an elderly adult. There may be some guidance there to guide your decision based on workplace stuff.
posted by AlexiaSky at 5:08 AM on January 4, 2024
Continuing to comment: I read the description again, the bar for serious services like facility placement are very high, but adult protective services does do things like connect people with homemaker services, counseling and other out patient stuff too. Also at least in IL the screeners will make the call if something rises to the level of an investigation or not, and let you know.
Casually mentioning a senior center or other local resource in a chit chatty way could lead him to something new.
People do have rights to make bad choices but also cognitive decline of a real thing that makes things much more complicated than that.
posted by AlexiaSky at 5:14 AM on January 4, 2024 [1 favorite]
Casually mentioning a senior center or other local resource in a chit chatty way could lead him to something new.
People do have rights to make bad choices but also cognitive decline of a real thing that makes things much more complicated than that.
posted by AlexiaSky at 5:14 AM on January 4, 2024 [1 favorite]
I might also gather information on local resources and talk to him. Will he come into the bank regularly over the long term? Cognitive decline is also really common in acute grief, even for younger people. I share your concern for his wellbeing and also for his autonomy. This is a tricky one and I'm glad he has someone who notices and cares.
posted by wormtales at 5:36 AM on January 4, 2024 [1 favorite]
posted by wormtales at 5:36 AM on January 4, 2024 [1 favorite]
There are also specific things financial institutions can do to prepare for situations like this. NCRC has a resource page: https://ncrc.org/banking-and-financial-services-for-a-dementia-friendly-america/
And in MA there's another org with similar resources but might be more helpful since it's more local: https://dfmassachusetts.org/tools/df-training-resources-by-sector/banks-and-financial-services/
I believe there's also a dementia-friendly banking certification banks and credit unions can get - the most useful looking article on it was paywalled, but that might be something to ask whoever's in charge of professional development at your bank to look into.
posted by snaw at 6:31 AM on January 4, 2024 [1 favorite]
And in MA there's another org with similar resources but might be more helpful since it's more local: https://dfmassachusetts.org/tools/df-training-resources-by-sector/banks-and-financial-services/
I believe there's also a dementia-friendly banking certification banks and credit unions can get - the most useful looking article on it was paywalled, but that might be something to ask whoever's in charge of professional development at your bank to look into.
posted by snaw at 6:31 AM on January 4, 2024 [1 favorite]
Ugh, I have been the adult child of the bank customer in this situation. THANK YOU for caring. A kind bank employee took it upon herself to help my mother pay her bills as her dementia got worse and worse. Mom stayed in her house longer than she would have (also: should have) because this kind woman went out of her way, thinking no one was in mom's life to help her. (And she was right. Mom was estranged from everyone.)
However, I agree with a couple of posters above: It shouldn't fall to staff to figure this out on a case by case basis. Get a policy implemented. Add a trusted contact to the client's account. Maybe you can start by asking the client something to the effect of "I'd like make sure your beneficiary/power of attorney/any other designee paperwork is in order, in case of emergency. Is there a relative, friend, or neighbor who might be able to accompany you to an appointment to get that done?" That person can get eyes on the situation and possibly facilitate a set of POA paperwork as well. Or produce the person who is already POA.
When I finally accompanied my mom to the bank because I became aware she could not handle her finances, the bank staffer was so relieved. She asked Mom to sign a piece of paper allowing me to talk directly to the bank about her accounts. From there, I was able to square up all her accounts, arrange for auto-pay, and then concentrate on the hard stuff: Where she would live.
posted by ImproviseOrDie at 11:50 AM on January 4, 2024 [1 favorite]
However, I agree with a couple of posters above: It shouldn't fall to staff to figure this out on a case by case basis. Get a policy implemented. Add a trusted contact to the client's account. Maybe you can start by asking the client something to the effect of "I'd like make sure your beneficiary/power of attorney/any other designee paperwork is in order, in case of emergency. Is there a relative, friend, or neighbor who might be able to accompany you to an appointment to get that done?" That person can get eyes on the situation and possibly facilitate a set of POA paperwork as well. Or produce the person who is already POA.
When I finally accompanied my mom to the bank because I became aware she could not handle her finances, the bank staffer was so relieved. She asked Mom to sign a piece of paper allowing me to talk directly to the bank about her accounts. From there, I was able to square up all her accounts, arrange for auto-pay, and then concentrate on the hard stuff: Where she would live.
posted by ImproviseOrDie at 11:50 AM on January 4, 2024 [1 favorite]
the advice about elder affairs/etc I am hoping to gather here is to share with higher-ups rather than to act on unilaterally.
While I’m usually a fan of presenting a solution whenever possible, this is about which something your bank should already have procedures in place. I would bring this to the attention of your supervisors. I can almost guarantee you they’ve seen this kind of thing play out before.
That said, I truly appreciate your concern. I had a family member who was being exploited financially. To make things worse, a family member worked at his bank and the exploiters kept leaning on them to help with the exploitation, which made for an uncomfortable situation. This was brought to the bank’s attention and the family member was barred from any transactions or anything else related to the account (much to their relief.) That said, follow the rules and report it higher up to avoid potential issues later.
posted by azpenguin at 12:06 PM on January 4, 2024
While I’m usually a fan of presenting a solution whenever possible, this is about which something your bank should already have procedures in place. I would bring this to the attention of your supervisors. I can almost guarantee you they’ve seen this kind of thing play out before.
That said, I truly appreciate your concern. I had a family member who was being exploited financially. To make things worse, a family member worked at his bank and the exploiters kept leaning on them to help with the exploitation, which made for an uncomfortable situation. This was brought to the bank’s attention and the family member was barred from any transactions or anything else related to the account (much to their relief.) That said, follow the rules and report it higher up to avoid potential issues later.
posted by azpenguin at 12:06 PM on January 4, 2024
I cannot add anything to the advice you have been given, but I do wish to mention something that may be of interest to anyone caring for an elder regardless of whether they have dementia or not: my mother had Alzheimer’s Disease and every single time she exhibited a sudden deterioration of her cognitive ability, it was due to a urinary tract infection. The change once she was treated was instant.
posted by strasbourg at 4:39 PM on January 4, 2024 [6 favorites]
posted by strasbourg at 4:39 PM on January 4, 2024 [6 favorites]
This thread is closed to new comments.
Massachusetts towns tend to have some decent resources and I love you for looking out for him.
posted by ReluctantViking at 4:57 PM on January 3, 2024 [7 favorites]