A nationwide effort to better identify signs of dementia and assist those afflicted with it has made its way to the financial services space.
Earlier this year California-based Ventura County Credit Union was officially certified by the Camarillo Health Care District as a “dementia-friendly business.” It is believed to be one of the few financial institutions – if not the only one – to hold such a designation, and the move is seen as the tip of the iceberg in banks and credit unions being more aware of memory issues for older Americans.
Along with health issues, that demographic is also subject to elder financial abuse, which can be exacerbated by dementia and associated diseases. About 5.8 million Americans are living with Alzheimer’s dementia, according to a 2019 report from the Alzheimer’s Association.
As the largest credit union in California’s Ventura County, $890 million-asset VCCU had to demonstrate that it understands how to recognize the signs of dementia, and implement measures to create a “safe and respectful” environment that accommodates the “unique needs” of those with dementia.
The certification process included training VCCU employees on how to identify members who might be dealing with dementia, along with basics such as speaking clearly, listening closely, making eye contact, paying attention for signs of confusion or distress, and more. VCCU has also worked to ensure in-branch signage is clear, entrances are well-lit and visible, and the facility has quiet areas for those feeling anxious or confused.
Joe Schroeder, VCCU’s president and CEO, explained that the credit union’s board chair is an advisor to the Ventura County Area Agency on Aging, an organization VCCU has worked closely with for years. That group helped spearhead the issue following a 2015 White House Conference on Aging that focused on the growing number of Americans with Alzheimer’s and dementia.
Because of the close connection, “our credit union was a natural partner for this effort,” said Schroeder.
Dr. Jeffrey Cummings, a professor at the University of Nevada, Las Vegas, defined dementia as a generic term for when someone has enough memory loss to compromise everyday life. Alzheimer’s is a specific disease that is the most common cause of dementia in older people, he explained.
It can be difficult to recognize the signs of dementia, but two signs to watch for are confusion and repetition, Cummings noted. “They might say to the teller, ‘I want to make a withdrawal today,’ have a conversation, then say, ‘I want to make a withdrawal today.’ This is because Alzheimer’s affects recent memory more than any other aspect of brain function.”
According to Dr. Ashley Sarasan, another UNLV professor and a former Mayo Clinic fellow in geriatrics, noted that incidents of dementia are increasing in patients over the age of 80, and one of the most common difficulties that comes along with that diagnosis is managing finances.
“Long before they cannot take care of themselves, there are issues with transportation and finance,” she said. “Often family members take over an older person’s finances. We advise patients to get help when they can. We do an assessment that includes math to check cognitive issues. If those are concerns we advise against driving or managing their own finances.”
Unfortunately, sometimes when children get access to an older person’s finances that “assistance” gets abused, Sarasan continued. “We encounter this on a daily basis.”
Throughout the certification process, the credit union’s branch managers and various leadership groups met with representatives from VCAAA and other community organizations to ensure best practices were being followed.
In train-the-trainer fashion over approximately six weeks, VCCU’s internal trainer provided all of the education needed for the front line and support teams. This training has become part of VCCU’s annual compliance program and is always available online for anyone needing a refresher, Schroeder said.
“The greatest difference is our level of education concerning some of the specific challenges faced by those with dementia,” he said. “Not only do our team members now have a greater level of sensitivity, but our members do, as well – thanks to collateral we have posted within our branches. Our members are happy that we continue to support the senior population.”
Cummings called the dementia-friendly movement a “fantastic program,” and was pleased to hear what VCCU had done.
“I was not aware it had reached out to financial institutions,” he said. “People with dementia are forgetful, so they can make poor decisions that can affect their and their family’s financial futures.”
What CUs should watch for
Even if credit unions do not go through a formal certification process, advocates say there are many steps they can take to take care of those with memory issues and prevent elder financial abuse.
“To be dementia-friendly, look for someone who is forgetting their account numbers or [forgetting to make] their payments,” Sarasan offered. “Credit unions can make simple apps with reminders for those with memory problems. They also should train their staff in assisting members with dementia. Make sure a family member has legal power of attorney. If the patient does not have a family member, get power of attorney for the person’s lawyer or physician.”
According to Lee Ann Mandarino, the head of Dementia Friendly Nevada, as much as 75% of those affected by dementia experience difficulty with banking.
“Banks can be intimidating,” Mandarino said. “Many cognitively normal people forget their PINs and passwords, and get frustrated with long lines and difficult math problems – so just imagine how a person with dementia feels.”
Mandarino recommended doing an assessment of all service areas to ensure adequate lighting, seating, safety and quiet areas where a person living with dementia, their caregivers and personnel can discuss banking matters. Second, she said member service representatives and financial advisors should become educated on the behaviors of individuals with dementia.
“They might be slower to process information, so don’t use complex terms,” advised Sarasan. “Break down the process. Ask them to repeat back what was discussed to ensure they heard and understood. This is called the ‘teach back’ technique.”
Sarasan and Cummings acknowledged there is only so much a credit union can do.
Cummings suggested CUs try to find a way to not act on a financial decision unless confirmed by a family member if the person is confused or repetitive, especially if the person is asking to make a substantial withdrawal.
“A credit union can only advise, it cannot act for the person,” Sarasan said. “But if they see something of concern, such as a change in the way the member is handling finances, suggest the person go to their primary care doctor to be evaluated for memory function.
“Yes,” she added, “that is a tough conversation.”
