Introduction and Housekeeping
00:00:00
Francisco Sirvent: Good afternoon, everybody. We’ll get started here in just a minute. I’m trying to get a couple of the system settings set correctly, so give me just a couple more minutes and we’ll get going. Hang tight.
Well, I think—I hope—I have the settings correct. There may be a couple of glitches along the way, but we’ll figure it out. Good afternoon, everybody. For those of you who don’t know me, I am attorney Francisco Sirvent, and I’m the founder of Keystone Law Firm and Lifestyle Planning in Chandler, Arizona.
We have been doing webinars all last year and into this year. The topics are driven by you—driven by people in our circle of influence who have questions about things. So, if you ever have something you want to learn more about, let us know. If it’s in our wheelhouse, we will happily talk about it and teach on the topic.
00:06:20
Francisco Sirvent: Just a couple of things about these webinars as we go: we are recording them, and you can see a replay on our YouTube channel if you want. That means what we are saying and recording here is going to be shared publicly. There are a number of people who can’t make the specific time slots we have for the live sessions, and recording is the best way for us to get this information back out to them.
While we will have a Q&A session here, I want to encourage you to ask your questions in a way that doesn’t reveal anything more than you want posted on YouTube. Keep your questions generic enough that you don’t reveal confidential information. Also, if your question is very specific to a situation you’re going through right now and you can’t quite make it a generic question, I encourage you to just schedule an appointment and speak with someone one-on-one so that it can stay private and you can get the best guidance possible.
00:07:36
Francisco Sirvent: As a reminder, you can go to our YouTube channel and find dozens of our prior webinars. It’s youtube.com/keystonelawfirm, and you’ll find the full recordings there. They’re 30 to 60 minutes long, and you can learn a whole lot of information.
Wait—it looks like my settings got goofed up and my microphone got muted. That’s weird. I don’t know how it did that. Anyway, our YouTube channel has all of our prior recordings, so go learn. You can play them at a faster speed if you want to get through them quicker. Today, we are going to talk about a topic that is sometimes scary: “Mom has dementia. Now what?”
Moving from Crisis to Management
00:09:06
Francisco Sirvent: I want everybody to just take a second right now. Breathe. If you’re in this situation, you might be feeling a heavy mix of feelings. It can be scary thinking about what the future holds. Maybe you’re feeling grief for your family member, or you’re feeling overwhelmed about where to start. We’re going to tackle this topic truthfully with some actionable steps to help remove that sense of overwhelm.
If you’ve spent any nights up at 2:00 AM Googling for answers, it’s understandable that you feel like you’re in a daze. I want to tell you that is normal. It’s a situation you’ve never been through before, so you’re not expected to have all the answers. In one little webinar, you’re not going to get every single answer today.
00:10:22
Francisco Sirvent: The goal isn’t to turn you into an expert; it’s to move you from that “crisis mode” feeling—where you feel like you’re just putting out fires—into “management mode.” We want to give you a roadmap so you know what the next one or two steps are.
Before I continue, I have to give the legal notices. What we’re talking about today is not specific legal, tax, medical, or financial advice for any one person’s situation. This is general information of an educational nature. If you need specific advice, speak with a qualified professional.
When a doctor mentions memory issues or dementia, you want to look at this differently. It’s a journey—a new chapter of life. It’s a difficult one, and the roadmap of what life was supposed to be like is probably going to change. But your loved one is still here. We are going to shift the focus from trying to “cure” the diagnosis to “caring”—managing and caring for this loved one.
The Medical Groundwork
00:11:32
Francisco Sirvent: Today, we’re going to cover the medical groundwork and the basics of what to do in that stage. I’m not a doctor, but I’ve been through enough of these cases with clients that I can give you a couple of tips.
I am very excited to have a guest here today, Candace Dutton, whom I’ll introduce shortly. She is the owner of Senior Care Arizona and has been doing this for a long time. She is exceptionally amazing at what she does. We’ll talk about the emergency legal safety nets, the home environment, and how to take care of yourself as the caregiver. By the end of the hour, I hope we’ve lifted some of the fog. You don’t have to climb the whole mountain today; you just need to know where to put your foot next.
00:13:48
Francisco Sirvent: First, let’s talk about the word “dementia.” The way this diagnosis is used in the medical community has shifted a lot. Dementia is really a symptom; it’s not a specific disease diagnosis. It’s like the word “fever.” A child has a fever, but the fever isn’t the cause—it’s a symptom showing that something is happening in the body. To take care of your mom effectively, you need to get clear on the specific diagnosis. Is it Alzheimer’s? Vascular dementia? Something else?
Usually, the first diagnosis comes from a primary care doctor or at the hospital. You really need to get a second opinion. Get a specialist involved, like a neurologist or a geriatrician, to evaluate the underlying root cause. This ensures you’re aiming for the right kind of treatment, as protocols differ between types.
00:16:14
Francisco Sirvent: You also want to rule out other things. For example, a UTI (urinary tract infection) can cause cognitive dysfunction in seniors. A simple round of antibiotics can clear that confusion up. You should also check for vitamin deficiencies (like B12), thyroid issues, or medication interactions. Knock all of those out first. If it’s one of those, mom might be back to her old self once it’s resolved.
Your goal with the medical team isn’t just to fix the memory; it’s to manage mood and safety. We want to address anxiety, sleep disruptions, and agitation. If mom is calm and sleeping well, her quality of life—and yours—will be significantly higher than if she remembers what she had for breakfast but lives in a constant state of panic.
Legal and Financial Protections
00:17:31
Francisco Sirvent: Now let’s look at the legal and financial side. There is a giant checklist of things to look for, but I want to give you the key pieces that are usually urgent.
Years ago, I had a client in her 50s whose husband had been forced into retirement due to early-onset dementia. When he reached the point where he couldn’t manage the finances, she went to the bank with their trust and power of attorney documents. The financial institution rejected them, saying the trust wasn’t implemented correctly and the power of attorney was “too old.”
Because her husband no longer had the legal capacity to sign new documents, she had to go to court to become his conservator. It was a painful, expensive 9-month battle that cost between $30,000 and $50,000 in legal fees. Now, she has to file annual accountings with the court, reporting every single penny spent to a department of auditors.
00:21:25
Francisco Sirvent: A dementia diagnosis does not always mean someone lacks the capacity to sign legal documents. If caught early, there is often still sufficient capacity to put protections in place and avoid a conservatorship. This is the window to act.
You should also do an inventory of financials. Organize bank accounts, investments, real estate, and bills. Start getting that knowledge out of her memory and into your notes. Monitor the mail and transactions.
The two main documents you need are a Durable Power of Attorney for Finances and a Healthcare Power of Attorney. You might also want an Advanced Directive (called a Living Will in Arizona), which states your wishes regarding life-sustaining treatment if you are in a terminal condition or a persistent vegetative state.
00:24:11
Francisco Sirvent: Start monitoring for fraud. We had a case where a woman was watching her brother’s accounts online and saw rapid-fire transactions sending thousands of dollars to Africa. He was being scammed by someone pretending to be in a relationship with him. Having someone who is “watching” even before they are “in charge” can save a family’s finances.
Home Safety and the “Car Key” Conversation
00:25:27
Francisco Sirvent: Next is the home safety audit. I’m going to bring in Candace Dutton. I’ve known Candace for years, and her company, Senior Care Arizona, is one of the most successful at helping people find care homes and navigate the senior care system. Candace, give us some ideas on home safety.
00:27:46
Candice Dutton: Thank you, Francisco. The goal should always be how to keep individuals at home safely. A great solution is a “Home Safety Evaluation.” A physical therapist comes into the home and looks at everything—grab bar recommendations, commode accessibility, and shower access. Setting this up early ensures future success. The good news is that this evaluation is often covered by Medicare or private insurance. Your primary physician or neurologist can write the order for you.
We look at tripping hazards, like coffee tables, and we focus heavily on the bathroom and kitchen, where most falls happen.
00:29:35
Francisco Sirvent: That is phenomenal. One of the toughest conversations, though, is the car keys. The earlier you talk about it, the less scary it is when it’s time to actually surrender them.
Candice Dutton: If you have concerns, you can confide in the physician. You can also submit an anonymous report online to the Department of Motor Vehicles. They will send your loved one a notice to come in for a driving test. This takes you out of the “bad guy” role and makes it an objective decision by the DMV.
00:32:01
Francisco Sirvent: There is also great technology now for “wandering prevention” and electronic caregivers that can help a person stay home longer even if they live alone.
Building the Caregiving Team
00:33:17
Francisco Sirvent: If you’re stepping into the role of caregiver, you’ll likely become the central point of contact. You’ll need the Healthcare Power of Attorney, and as Candace mentioned in the chat, Arizona has a specific Mental Health Power of Attorney that you want to make sure is included.
But don’t believe that being the “agent” means you have to do it all yourself. That will wear you down. You need to build a team. Delegate to siblings or professionals. However, avoid “informal” arrangements where someone moves in for free rent in exchange for care. That is a bomb waiting to happen. We’ve seen cases where informal caregivers wiped out $600,000 to $800,000 of a senior’s finances.
If you bring people into the home, they should be licensed and insured. Candace, what else should people think about?
00:37:06
Candice Dutton: If your parent has long-term care insurance, you must use a licensed agency. If you pay someone privately, those expenses usually won’t count toward the policy’s elimination period.
Also, make sure the agency background checks and fingerprints their employees. You’d be surprised how many don’t. These people have access to your loved one’s mail, valuables, and identity.
00:39:13
Francisco Sirvent: When dividing responsibilities, we recommend having one person as the final stop for medical decisions and one person for financial decisions. Don’t make the financial role “joint.” It’s too difficult to implement at banks.
You also need a “break” person—someone who can stay with mom while you run errands or go to your own doctor. And I highly recommend a “fun” person. Someone in the family whose only job is to bring over the grandkids, the puppy, or coordinate a nice dinner. Quality of life is the goal.
Changing Rules of Engagement
00:42:53
Francisco Sirvent: Relationship dynamics shift with dementia. You can’t argue with your parents the way you used to. As the disease progresses, you have to lean into “redirecting.” If they are talking about something from 20 years ago, enter their reality. Ask questions and let them enjoy that memory rather than correcting them.
Break instructions down into very simple steps. Be comfortable with silence; it takes them longer to process questions. If you preempt their answers, it can be frustrating. When words stop working, lean into body language, eye contact, music, and touch.
00:47:04
Candice Dutton: It’s so easy to get caught up in the tasks—cooking, cleaning, laundry—that you forget to be a daughter or a son. You can outsource the laundry, but you can’t outsource a loving hug.
Also, maintain their dignity. If you have an opposite-sex parent, it might be time to hire a professional for personal care like showering or toileting. It’s normal for a parent to feel frustrated with their caregiver. If they snap at you, remember it’s frustration with the role of the caregiver, not necessarily with you as their child.
Self-Care and Resources
00:50:39
Francisco Sirvent: You cannot play the martyr. This is a marathon, not a sprint. Statistics show that 60% of caregivers actually pass away before the person they are caring for because of the extreme stress and lack of sleep. Build in safety valves so you aren’t running at the “red line” every day.
There are great local resources:
Banner Alzheimer’s Institute and Barrows Neurological
Neighbors Who Care (in the Sun Lakes area)
Hospice of the Valley (they have a phenomenal dementia supportive care team)
00:54:18
Francisco Sirvent: Let’s look at a question from Sarah: “Is there a ‘pre-power of attorney’ for a loved one who still has capacity?” The Power of Attorney is that document. You sign it now while you have capacity to dictate what happens later. You can even include specific preferences about the type of facility or care environment you’d prefer.
Another question: “Is a power of attorney ‘too old’?” Arizona law doesn’t have an expiration date for these, but banks often have internal policies where they refuse to honor documents signed years ago. It’s frustrating because there is no penalty for a bank refusing a valid document. We recommend updating them every few years to keep them “fresh” for the banks.
00:59:03
Francisco Sirvent: We are just about out of time. Candace, thank you so much for joining me. You can reach her team at seniorcareaz.com. Thanks, everybody, for joining us. We’ll see you next time.
Transcription ended after 01:01:16
