Neighbour Walking

There’s a gentleman in my neighbourhood who I see walking some mornings. I first noticed him about a month ago. At that time, his appearance was very worrying.

He was large and breathless and lumbered along. Unsteady on his feet, he leaned forward as he walked and I was afraid he would trip over and fall flat on his face. So I watched him until he was out of sight. Every now and then he’d wipe his face with the towel draped around his neck. He had no mask on. A tiny lady, probably his domestic helper, walked two paces behind, so he wasn’t alone. One third his size, she would be of no physical help if he fell. But she probably had a handphone or she could run home for help.

I saw him again this week, and to me he seemed much improved. His gait was steadier, though still wide as he is slightly bow-legged. He didn’t look as breathless. His helper followed ten feet behind and was swinging her arms as she walked. She looked more relaxed too.

I wondered about his story. Was he a sedentary businessman, staying at home for months during these covid times and deconditioned from lack of movement? Which doctor told him he must walk no matter what or die? Was it a wife who sent him out walking with the helper, or a daughter or a son who nagged at him? Maybe all of them, together.

Maybe he is self-motivated after a health scare. Maybe it’s all himself.

Without an LPA – Finance management

In my last post, I wrote about the process of putting an LPA (lasting power of attorney) in place, so when there’s a need because of a loss of mental capacity, someone has been assigned to have the power of attorney to make decisions and have access to finances.

What happens when there isn’t an LPA?

The joint bank account solution has been used by some. In the event of an emergency or loss of mental competence, the joint holder can operate the account. Unfortunately this also means the ‘trusted’ loved one can empty the account for their own purposes instead, and ahead of time.

If there isn’t a joint bank account, I’m sure other methods such as the ATM card (and shared pin) or forged cheque signature have been used in a pinch. Again these methods can surreptitiously be used ahead of time! Still, we do need to trust someone in our time of need and we hope that someone will not betray our trust.

Sometimes the elderly person is brought to the bank by a relative to transfer all their funds to that relative. Singapore banks have been on the lookout for scams and will stop bank transfers from someone they suspect has diminished mental capacity.

There was a huge cheating case here in recent years where a chap used the LPA process to cheat a generous old lady of millions of dollars. He made himself the recipient of the LPA, had her declared to have dementia and then helped himself to her money, her art and her house.

Fortunately for the lady who was childless, her niece stepped in and had the resources and smarts to fight the case. It must be said though, the old lady is still very fond of the scoundrel who cheated her whom she considered an ‘adopted son’. She does have dementia and I suspect it was a tough court decision to determine which decisions were made with a sound mind and which were not. Some info on the case here.

I’ll share about medical decision-making without LPA in another post.

Shrinking Brain

Some years before my mother was diagnosed with dementia, there was a brain scan. I thought there was a little too much space in there, the brain pulled further away from the skull, the brain folds too deep and the gaps too wide.

I sought a friend who was supposed to know about these things and asked my questions. My mother is slowing down, she seems less sharp. Does this scan indicate early dementia changes, perhaps?

No, no, he said. You cannot tell dementia from a brain scan. People can have less brain matter and still function normally. On the other hand, there can be dementia with a normal brain scan.

Surely this scan of a shrinking brain is consistent with my experience that she is slowing down? I asked.

No, he said. This scan looks normal to me. I cannot agree that there is any brain shrinkage.

Neither of us was wrong. I already knew she was changing and sensed the onset of dementia. I wanted the brain scan to support what I felt was happening. However, the scan might have passed as normal then, and it is true many older persons will have more space in their skills without having any symptoms of dementia.