Summary
In this episode of CareLab, Charles E. Wallace Jr. shares the beginning of his mother's story and how a seemingly helpful new friend gradually became involved in her life as she began experiencing cognitive decline. After her husband moved away, Charles noticed changes in her health, behavior, and decision-making. Despite clear warning signs, her symptoms were initially attributed to Lyme disease rather than dementia, delaying proper diagnosis and intervention. As Charles and his family uncovered medical records and sought answers, they learned that her cognitive impairment was far more serious than they had been told.
Key Questions Answered
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What first raised concerns about Charles's mother's condition?
She had lost a significant amount of weight, was living alone for the first time in decades, and showed noticeable changes in behavior and decision-making. Charles also became concerned when she mentioned having a "new friend" who quickly became involved in her daily life and finances.
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Why was dementia not immediately suspected?
Her primary physician attributed her symptoms to Lyme disease, despite her having little likelihood of exposure. This diagnosis delayed a referral to a neurologist and postponed a proper cognitive evaluation.
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What is the MOCA test, and what did it reveal?
The Montreal Cognitive Assessment (MOCA) is a screening tool used to evaluate cognitive function. Charles later learned that his mother scored 16 out of 30, indicating significant cognitive impairment. A follow-up score of 17 showed little meaningful improvement.
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What warning signs of financial exploitation emerged?
Large amounts of food were being purchased unnecessarily, receipts were difficult to obtain, and the caregiver became increasingly involved in financial matters. Charles later learned the caregiver had experience working with vulnerable older adults and suspected she was taking advantage of his mother's declining cognition.
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What happened after the family obtained a capacity letter?
A neurologist provided a letter stating that Charles's mother lacked the capacity to make financial decisions. After the letter was shared with her attorney, CPA, and financial advisor, Charles and his sister were unexpectedly removed from their mother's medical power of attorney within ten days, setting the stage for the next chapter of the story.
Transcript
Emilia Bourland
Welcome to this episode of CareLab. We have something really special for you here today. We've got a trusted caregiver, a vulnerable woman with dementia, and a devastating betrayal hidden in plain sight. In part one of this special series on financial exploitation, we are sharing the story of a woman living with dementia whose trust was slowly manipulated by someone close to her. What began as small concerns eventually uncovered a heartbreaking case of financial exploitation.
We're going to explore the early warning signs, the emotional impact, and the journey of one man determined to do something about it.
Brandy Archie
And that man is Charles E. Wallace Jr. He has a technology background in the finance, banking, healthcare, and collections industry, which is so interesting to tie into the story and what happened. He's married with two daughters and two grandchildren. And when he's not spending time with his family working or writing, he enjoys coaching youth basketball, outdoor activities, and cooking, and the caregiver's game, unraveling, unraveling financial deceit.
And the Shadows of Dementia is his first book and we are gonna talk about the story. Chip, thanks for joining us.
Charles Wallace
you're welcome.
Emilia Bourland
Yeah, thank you so much for being here. Let's jump right in and let's not get too into the nitty gritty first. Kind of lay the foundation for us. Give us a little bit background. know, who was your mother? ⁓ Just kind of usher us in, tell us who the characters are here.
Charles Wallace
Sure.
Yeah, so my mother had always been an independent ⁓ woman. She'd been married ⁓ for about 30 years, 25 years to the one man, but she'd been married four other times. So she had been through a number of husbands. And so this husband, she...
had lived with at this condo that was my grandmother's and she moved in in the mid 90s so she'd been in the same place since the mid 90s. People around her knew her, she'd actually been on the board for the condo, it was a high-rise condo ⁓ complex there in the middle of North Dallas and she was pretty comfortable there and had no interest in leaving. ⁓ Myself and my siblings had all moved away.
And so I was in southern Illinois around the St. Louis area. My siblings are on the West Coast, so I was the closest and I was supposed to watch, kind of watch over. One of the things that she had done though, she had been working with a stockbroker for 40 years. She worked with my grandmother.
a CPA since the early 90s. So long time fiduciaries that were around. And so I'd always figured, you know, if she gets stuck, she would reach out to them. In mid 2017, in August, her husband had an issue with his mental health and needed to move away. He was about mid 80s and moved down to Austin, about 200 miles away, leaving my mother alone for the first time in several decades.
So she, when I went to visit her in late 17, she was down to probably about 95 pounds. She was about 5'5". And she was always wanting to keep herself thin. She was always wanting to, you know, make sure she looked good. One is, you know, look like something on a magazine. And she had the painting, which is on the cover of the book, that was from when she was about 17 years old.
And so she was, she always thought, you know, pretty well over herself and, but now she was starting to get a little too thin. And I suggested then I said, well, why don't you get someone to cook for you? You know, you've, you're in a building here. A lot of older folks are in the building. Someone's probably, you know, probably has somebody that comes in a few times a week and sets up something for you because her fridge at the time was pretty barren. And so we talked about it. And a few months later.
Emilia Bourland
Mm-hmm.
Charles Wallace
Suddenly she contacts my sister who tells her, I have a new friend. And I wasn't aware of that phrase being a clue to what was going to happen over the next few years. so, but let's begin, we were distant. And so it was really up to her. She stayed in the building, people were around. ⁓ But when I went to visit about a month later, she had...
a ton of food in the fridge. I mean, the type to a family of four or five. And since she had always been slim, that much food was kind of silly. There was no way. So I asked her for receipts and the caregiver, at the time, wasn't really a caregiver, it was more of just kind of someone who was helping with their food bills and stuff. Said, well, I'll get receipts if your mother asks for them, because I work for her. And then I looked at my mother, who had never been quiet before.
Brandy Archie
Yeah.
Emilia Bourland
Mm-hmm.
Charles Wallace
and she's now about 78, 79 years old. She had someone who had never in the past given large sums of money, for example, to anybody outside the family. ⁓ Even her donating to places like Salvation Army was probably a little thin. To see her act like that was a concern, so we figured we'd ask the CPA who was watching to get receipts. Well, we received probably two receipts that spring and then it stopped.
never really see much. And so that was through 2018 and she was not seeing a neurologist at the time. She was seeing a regular general practitioner doctor and he diagnosed her with Lyme disease. So that's why you've got a mental, you know, mentally fog and can't have a, you know, have a memory issue. Yeah.
Emilia Bourland
Hmm.
Wait, hold on, Lyme disease? This is
a woman... Now, y'all know I used to live in, I lived in Dallas for a long time. There's not a lot of ⁓ outdoor space for ticks in North Dallas.
Charles Wallace
Mm-hmm.
deer. Correct. Correct. There's
not. And that's what I said. Exactly. I said, I said, my mother lives in a cement area. You know, she goes from one building to the mall to another building. And that's really what she's always done. I said, there's no way something, you know, funny is going on. But she believed it and wanted to believe it because if she didn't, that she had to admit she was getting old.
Emilia Bourland
Mm.
Brandy Archie
Mmm.
Charles Wallace
And
so she started this program that he put her on of the antibiotics. Said, you've got to do it for 13 months. And I said, that's a really interesting number. ⁓ And at the time said to get this by antibiotic, you'll need to contact this number in New Zealand. You should be. She did. He was a DO. Yes. ⁓
Emilia Bourland
What? Wait, hold on, wait, back up. I feel confused now. I thought she went to see a doctor.
Brandy Archie
Whoa.
Emilia Bourland
Her, was it her regular physician?
Charles Wallace
Yes, she'd been going to him for a number of years. And most of his clientele were Medicare clients. So it was older usually. And so he had said that. And so she put off seeing a neurologist for a year. And right, that treatment. And so we got close to end of that treatment, finally into the summer of 18.
Brandy Archie
Thank
Emilia Bourland
Okay. Okay.
Okay? Okay. Okay.
Brandy Archie
because she's going through that treatment.
Charles Wallace
And I called the doctor and I said, do you have a neurologist to refer to since we're about done with her 13 months? And again, his clientele is 70 % probably Medicare folks. And he goes, well, I went to go look at my list, but all my referrals have retired. And I'm sitting there thinking, you've got aging clientele and you don't have an active referral for a neurologist? He goes, yeah, let me find one. So we eventually get one set up.
And so we go see the neurologist in the fall and the caregiver came with us. And at the time she thought that that was good. They had been getting along pretty well. And I knew nothing about what you should or shouldn't do going in this situation. Watch them do what they call the Mocha test.
and do the words, can she draw, can she identify things? And watching her draw was like watching a small kid holding a pencil and trying to do something. Well, I didn't know what I was watching. My mother had shown us a few months ago earlier that she had been kind of diagnosed with something that was on off Parkinson's because I've seen the handshake and things like that. Dementia was never in my head. But the caregiver knew what she was watching.
Brandy Archie
Mm-hmm.
Charles Wallace
And so we didn't see the score of the test. Even though we had medical power of attorney, we didn't see the scores until months later. We didn't see any of the medical records. ⁓
Emilia Bourland
And just for reference here
for folks who are listening who don't know what a MOCA is, MOCA stands for the Montreal Cognitive Assessment. It's a very common cognitive assessment that is a quick and easy ⁓ assessment for ⁓ cognitive decline in people. So often if cognitive decline or dementia is suspected in someone, the doctor or social worker, whoever they're seeing will give a MOCA as a very quick way to get an idea about what their baseline cognitive. ⁓
Brandy Archie
Mm-hmm.
Charles Wallace
Mm-hmm.
Emilia Bourland
capacity is.
Charles Wallace
Yeah,
and it's a 30-point test. And from what I heard from another doctor later on, if you score worse than a 25, you've got a pretty good issue. She scored apparently a 16 on it.
and took it again in February of 2019, so the next year, and apparently scored a 17. Well, we didn't see it, but all we heard was she told my sister, ⁓ I must be getting better. I scored better on the test. She didn't tell us by one point, which is kind of irrelevant. You're already in the teens. There's an issue. ⁓ Sure.
Brandy Archie
I got a question though. In the moment
in which you were at the doctor's appointment and she was taking the test and you're watching it, ⁓ did they not give any... Did that session end with like, thanks for coming in, we're gonna look at the test scores and get back to you? like, usually at the end of something they're telling you something.
Charles Wallace
They
set up a follow up and also she told the lady she'd been kind of depressed. So she set up an appointment with a psychiatrist to kind of talk through that. The depression was obvious, you know, her husband had left and she was on her own. And so she did that and she went and saw a doctor and a psychiatrist over at UT Southwest.
and they she started on some medicine didn't like the side effects and quit so she only did it for 30 days the depression medicine.
⁓ in the meantime, the caregiver who I found out later had worked with people like this before and had taken advantage of folks like this. was, she was obvious, know, case, no one's around. We can do that. So she was taking care of my mother. so my mother, we didn't know much until probably the summer of 19, when we started requesting some medical records. And when I first requested medical records and we got them from the DO, who was the one that did the Lyme disease.
The Lyme disease test was in the packet and the results were inconclusive. And so when I did a little research on the DO discovered that he had a habit of diagnosing Lyme disease for folks. I found a review on MedWeb or someplace that mentioned the doctor tried to diagnose her mother with Lyme and she thought that was silly and they left.
Emilia Bourland
Interesting.
Charles Wallace
I was able actually to look up his records in CMS. Back then you could get the spreadsheets pretty fast. And so I had a history of diagnosing his patients, these older patients. Usually with that age of Medicare, you're gonna have over 40%, maybe 60 % of some type of Alzheimer's or dementia issue, just because of the age. His range was 10%.
So he wasn't diagnosing people, which is why he didn't have any referral from neurologists because he didn't need them. And so, but it also played to my mother because she wanted to believe she wasn't getting older. And so it made her susceptible to anybody who would just compliment her and say, know, you're doing good. Don't worry about it and we'll help you out. And so it kind of went from there. So 2019, we got the medical records, saw stuff.
My sister suggested, hey, maybe we should get a competency letter from the neurologist that she's seeing now in case something comes up. Because my sister had gone to town during that summer and saw that she was not doing well. We get the letter capacity from the neurologist. He said, no, she doesn't have the ability to really make financial decisions. So that's the end of July of 2019. send it to. Yeah, sure.
Emilia Bourland
Mm-hmm.
Hold on, wait, can we back up again? So
did anyone tell you before that time, before your sister went to get the letter of capacity, did anyone tell y'all before that time that your mother wasn't capable of making financial decisions based on their assessment of her?
Charles Wallace
No,
no, we had no feedback from any medical visits. ⁓ And the folks, the fiduciaries around her all thought because she had the ability to have communication conversation for five to 10 minutes that
Emilia Bourland
conversation.
Brandy Archie
Yeah.
Emilia Bourland
Which
by the way is so common. And so many people go undiagnosed because they can have a face value high surface conversation. And so it seems like they're okay, but you have to start digging a little bit deeper. I don't think, people aren't trying to do the wrong thing. It's just that if you're not looking, it's easy to miss. I'm sorry, go ahead, go ahead, Chip.
Charles Wallace
Mm-hmm.
Brandy Archie
Mm-hmm.
Charles Wallace
you spent 30 minutes with them? Yeah.
Yeah, I know.
And I tried to get, I had that that summer I suggested to the broker, I said, you and the CPA take her out to lunch, just the three of you. And I said, when you do, you guys can eat whatever you want, but don't let her order soup. Have her order something else, sandwich, whatever, but can't order soup. Because I wanted to have them see her.
use your hands and manipulate things. My sister had seen my mother try to eat a waffle with an upside down fork, for example, that summer. So I wanted them to experience that issue. But we didn't know what it was medically because we hadn't been around it before. And the CPA responded at the time to my sister's, she's all right. It's not like she's drooling. And we were.
Brandy Archie
Yeah.
Charles Wallace
We didn't know what to do with him, but we couldn't do anything because he was also going to be her executor ⁓ besides her power of attorney. So when we sent that capacity letter to those three fiduciaries, an attorney as well, within 10 days, my sister and I were kicked off the medical power of attorney.
Brandy Archie
Ooh, let's hold there. And that's because we are going to have you back for another episode. And so let's finish. Let's keep continuing with the story there, because I'm also really interested in like how the caregiver became a part of the life to write, like where the caregiver came from. So if you made it to the end of this episode, make sure you like and subscribe so that you can know when the next iteration of this really interesting story drops.
Charles Wallace
You
Emilia Bourland
Yeah.
Charles Wallace
Mm-hmm. Sure.
Brandy Archie
See y'all next time.
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