Have you noticed bills piling up in the home of your person living with dementia? Are you worried that some important aspects of daily life, such as their finances, are not being managed well anymore?

As various forms of dementia progress, including Alzheimers Disease, it becomes increasingly difficult for the person to remember and complete the many sequential steps that are needed for tasks such as paying bills or balancing a checkbook.

Managing finances, transportation, driving, cooking, and other similar daily activities can become troublesome for people that have reached a mid-level, or Emerald State, dementia. At this state, the brain has changed and deteriorated to a point where communication becomes more vague, and the person may struggle holding on to details. You might start seeing mistakes, but likely the person is not aware they’re making them. They tend to think that they’re just fine.

So, what can you do to be help without appearing to take over or making the person feel incompetent? Below are a few things to keep in mind as you try to assist with the situation:

1. Remember that they may not realize how much has changed


If your person living with dementia still feels fully capable of handling things when it’s clear they can’t, remember that they’re not trying to cover up or purposefully mislead you. To them, little appears to have changed as their brain will try to compensate for lost skills and missed details by making up stories to explain why things are the way they are. This is not intentional, but an involuntary, altered reality created by their brain.

So as a caregiver, or care partner as we prefer to call you here at Positive Approach to Care ®, try not to correct them, but rather go with the flow. Remind yourself that this phenomenon is not intentional, and that letting go of being right increases your chances of successfully solving this matter while protecting the relationship between you two.

2. Consider their role in the past

Have you ever noticed that a person living with dementia can tell you stories from their youth in detail, but will struggle to remember that they joined you for dinner just two days ago? This is because some types of dementia affect the formation of new memories, while old memories can stay preserved for quite some time.

Consider this in your current situation: Was your person living with dementia always the one to manage the finances? Or is it that while your late dad handled these matters most of his life, this new responsibility is less familiar for your mom?

Depending on your answer, it may be natural for your loved one to require more support. But, how do you offer that without making them feel less capable? Learn more in the next point below.

3. Break tasks into smaller pieces and use supportive communication


If you’re living with a healthy brain, you likely take for granted the amazing feats your brain does for you every single day.

Try to just think through the many tiny details that are required to pay a bill:

– Remember there’s a bill to pay
– Remember where to find the checkbook
– Remember where to find a pen
– Remember where you placed the bill
– Locate the correct due amount
– Remember where and how to write the recipient’s name
– Remember where to write the numerical dollar amount, and where to spell it out
– Remember to sign the check
– Find an envelope
– Find stamps
– Remember to put both the check and pay-stub into the envelope
– … and so forth

While you and I may not have to consciously think through these steps on a normal day, a person who is living with dementia will have trouble sequencing all of these many, tiny steps. To help the person complete this task, try breaking it down into small bites, and offer your support on every step.

In this example conversation below, Teepa helps mom pay a bill while offering her support throughout:

Teepa: Hey, mom, I have a question for you.

MomOh, what’s that?

TeepaI’m wondering if you could help me out, because I know that you and dad made some arrangements to do some things after he passed, right? You guys talked about some things with the lawyer that you wanted to have happen.

MomOh, he had a bunch of stuff written down. I don’t know if I’ve looked at that lately.

TeepaYeah, there was a bunch of stuff. You’re absolutely right. So, oh, I’m wondering, can we tackle one piece that I think you care a lot about? How about if we work on that one first?

MomWell, what’s that?

TeepaWell, you know, the checkbook. Because I know that you like to get things balanced out, right?

Mom: Oh, you gotta have the money.

TeepaYeah, you like to know you’ve got money here and money there. So, here’s what I’m wondering. I gathered up a lot of the bills that I saw you had on the desk. I’ve got them all right here.

Note here that while Teepa has already done a little work and she has an agenda, she’s not pushing it in her mom’s face. Instead, she’s trying to be the helpful, focused daughter.
Teepa: And I know you like to get these all in. And so, I gathered these up so you can do the thing you like to do.
Did you notice how, even though Teepa did notice the unpaid bills laying around, she didn’t point them out to her mom? She’s not focusing on what her mom didn’t do or blaming her, but directs the conversation towards the task instead.
Teepa: So tell you what, how about, here’s your checkbook.

Did you notice how Teepa is not saying you have to do this or you have to do that, and expecting her mom to get it done without her help? Instead, she’s assisting her mom with sequencing through the task of paying the bills.

Also, did you notice that she said “here’s your checkbook,” allowing her mom a sense of continued ownership over the task?

Teepa: Oh, now do you want this pen or that pen to write with?

Notice how Teepa is not asking her mom an open-ended question like Which pen do you want to write with?

Instead, she offers her a this or that type choice, which helps her mom quickly pick one and sequence to the next task, while also allowing her a sense of independence and involvement in the matter.

Teepa: Okay, so first I think we’re going to do… Would you rather do the water bill or the electric bill first?
Once again, Teepa offers her mom one of two choices with this or that to support her through the process.

Mom: Yeah, let’s do the electric because I need the light.

TeepaOK, so what check number are you on?

MomOh, I don’t know.

Teepa: Oh, it’s up here in the corner. It’s 107. So, do you want to write it over here, or something else?

Did you notice Teepa giving her mom a choice again? Another common question you may want to try using to help your person with dementia move through their tasks is this or something else?

Mom: Well, you just fill the thing out and I’ll sign it.

Teepa: Okay, good enough. So, I’m going to write 107. Now, take a look here where my finger is. This is how much you’re going to owe there. So, how much is that?

MomI can’t see, you just write it out and I’ll sign it.

TeepaYou want me to write it out. You got it. I’m going to write that out now. Here’s what I do need, mom. Your signature on the check. Here you go.

Did you notice how Teepa used reflection here? By repeating the last words your person living with dementia said, you can help them better process and continue your conversation.

Mom: I can still do that.

Teepa: You absolutely can. And you know what that means? One bill done. Let me work on the second one, and I’m going to need your signature again. Oh, now this one’s the water bill. Oh, you haven’t been using much water. Here you go. Are you ready for your signature, or something else?

Did you pick up on the two techniques Teepa uses here we discussed earlier? If you caught on to reflection of the person’s last few words and a this or something else type choice, great job!


As a dementia progresses, the person’s abilities will change. It can be surprising when you realize that your loved one’s water bill hasn’t been paid in months, or that the task of making scrambled eggs has become a challenge.

By realizing that the person may not have awareness of their changes, thinking through their past, and by breaking tasks into smaller pieces with respectful communication, you too can support your person living with dementia in the most effective and respectful way possible.

By Valerie Feurich
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