Nearly everyone knows a family in the throes of dementia. According to the 2024 Alzheimer’s Association annual report, nearly 7 million people in the United States are impacted by dementia. Dementia is a general term that describes a group of symptoms including impairments in memory, retention, language, problem-solving and other cognitive skills that affect a person’s ability to perform activities of daily living.
As a financial advisor, you should be thinking about dementia. The lifespan of a person with dementia can be nearly 30 years, making dementia one of the most expensive diseases. It’s often referred to as “the long goodbye.” In time, the person with dementia will need 24/7 care.
Dementia also has a significant impact on adult children who often take early retirement, decline job promotions and jeopardize their careers because they are in over their heads with caregiving demands.
Understanding Dementia
Before getting into what advisors should be doing, it’s important to understand more about dementia itself. People often ask what the difference between dementia and Alzheimer’s disease is. Alzheimer’s is a form of dementia, much like Parkinson’s disease, Lewy body dementia, frontotemporal dementia and many other ailments.
Families often ignore the warning signs of dementia, including memory impairment; poor decision-making; changes in mood, behavior and personality; shorter attention span; and poor safety awareness. More serious behavioral changes include wandering, pacing, sundowning, agitation, hallucinations and paranoia.
Too often, families take symptoms seriously only after the disease has progressed significantly — several years after the first warning signs. A family’s awareness is often triggered by safety issues such as their loved one leaving the stove on and nearly burning down the house, failing to take medications properly (either too much or not at all), getting lost, crashing the car, or wandering away and becoming a Silver Alert.
Other red flags include behaviors like paranoia, restlessness, pacing, wandering, sundowning, aggression, violence, and refusing help with showers, dressing and grooming. Perhaps most heart-breaking is when the loved one no longer recognizes their own family members.
Be Proactive with Clients
Before your aging clients start to exhibit signs of decline, you need to transition conversations to aging and long-term care. Encourage them to stay active and engaged to ward off immobility and social isolation. Your middle-aged clients are likely starting to see declines in their aging parents or are already caregiving to them.
Many adult children don’t live near their aging parents, so they are often unprepared when they are thrust into the role of family caregiving, especially if the primary caregiver spouse takes ill and/or dies. Family members usually have no understanding of how to manage the behaviors, personality changes and extensive needs of their demented loved one. They are often blindsided by the disease progression and at a loss for what to do.
And many times, the primary caregiver spouse has refrained from sharing the level of memory impairment or behavioral issues with the adult children. It isn’t until the primary caregiver takes ill or dies that the kids discover the severity of the illness.
The Most Important Questions
Advisors with clients dealing with dementia in the family need to start asking questions. Are you a family caregiver? How is it impacting your job, health, relationships? Are you noticing changes in your health? Are you keeping active and engaged at home? Have you had any falls, concerning events at home or hospitalizations? Are you able to manage your mail and bills? Who is your trusted contact in case we have concerns as you age?
Verifying that your clients have estate documents in order is critical. Without them, they may have to spend thousands of dollars in emergency guardianship or conservatorship legal fees if capacity becomes an issue.
Collaborate With Experts
Advisors can further help their clients by collaborating with aging and dementia experts. You might broach the subject with your client like this: “I have your financial plan in good order, but just as important is a plan for aging, caregiving and care needs. I’d like to introduce you to X via an email introduction.” The same goes for estate planning, tax planning and aging planning.
Referring clients to experts in these areas is a differentiator and adds value. Using a team approach shows you care about all aspects of your clients’ needs. Addressing the “human side” of clients’ needs and not shying away from these aging conversations is a wise marketing strategy.
“You don’t want a client confronting you when care is needed and you failed to properly calculate the costs of care.”
Advisors need to be knowledgeable and prepared to address these topics with their clients. Understanding the costs of care is crucial to prepare a proper financial plan. You don’t want a client confronting you when care is needed and you failed to properly calculate the costs of care. Too often, when I ask an advisor how much they suggest their clients budget for 24/7 care, they cite $5,800 per month — incredibly far from the truth.
Most of my clients who are aging at home are spending upward of $30,000 per month in 24/7 home care for just one parent. If both parents need care, the cost is even higher. Because of healthcare worker shortages across the country, aging at home with 24/7 care may require several home-care agencies partnering to fill the needed shifts.
And because of the concerning quality of care provided in most senior care communities, many families are faced with paying not only the facility fees but also private-duty companions as well, doubling the cost of care. Working with an aging expert allows an advisor to formulate a realistic financial plan.
Plan for Caregiver Burnout
An aging plan is essential for all families and especially for families in the dementia journey. Often, it is just a matter of time until the family becomes overwhelmed and burned out. Before this happens, families should properly budget for when 24/7 care is needed and also proactively have their loved ones on waiting lists of quality care communities that can meet the needs of both parents until death.
I’ve also teamed up with a travel agent who is a registered nurse to offer dementia-friendly family cruises that educate caregivers and give them a break while their memory-impaired loved ones enjoy adult-daycare programming.
The dementia journey is long and difficult. But a neutral third-party family-meeting facilitator can help families understand aging, caregiving, disease progression, current and future care needs and costs, the importance of care advocacy and the support that’s available through the end-of-life process.
Annalee Kruger, president of Care Right Inc and co-founder of Plan4LifeNow, helps family caregivers and their aging loved ones across the globe develop customized Aging Plans which include facilitate family meetings, understand aging, caregiving issues, aging at home considerations, long term care communities that can accommodate seniors through end-of-life, provide care advocacy, dementia education and support families through end-of-life. While Annalee’s goal is to reach families proactively, the reality is, 92% of families seek Care Right when the family is in crisis mode and needing to make big decisions quickly.
