To prepare clients for a successful retirement, some advisors frame it as three distinct phases. First come the “go-go” years — more time for travel, hobbies and recreational activities, spending time with family, etc. Then come the “slow-go” years as health challenges increase and mobility declines. You may need a walker, cane or wheelchair. You may or may not be able to drive. The last phase of life may include “no-go” years, where you need far more help, particularly with activities of daily living, and your freedom is greatly restricted. In my case, I went from “go-go” to “no-go” overnight!
After 40 years practicing as an independent financial planner, I successfully sold my business in 2016. Our children were grown, educated, married and on their own. My wife and I loved to travel and roam we did. Our trips spanned every continent, including Antarctica and Australia. We enjoyed a busy and varied retirement. Then my wife became seriously ill and I learned a great deal about the rigors of caregiving. Sadly, my spouse of 55 years passed away in 2022 and I became a widower.
In 2023, I resumed my globetrotting ways. I visited 10 different countries that year, ranging from Patagonia in South America to the remote Svalbard Islands in Arctic Norway. Ambitious plans in place for 2024!
‘Man Plans, and God Laughs’
There’s an old Yiddish adage that gives testimony to the unpredictability of life and the derailment of the most carefully laid plans. “Mann tracht, un Gott lacht,” which means, “Man plans, and God laughs.” In February of this year, a doctor hit me with three words that changed my life in an instant. “You have cancer,” he said.
Hodgkin lymphoma is a blood cancer arising in the lymphatic system. My case was detected when a pulmonologist, who was monitoring my lungs due to a long-Covid effect, noticed swollen lymph nodes on a positron emission tomography (PET) scan. A PET scan is an imaging test that uses a radioactive tracer to create 3D images of the inside of the body. PET scans show how organs and tissues are working, and can detect disease, such as cancer. The pulmonologist referred me to a hematologist, one who specializes in cancer treatments.
When the doctor told me that my biopsy came back positive for cancer, I said that I was scheduled to fly out three days hence for a food, wine and culinary adventure in Morocco. “Should I cancel the trip?” I asked. He urged me to take the trip, which I did —a most enjoyable adventure, despite what was hanging over my head.
A Shock to the System
Chemotherapy ensued in March of this year, following hospitalization for a nasty upper respiratory infection that I most likely contracted while traveling. My reaction to the chemo was severe. My daughter said, “Dad, you can’t go home. There’s no one to take care of you.” A woman at the hospital gave her a list of recommended senior living centers and she visited multiple facilities in her search.
Since my idea of “camping” is a 5-star hotel with a killer beach, my daughter strongly took into account my high standards when deciding where to put her dad. I’m writing this article from my apartment in a senior living facility in Alpharetta, Georgia, a suburb of Atlanta. I have learned much, fast, about the complications of aging and dealing with the complexities of healthcare, I can tell you that I don’t think that planning clients really understand what’s coming at them as the Age Wave rolls on. Here’s what I’ve learned, that you may find helpful with your clients.
The Three O’clock in the Morning Question
Soon-to-be retirees, including aging closely-held business owners, are a popular marketing target. Yes, a happy and well-funded retirement is a goal, but what about the “What if?” questions?
You are meeting with Joe and Sally. Look at Joe and then turn your attention to Sally. Pointing to Joe, you say, “Sally, I want you to think of something. It is 3 a.m. Joe is either having a heart attack or a stroke. You’re in a panic calling 911 to get him to the emergency room. Once he’s in the hospital and stabilized you are going to make another call. You have three adult children. Who is going to get the second call?”
That is a startling question. Sometimes clients know which alpha child will play a dominate role in aging-parent decision-making, but often they don’t. For those who do, most often it is a daughter, although it can be a son. (A “family care team” may be an objective in difficult circumstances, but that’s another subject).
Who is the daughter who gets the frantic phone call about dad (or mom)? In general, she is married, and often between the ages of 47 and 55. She may be working, juggling career and home-front challenges of her own. Kids off to college. The “surprise baby” still in middle school. She and/or her spouse may have their own health challenges. The daughter may be dealing with ailing in-laws. She may be divorced or never married.
Reduce Middle-of-the-Night Angst
When you ask Joe and Sally what the go-to child knows about what they want, often the response is that there is no planning in place.
The next step is to suggest a family meeting, getting Sally and Joe together with the go-to adult child and that child’s spouse, or other family members, to discuss “what if?” planning for mom and dad.
The conversation may touch on powers of attorney for healthcare and financial matters, trust planning, etc. You can’t give legal advice if you are not an attorney, but an estate-planning attorney should be part of your referral team. You can educate clients about the lack of advance planning and the startling reality of the soaring costs of aging amidst a myriad of confusing choices.
Aging Can Be Very Expensive!
Monthly costs vary by location but a really nice facility in the Atlanta area can range up to $7,000 to $8,000 per month or more. (That does not include a beach but may include a swimming pool.) Multiple factors influence the cost of senior living and assisted living facilities, including the type and level of care one needs.
Genworth, the long-term-care financial company, reported that in 2024 the average monthly cost of assisted living in Georgia is $4,120, a cost that has increased by 16.55% since 2021. Inflation is a major factor in long-term-care planning. Genworth notes that the estimated median cost of long-term-care nationwide is $5,511 per month for assisted living and $10,025 a month for a private room in a nursing home.
For home care, Genworth notes that costs for a home health aide can run approximately $5,720 per month. Adult day care can approximate over $2,000 per month. When it comes to family-care planning challenges, it’s not just about the elderly. Of 1,000 parents recently surveyed by Savings.com, nearly half (47%) reported providing ongoing financial assistance to their adult children, citing hardships such as student debt or stagnant wages. Nearly 58% of parents worry they are sacrificing their own financial security to help their children. These may be the same parents who will get the 3 a.m. phone call concerning an aging loved one. What now?
Insurance Must-Knows
Medicare does not cover long-term care. Financial planners can educate clients and their go-to adult children about what Medicare does or does not cover. In March 2022, doctors determined my wife was dying from congestive heart failure and nothing could be done. She was placed in hospice at home and Medicare covered the entire cost until her death at the end of July 2022. Hospice at home was an amazing service for me and my adult children during a stressful and sad time.
Clients may qualify for long-term care through Medicaid or they can purchase private long-term-care insurance. Medicaid covers long-term-care services for millions of Americans, paying for more than half of all long-term-care in the country. This is a growing budget-busting challenge for Uncle Sam. However, Medicaid in general is aimed at folks with limited income and few assets.
The goal in long-term career and financial planning is to create more-than-adequate income and assets over time, in sync with client goals and aspirations. Outside of pro bono work, financial planners generally don’t deal with Medicaid-eligible clients. Yet it’s important to learn Medicaid’s rules for long-term-care as people live longer and the cost of care continues to climb.
My cancer is in remission and immunotherapy has replaced chemotherapy. But the complexities of dealing with different medical professionals, management of prescriptions, an aging body with aches and pains, and not being a burden on adult children who love me, continue to challenge. None of this is a day at the beach. Keep the prayers coming!
Lewis J. Walker, MBA, CFP®, CEPA, graduated with the third class from the College of Financial Planning in 1975. He served for many years on the board of the Institute of Certified Financial Planners (a forerunner of the Financial Planning Association), as national president and chairman. The FPA honored Lewis as a pioneer in the profession of financial planning, presenting him with the P. Kemp Fain, Jr. Award in 2011. No longer in active practice, Lewis continues to serve as vice chairman of the board of Atlanta-based SFA Holdings, Inc., parent company of The Strategic Financial Alliance and SFA Partners.
