Planning for Memory Loss

By Lisa Counsell

THE STATISTICS ARE SOBERING. Studies show that as many as two out of three Americans experience some level of cognitive impairment, on average, by age 70. The CDC reports 10% of the U.S. population aged 65 and older has dementia, and nearly 7 million Americans are living with Alzheimer’s disease. 

Age-related cognitive decline is described as a gradual loss of ability characterized by subtle changes in memory, attention, processing, and problem-solving skills. While age-related cognitive decline is common and does not typically disrupt daily life, dementia is the loss of functioning that interferes with daily life and activities. Alzheimer’s disease, the most common cause of dementia, is a progressively worsening neurodegenerative disease that destroys memory and thinking skills. 

Estate and financial planning serve many purposes, one of which is to build a support system that will carry you through both the expected and unexpected trials of life, including memory loss. The good news is that the work you already have done or intend to do to establish an estate and financial plan will function as a safety net should you be faced with memory loss. To your planning, you can add a few additional considerations to assure the best possible transition and quality of life possible in the event of memory loss. 

Organize 

The first step is to organize information. It can be helpful to create a file or binder with the following information kept updated: 

• Inventory of assets 
• Sources of income, including contact information (pension, annuity, Social Security, etc.) 
• Recurring expenses, including contact information for payments 
• Documents related to outstanding debts, including contact information for the lender (mortgage, credit cards, college loans, etc.) 
  • Professional and personal service contacts 
  • Attorney, accountant, financial manager, trustee, primary care provider, hospital of choice 
• Property maintenance provider, house cleaner, emergency technicians (plumber, electrician) 
• Location of important documents 

While it is also helpful to keep a list of specific account information and passwords, it is critical that such information be stored securely. There are many options for secure electronic storage and you are encouraged to do careful research before choosing a provider. You may elect to keep account information and passwords in a home safe. Whatever you choose, it is important to identify a trusted agent (spouse, attorney-in-fact, trustee) who knows where you keep your file or binder and how to access the necessary account information and passwords.

Identify Your Care Team

If you are not able to act for yourself, whom will you trust to carry out your wishes and act in your best interests? There are several important roles to fill:

• Your Agent under a General Durable Power of Attorney will be granted extensive power to act as you would in any matter related to your personal finances. Further, your Agent may be your nominee as Guardian should one be necessary.
• Your Successor Trustee will have the power to manage any and all assets owned in Trust.
• Your Healthcare Agent, under a Healthcare Powerof Attorney or Advance Directive, will make decisions about your medical care when you cannot.

As you know, Trust Company of Vermont can accept an appointment as Successor Trustee. We can also, in certain circumstances, accept an appointment as Agent under Limited Power of Attorney when there is no other qualified family member or close friend who can fill that role.

Make Sure to Lean on your Team

Begin to involve your care team now in your life and decision-making. Familiarity with your affairs will make it easier for them to fulfill their roles if needed. Just as important is the assistance they can offer you before the time, if it arrives, when you are not able to act for yourself. Close connections with others and timely help and advice can keep you independent and safe for longer. For instance, bad actors know that ordinary age-related cognitive decline may make seniors more vulnerable to internet, mail, and phone scams, and so seniors are specially targeted for these fraudulent schemes. Take some extra time and lean on your team to ensure you’re not urged into falling for one.

Plan for the Cost

Common costs related to memory care are treatment, equipment, home modifications, safety services, prescriptions, adult day care, in-home care, and full-time residential care. Familiarize yourself with the coverage offered by your Medicare plan and any long-term care insurance policies you may own.

Full-time residential care can cost $120,000 a year or more. 24-hour in-home care can exceed $300,000 annually. Financial planning is a good way to consider the “what-ifs” of long-term care. We would be happy to work with you to create and consider scenarios in eMoney, our robust financial planning software.

Think About Where You Will be Most Comfortable

When the time comes, you may not be able to be involved in deciding where you will receive care. Regardless of whether you think you will need the assistance, take some time to research in-home care providers as well as full-time residential care facilities. There may be waiting lists to consider, and some residential facilities offer a tiered approach to care that begins with independent living. You may wish to plan ahead for downsizing and simplifying your life at some point, regardless of health.

Ultimately, you will feel better knowing that you have personally considered your options and prioritized your choices. Communicate your wishes and your research to your support network whether it be spouse, family, close friends, professionals, or any combination thereof. These are difficult and emotional conversations, but you will be giving your loved ones a gift in knowing your wishes so that, when the time comes, they can focus their attention on being with you.

Finally, take some time to research and understand the resources available in your community for support. For Vermonters, the Vermont Council on Aging can be a great place to start: cvcoa.org; svoca.org; nekcouncil.org. Senior Solutions is another very helpful Vermont organization, with a focus on southern Vermont: seniorsolutionsvt.org. More generally, the Alzheimer’s Association offers a wealth of information and resources: alz.org.

No time is as good as the present to begin planning or to revisit a current plan in the context of potential memory loss. Remember that a well-crafted estate plan works for you during life, not just after death. Never hesitate to reach out to your TCV team. We have a wealth of experience working with clients at all stages of life and health. We are honored to be part of your team and can offer support to you and to your family in talking through your concerns, considering a plan, and putting a plan in motion when the time comes.