Author Topic: Preparing for senility?  (Read 7420 times)

RedmondStash

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Preparing for senility?
« on: November 06, 2017, 07:52:31 PM »
I know we like to think we'll be mentally sharp and physically hale until the very end, but has anyone planned for what to do regarding managing finances if their mind starts to slip? I've seen grandparents and one parent lose significant mental function, and even my memory is not what it once was. I want to have a plan in place for the eventuality of senility, dementia, etc., just in case.

No kids, no younger relatives to rely on. Just me and spouse, who is older than I am.

Moustachienne

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Re: Preparing for senility?
« Reply #1 on: November 07, 2017, 12:07:06 AM »
I've been thinking about this as we have no children and are currently doing quite a bit for elderly parents and other relatives.  I hope others chime in with good ideas.

So far we're planning to annuitize more and more funds as we get older, I.e. mid-seventies and after.  We're also planning to downsize into a physically accessible place by 80 or so at the latest. Our credit union can organize power of attorney for us, which seems like a good idea. Bills can be on autopay.

Basically, we're planning to set up systems/make living changes before we're in an emergency state.  This is what we're seeing elderly relatives fail to do and then get into trouble.  It seems like human nature to deny the realities of aging though, so I hope we can stay ahead of the curve.

Or, since we don't have any kids to stop us, we'll just barricade ourselves into our hoarded home on the overgrown lot and go down on our own crazy terms.  :)

RedmondStash

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Re: Preparing for senility?
« Reply #2 on: November 07, 2017, 05:33:52 PM »
Maybe I should move this thread to the Welcome and General Discussion section.

Or, since we don't have any kids to stop us, we'll just barricade ourselves into our hoarded home on the overgrown lot and go down on our own crazy terms.  :)

There is a certain temptation there. :)

katekat

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Re: Preparing for senility?
« Reply #3 on: November 08, 2017, 02:38:32 AM »
I don't have much to add on the specifics, especially the legal specifics, especially since I'm not in a US.

But since the assumption in this thread seems to be that you just need to get power of attorney sorted out before you age/as you notice your faculties fail, I'd question that assumption. Like a will, it's something you hope you won't need until you're old. But like a will, somebody could be looking for it tomorrow.

I've seen people in my life immediately, permanently, lose the faculty to make their own financial & medical decisions at a young age through acute events. If your affairs require a will, you should set one up ASAP. Likewise, if your affairs require power of attorney, you should make sure to set one up ASAP.

MayDay

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Re: Preparing for senility?
« Reply #4 on: November 08, 2017, 06:54:34 AM »
Ugh.

People think they'll know they are declining. Yah no.

You best be getting things sorted way before 80.

Sibley

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Re: Preparing for senility?
« Reply #5 on: November 08, 2017, 01:45:43 PM »
Hate to break it to you guys, but my parents in their 60s are needing help with some things, not all of which they're willing to admit yet. Cancer and dementia can strike even if you do everything right.

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Re: Preparing for senility?
« Reply #6 on: November 08, 2017, 02:54:02 PM »
Timely topic.  My 81-year-old Dad is still in command of his faculties but is losing some of his mental abilities.

Here's what we have done for him (and comments on myself at age 48 in some cases):

1.  Before my Mom died, she started putting every financial and medical piece of mail into a paper box lid and trained me to go through it.  In her case she wanted me to know everything so that when she died I'd know where to go and what to do, which worked out fairly well.  Now that she is gone, my Dad and I are habituated to it and as I see him decline I can gradually step in a little bit more and more over time.

2.  She and my Dad also had a green binder that had all the important documents, passwords, and paperwork, which helped when she died and will be helpful when my Dad dies.  I have a similar document for myself and have told my sister where it is located.

3.  My Dad decided to stop buying and selling stocks about two years ago and put things into a set-and-forget investment plan.  Fewer decisions, fewer documents, less hassle at tax time.

4.  My Dad's credit cards and bills are all on autopay.  Same is true for my bills and most of my cards.

5.  My Dad has a POA and living will in place, and I do too.

I think the tough thing for OP is to not have someone to delegate this stuff too.  My Dad has me, and I have my sister and eventually my daughter to rely on.  So you probably have to pick your best alternative and make sure there are criteria and a plan in place for transferring those responsibilities.  It would be on the expensive side, but maybe an accounting firm or an attorney could handle the finances for someone like OP.  Or, in this day and age of the Internet, if there is a distant (geographically) relative who could handle things remotely, that might work also.

Bicycle_B

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Re: Preparing for senility?
« Reply #7 on: November 08, 2017, 04:00:38 PM »
I know we like to think we'll be mentally sharp and physically hale until the very end, but has anyone planned for what to do regarding managing finances if their mind starts to slip? I've seen grandparents and one parent lose significant mental function, and even my memory is not what it once was. I want to have a plan in place for the eventuality of senility, dementia, etc., just in case.

No kids, no younger relatives to rely on. Just me and spouse, who is older than I am.

Similar situation but no spouse.  Early 50s here.

Preparations performed:  establish medical and financial power of attorney, will and living will, HIPAA statement that includes my sister (the chief POA holder) and her husband.  Asked close friend to serve as backup, included friend in all legal documents.  Discussed possibility of incapacity, verified mutual "I will manage your money on your behalf and monitor your caregivers" pact with Sis; legal docs are to support that.  Discussed scenarios with Sis and friend several times.  Evaluated scenario costs, included in cFiresim-style financial projections.  Verbally committed to periodic tests of mental acuity so that there are data to establish competence/incompetence.  Got baseline test of mental acuity done. 

Preparations still needed: Buy long term care insurance.
« Last Edit: November 08, 2017, 10:03:19 PM by Bicycle_B »

merlin7676

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Re: Preparing for senility?
« Reply #8 on: November 09, 2017, 08:21:28 AM »
Husband and I. No kids. No close family.  Assuming we make it long enough to get that far.  On my side of the family, nobody lives long. Don't think I know of anybody who's made it to 70...although I'm in much better health and take care of myself.
Husband's side they do live a long time but he has some health issues that may or may not play a role in length of life later on.
So we'll keep going as we do until one or both of us dies or really goes off on the crazy train. At which point I think it's time to "exit with dignity" anyway.

I like the idea of a binder with all the important information about assets, locations, passwords, ect. We'll probably just set something with the a lawyer that specializes in estate planning and have them liquidate it all and donate to various charities.

RedmondStash

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Re: Preparing for senility?
« Reply #9 on: November 09, 2017, 09:11:30 AM »
Thanks, everyone. Some good thoughts here.

GuitarStv

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Re: Preparing for senility?
« Reply #10 on: November 09, 2017, 09:41:59 AM »
I've been planning to do a power of attorney thing with my son when he and I are old enough.

Catbert

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Re: Preparing for senility?
« Reply #11 on: November 09, 2017, 11:53:52 AM »
Similar situation although I do have sisters and nieces and nephews.  I was a teenager when my last sister was born.  Luckily for me she lives in the area and could be counted on for arranging support as needed.  I wouldn't expect her to actually pay bills or physically take care of me.   The only nieces/nephews in my area are only teenagers now so not sure if they would be a resource.  I have enough money to pay for needed services.

Im now in my 60s and DH in his 70s.  I take care of all the financial stuff from paying bills to determining asset allocation.  I've promised myself that when I turn 75 that I will turn over portfolio management to Fidelity.  Yeah, it'll cost us 1% or so, but better than me making hairbrained decisions as I get older.

We have POAs, wills, living trusts, etc.   I've just started a project of "what-to-do-if-your-wife-gets-hit-by-a-car-and-dies".   This is going to me a massive project.  It'll range from how to notify my pension to where to find passports and who can help in various areas.  I've already determined that I need to re-do my "filing" system because I've added categories along the way without rethinking the entire system.  For example, passports are in a file of "official documents."  But as we've traveled more other travel things  are kept elsewhere.  Makes more sense to keep all the travel stuff together. 

Dicey

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Re: Preparing for senility?
« Reply #12 on: November 09, 2017, 11:08:18 PM »
I know we like to think we'll be mentally sharp and physically hale until the very end, but has anyone planned for what to do regarding managing finances if their mind starts to slip? I've seen grandparents and one parent lose significant mental function, and even my memory is not what it once was. I want to have a plan in place for the eventuality of senility, dementia, etc., just in case.

No kids, no younger relatives to rely on. Just me and spouse, who is older than I am.

Similar situation but no spouse.  Early 50s here.

Preparations performed:  establish medical and financial power of attorney, will and living will, HIPAA statement that includes my sister (the chief POA holder) and her husband.  Asked close friend to serve as backup, included friend in all legal documents.  Discussed possibility of incapacity, verified mutual "I will manage your money on your behalf and monitor your caregivers" pact with Sis; legal docs are to support that.  Discussed scenarios with Sis and friend several times.  Evaluated scenario costs, included in cFiresim-style financial projections.  Verbally committed to periodic tests of mental acuity so that there are data to establish competence/incompetence.  Got baseline test of mental acuity done. 

Preparations still needed: Buy long term care insurance.
Great reply B_B! It sounds like you've made a lot of wise choices to prepare for your future. I am very curious about your last sentence. If you have no dependents, doesn't your 'stache serve as your LTC Insurance? I am having a very hard time with this decision, but I just don't see the value for the money spent. Most LTC policies are only good for a few years and pay only a fraction of the actual monthly cost. I'm not telling you what to do by any means. I'd just like to know more about your thought process on this pertinent issue.

Bicycle_B

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Re: Preparing for senility?
« Reply #13 on: November 10, 2017, 08:03:47 PM »
Hi, Dicey.  My thought process is based on having a skimpy minimalistic stash - perhaps ok for a hardy flexible person, but risky if my roll-with-it skills fade with age.  Also, family history of Alzheimer's.  Therefore:

Track 1, Alzheimers is Expensive - as long as my mind is sharp, I can scrape by.  Sure my 375-to-400k stash (450 but with some deferred house maintenance and planned insurance premiums now mentally deducted) leaves little margin for error, but I can deal with it.  I think I'm going to go increase it anyway through some further work, but if I fail, I can still make ends meet...unless Uncle Al Z Heimer butts in. 

At that point, my expenses will go up and so will my mistakes.  Sure the disease will prevent me from living too long, but an extra 100k to 150k might be needed.  Insurance would essentially trade tens of thousands in premiums for a payback+100k in time of need, providing just enough to pay for the likely cost of care as I estimate it.

Track 2, Thanks to Sis - my sister performed wonders and I moderately helped out in turning my Dad's adequate resources into good quality care during his Alzheimers.  We concluded that a competent advocate makes a big difference.  Our agreed principle in confirming that we will be each other's advocate if needed and able is that we will each take responsibility for providing the funds for our own care.  The advocate sibling's job will be to administrate funds and choose/supervise caretakers, not provide funds or daily hands-on work.  Buying an insurance policy will a) improve the odds of fulfilling my commitment to provide adequate funds, and b) demonstrate that I Really Tried The Best I Could.  Sis is hesitant about the scrape-by-on-400k plan, but will likely accept insurance as a substantial responsible effort.

Track 3, Mollify Pessimistic BIL - Sis's husband believes that my jobless life implies I will soon be broke and homeless.  My failure to find employment of note since 2013 clearly indicates that I must be planning to mooch off them by living in their house as soon as I do go broke.  Since invasion of his space greatly disturbs his treasured peace, this is his biggest fear and apparently troubles him a lot.  Sis believes an insurance policy will make him believe that maybe I mean it about paying my own way, and in any case reduce any rational fears.  Irrational fears we can't fix, but let's do our part to limit rational ones. 

4) Track 4, Because cFireSim and Responsibility - I hesitated to waste money on this at first, despite all the reasoning above, until I sat down to compare scenarios in cFireSim.  I hadn't become clear on the 100k part above when I sat down.  But when I looked up length of care data for Alzheimers, multiplied by cost of care data from experience, and included the costs to account for an Alzheimers scenario vs a non-Alzheimers one, I realized that getting the insurance made a difference even though it didn't change the overall odds of success. Based on a guess of 25% chance to suffer from Alzheimers (family details redacted), the main effect of insurance isn't to change the probability of financial failure, it's to shift the probability of failure from one scenario to another.  Without insurance, I have maybe a 4% chance of financial failure with sharp mind scenario (4 out of 75), 3% with Alzheimers (3 out of 25).  With insurance, financial failure with sharp mind jumped to 6%, but failure with Alzheimers dropped to 1 percent.  Either way it's about 7 percent total after including the Alzheimers expense the way I calculated it, but insurance means that my sister is protected while I take responsibility for managing the failure case.

Numbers for this last branch are still being firmed up as I get actual quotes.  Some of the scenario planning is more seat of the pants than it should be.  But now that I realize the responsibility effect of the insurance, and also realize that the responsibility shift is intuitively obvious to Sis and Hubby, I am hot on the trail of the insurance.  Base goal is insurance by Christmas, stretch goal insurance by Thanksgiving.
« Last Edit: November 10, 2017, 08:05:20 PM by Bicycle_B »

Apples

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Re: Preparing for senility?
« Reply #14 on: November 14, 2017, 02:17:33 PM »
I'm 26, so no plans for senility for myself yet.  This winter DH and I are getting our adulting acts together to get will/POA/health care directive type stuff put together.

My grandma is 83.  This past winter she got severely depressed and had psychosis.  She went downhill fast, and the pride of my grandparents hindered a quick response because they wouldn't admit a real problem.  The person who was most helpful was their housekeeper.  Because she was there for several hours every week and could see how functional or not my grandma really was.  Were the bills in a messy pile?  Was she cooking?  Did she have something for the housekeeper to do? My grandma was always on her best behavior when family visited - things tidied or put away in a drawer.  Having a non-family member (and thus a person who wasn't going to push my grandma to make responsible choices) stopping in every week was a great help in truly assessing the situation.  But also, now I pay their bills.  You can't put absolutely everything on autopilot.  And record keeping needs to be done by someone.  How will people without kids handle these things?

My grandpa is 84 (other side).  He is going to need full time nursing care soon.  His wife will never admit it.  It's going to take all of the kids' efforts to get him into nursing care.  If they didn't have kids, I have no idea if he'd ever get the nursing care, and probably be much more uncomfortable.  How do people out there without kids plan for this sort of thing?

For all of them, the big stuff (will/trust/POA/health directives) are done.  But so far it seems that other people need to be around to watch for signs of decline, and get them care.  I like the person who has a friend ready for this.  Kids are the obvious answer.  What else do people have planned?

RedmondStash

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Re: Preparing for senility?
« Reply #15 on: November 15, 2017, 08:37:27 AM »
But so far it seems that other people need to be around to watch for signs of decline, and get them care.  I like the person who has a friend ready for this.  Kids are the obvious answer.  What else do people have planned?

Yeah, I think this is at the core of my question. Spouse & I have no kids or family to take on this kind of responsibility. I don't have a lot of younger friends, none close enough to do something like this.

We're doing all the planning we can while our minds are sharp, but I want to be prepared for a day when we can no longer handle this stuff alone, and we don't have the traditional familiar buffers built in.

Thanks again, everyone, for your thoughts.

GardenBaker

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Re: Preparing for senility?
« Reply #16 on: November 15, 2017, 08:56:17 AM »
Posting to follow. DH and I are in a similar situation with no kids or younger relatives to depend on. This topic does worry me, but DH does not have a care in the world. I'm hoping as he ages, he will realize this is something that needs to be addressed and planned for.

CowboyAndIndian

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Re: Preparing for senility?
« Reply #17 on: November 15, 2017, 09:07:54 AM »
PTF

frugaldrummer

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Re: Preparing for senility?
« Reply #18 on: November 15, 2017, 03:00:48 PM »
Best defense is a good offense. In addition to the legal and financial planning above, I suggest anyone concerned about Alzheimer's read this book:
The End of Alzheimer's by Dale Bredesen M.D.

I've seen Dr. Bredesen lecture on this work over the last couple of years at medical conferences and it is truly groundbreaking. Basically, his approach is that by implementing a whole bunch of little interventions aimed at brain health and the disease process of Alzheimer's, he has been able to reverse mild to moderate Alzheimer's. The results are stunning - way better than any drug we have available  And for those of us who don't suffer from dementia yet - implementing many of these interventions should significantly reduce our risk of ever getting it.

This is not BS, he has accumulated a series of several hundred patients now, has brain scans and neuropsych testing to document improvements. He has patients who had to quit their jobs because of their dementia who were able to return to work. 

This book just came out at the end of August and is readily available at Barnes and Noble or Costco right now.

(One caveat - I wish he had summarized his recommendations in a more concise form because I know most people never finish a book. If you want to see his basic recommendations in a one page table go to Pubmed and look up his original published paper from 2014, it's in table 1 in that paper.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221920/    )

He's a serious neuroscience researcher, this is not BS.  It's revolutionary but because there is no one drug for the pharmaceutical industry to profit from, it will take years to become standard of care.  You heard it here first.

lexde

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Re: Preparing for senility?
« Reply #19 on: November 16, 2017, 09:05:25 AM »
PTF


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marion10

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Re: Preparing for senility?
« Reply #20 on: November 16, 2017, 09:58:03 AM »
Probably not mustachian- but if you are single or a couple with no children and have significant assets then buying into a CCR (Continuing Care Retirement Community) is the way to go. You want something that has a spectrum from independent living to skilled nursing, you basically buy in and have care for the rest of your life.

Bicycle_B

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Re: Preparing for senility?
« Reply #21 on: November 16, 2017, 10:40:36 AM »
Best defense is a good offense. In addition to the legal and financial planning above, I suggest anyone concerned about Alzheimer's read this book:
The End of Alzheimer's by Dale Bredesen M.D.

I've seen Dr. Bredesen lecture on this work over the last couple of years at medical conferences and it is truly groundbreaking. Basically, his approach is that by implementing a whole bunch of little interventions aimed at brain health and the disease process of Alzheimer's, he has been able to reverse mild to moderate Alzheimer's. The results are stunning - way better than any drug we have available  And for those of us who don't suffer from dementia yet - implementing many of these interventions should significantly reduce our risk of ever getting it.

This is not BS, he has accumulated a series of several hundred patients now, has brain scans and neuropsych testing to document improvements. He has patients who had to quit their jobs because of their dementia who were able to return to work. 

This book just came out at the end of August and is readily available at Barnes and Noble or Costco right now.

(One caveat - I wish he had summarized his recommendations in a more concise form because I know most people never finish a book. If you want to see his basic recommendations in a one page table go to Pubmed and look up his original published paper from 2014, it's in table 1 in that paper.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221920/    )

He's a serious neuroscience researcher, this is not BS.  It's revolutionary but because there is no one drug for the pharmaceutical industry to profit from, it will take years to become standard of care.  You heard it here first.

Wow.

Followed the link.  Impressive possibilities.

 

Wow, a phone plan for fifteen bucks!