How to Plan for Unforeseen Health Challenges

How to build an estate planning strategy that can save you a great deal of pain and distress down the road.

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How to Plan for Unforeseen Health Challenges image

Older friends often tell me aging is not for the faint-hearted. They also tell me it can slip past you if you are not paying close attention. You may miss signs of memory loss or confusion — in yourself or in a loved one — that are clear as day to others. This can pose a particular challenge for estate planning.

Estate planning means more than taking care of personal money matters. It also means planning for unforeseen outcomes. No one wants to think about what will happen if we are diagnosed with Alzheimer’s or other types of dementia. But more than 5 million Americans have Alzheimer’s disease, a number expected to triple by 2050.


Terri Wilson is the Northwest Washington relationship manager at Koelsch Communities, a third-generation family business based in Olympia that operates memory care, assisted living, and independent living communities.

If you are concerned that Alzheimer’s, dementia, or other memory loss challenges may affect you or a loved one in the future, it is essential that it be accounted for in estate planning. Building a strategy now can save a great deal of pain and distress down the road.

The first step is considering how and where to live.

Many people assume they will continue to live with family as they age. But dementia and Alzheimer’s are progressive conditions, and the toll on caregivers and family members is both physical and emotional. Eventually, it can become overwhelming. Having a plan will make all the difference.

There are different kinds of care communities to consider. Assisted living, for example, offers burden-free living, committed caregivers and a supportive social environment. But as memory issues progress, it may be necessary to consider a higher level of care.

Dedicated memory care communities offer the comforts of assisted living and are carefully designed and staffed expressly for those living with memory care issues. This dedicated approach enables a focus on best practice care techniques and supportive environments that have advanced exponentially in recent years. Such communities successfully emphasize the dignity and personhood of each resident, centering on maintaining a high quality of life.

Sometimes family members have differing views on the best care options. A health care power of attorney is legally enforceable and can include decisions on where an individual will live. If signs of Alzheimer’s or dementia are already prevalent, you may consider an evaluation by a neuropsychologist to help determine executive function, capacity to make care choices and other competencies. In either case, working with a qualified lawyer is essential.

You will also need to determine what living with dementia will mean from a financial and legal perspective.

Some of these steps are straightforward, such as sorting out basic legal and financial documents, including your will, a living trust and advance directives. Regarding advanced directives, it is wise to consider both a financial power of attorney and medical power of attorney or medical proxy. Indeed, many lawyers advise against combining these two documents to ensure your moral, ethical and religious values are accounted for along with, but separate from legal and financial decisions.

One early step is to simplify finances by disentangling business and family income and assets. Most of us have multiple personal bank and investment accounts and multiple insurance providers as we get older. Now is the time to get these matters streamlined. If diagnosed with dementia, working with a trusted financial planner who can advise and work alongside you and your caregivers can help avoid ruinous mistakes. And if you are a business owner, it is important to develop a plan for either succession or the sale of your business in the event you are not able to oversee these important steps.

Finally, you will need to consider how to pay for getting the type of care needed. Long-term care insurance may come into play, and the sale of a business, investments or other assets may be necessary over time. Developing a plan with experts, such as lawyers, accountants, other advisers and a business’s leadership team is vital. As time progresses, working with a personal financial planner and a licensed geriatric care manager is crucial to making informed decisions about your plan.

No one wants to think about having to live with Alzheimer’s or other memory loss challenges. But it is never too early to plan what needs to happen should you be unable to decide for yourself. The time you take to plan now offers peace of mind for life in the future, however you want it to be lived.


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