Impending Alzheimer’s: what would be your investment for life?

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BigDrop
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Impending Alzheimer’s: what would be your investment for life?

Post by BigDrop »

A number of years ago I saw this topic on a similar message board. There were hundreds of responses and I read everyone over and over. Now, 74, it seems timely to introduce it to this board for comments.

If you knew that you would not be able to make any future investments because of illness and your wife/partner had no interest and no knowledge in overseeing your accounts snd, most important, you don’t trust any financial analyst to make a decision either-what would you do with your money?

How would you invest it knowing it may literally be the last investment?

Assume, say $2 million. Perhaps another 100k per year in pensions and social security. And both 74 years old.

Where would you invest your money knowing the decision will have to carry you both for the rest of your lives? This could possibly include the need for income for assisted living for an indeterminate period of time.

I raise this now because of interest rates, the fear of inflation and a stock market at an all time high.

I look forward to others’ thoughts.
Last edited by BigDrop on Sun Jun 20, 2021 7:59 pm, edited 2 times in total.
Gill
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by Gill »

I would leave it just as is.
Gill
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arcticpineapplecorp.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by arcticpineapplecorp. »

what responses would be different this time than on the "similar message board" from before?

did those messages not take inflation, interest rates and stock market at an all time high into consideration?

we'd need more info before you get any quality answers.

we don't know if they need to withdraw any of the money or their pensions and SS cover living expenses.

we don't know what their legacy needs are.

we don't know their marginal tax rate.

and so on.

if you care to post the details, then you'll get some good answers:

viewtopic.php?t=6212
It's hard to accept the truth when the lies were exactly what you wanted to hear. Investing is simple, but not easy. Buy, hold & rebalance low cost index funds & manage taxable events.
TheDDC
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by TheDDC »

BigDrop wrote: Sun Jun 20, 2021 7:53 pm A number of years ago I saw this topic on a similar message board. There were hundreds of responses and I read everyone over and over. Now, 74, it seems timely to introduce it to this board for comments.

If you knew that you would not be able to make any future investments because of illness and your wife/partner had no interest and no knowledge in overseeing your accounts snd, most important, you don’t trust any financial analyst to make a decision either-what would you do with your money?

Assume, say $2 million. Perhaps another 100k per year in pensions and social security. And both 74 years old.

Where would you invest your money knowing the decision will have to carry you both for the rest of your lives? This could possibly include the need for income for assisted living for an indeterminate period of time.

I raise this now because of interest rates, the fear of inflation and a stock market at an all time high.

I look forward to others’ thoughts.
I would continue to leave it at 100/0 on autopilot and maybe not reinvest dividends.

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Rules to wealth building: 75-80% VTSAX piled high and deep, 20-25% VTIAX, 0% given away to banks, minimize amount given to medical-industrial complex
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by jebmke »

I wouldn't change anything. Ours is now on automatic. Worst case, spouse would drag her feet on re-balancing into equity in a down market but she'd be fine either way.
When you discover that you are riding a dead horse, the best strategy is to dismount.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by stan1 »

With $100K in SS and pensions plus interest/dividends and RMDs I expect a lot of end of life expenses for you and your wife will be covered from income sources.

Do you have a child, younger sibling, nephew, or niece who could assist with taxes and some finances? Maybe this person also might already be named as the executor of your estate.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by tj »

BigDrop wrote: Sun Jun 20, 2021 7:53 pm A number of years ago I saw this topic on a similar message board. There were hundreds of responses and I read everyone over and over. Now, 74, it seems timely to introduce it to this board for comments.

If you knew that you would not be able to make any future investments because of illness and your wife/partner had no interest and no knowledge in overseeing your accounts snd, most important, you don’t trust any financial analyst to make a decision either-what would you do with your money?

How would you invest it knowing it may literally be the last investment?

Assume, say $2 million. Perhaps another 100k per year in pensions and social security. And both 74 years old.

Where would you invest your money knowing the decision will have to carry you both for the rest of your lives? This could possibly include the need for income for assisted living for an indeterminate period of time.

I raise this now because of interest rates, the fear of inflation and a stock market at an all time high.

I look forward to others’ thoughts.
If i continued to have 0 heirs, I'd probably just buy SPIA's or Charitable Gift Annuity and be done with it.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by Callisto »

My plan once I get (much) older is to buy a cushion of SPIAs. It ensures you do not prematurely run out of money before death, protects yourself from bad financial decisions made due to mental deterioration, and can be configured to easily pass to your spouse upon your death.

For all of these benefits you'd be looking at normally near zero real returns, and in the current climate, possibly even slightly negative. But at some point, I think its just irresponsible and greedy to try for more growth. Fortunately, you seem to have enough to shift gears into wealth preservation mode.
DangerDad
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by DangerDad »

I’m curious about the impending Alzheimer’s.
Is this something that you personally anticipate?
Or just interested as a hypothetical?

Cheers,
DangerDad
neowiser
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by neowiser »

Personally, I would dive into research on assisted care facilities and speak in depth with their consultants to determine financial entry and maintenance requirements. Some high quality continuing care facilities require a buy in of hundreds of thousands of dollars, in addition to monthly fees. Some of the cost is tax deductible since the care is medically necessary.

My mom was in assisted “memory” care for 5 years, and her expenses were covered by a small pension, interest payments from charitable annuities, RMD from an IRA and rental income from her former residence. The rental income alone covered half of her expenses.

A high quality facility provides the best care for Alzheimer’s patients, with continuous entertainment and social interaction. Friends (and family) fall away quickly when they realize they aren’t recognized.
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BigDrop
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by BigDrop »

DangerDad wrote: Sun Jun 20, 2021 8:51 pm I’m curious about the impending Alzheimer’s.
Is this something that you personally anticipate?
Or just interested as a hypothetical?

Cheers,
DangerDad
Hypothetical but sincere appreciation for asking. But that was the reason given on the board several years ago.
stan1
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by stan1 »

For someone with $100K/year in SS/pension income and $2M in assets a comfortable even near luxury CCRC is in reach if one wanted to do that. It doesn't take all the potential challenges away but it does create a support system (albeit one that comes at a cost).
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BigDrop
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by BigDrop »

neowiser wrote: Sun Jun 20, 2021 8:57 pm Personally, I would dive into research on assisted care facilities and speak in depth with their consultants to determine financial entry and maintenance requirements. Some high quality continuing care facilities require a buy in of hundreds of thousands of dollars, in addition to monthly fees. Some of the cost is tax deductible since the care is medically necessary.

My mom was in assisted “memory” care for 5 years, and her expenses were covered by a small pension, interest payments from charitable annuities, RMD from an IRA and rental income from her former residence. The rental income alone covered half of her expenses.

A high quality facility provides the best care for Alzheimer’s patients, with continuous entertainment and social interaction. Friends (and family) fall away quickly when they realize they aren’t recognized.
Interesting. There are “resort like” care facilities that charge, say $500,000 for a 1200 square foot two bedroom apartment + approx. $4,000 a month + nursing and medical assistance. 90% of the $500k is returned if you
leave or pass (returned to heirs if any or charity). This can become even more expensive depending on the amount of additional care. Then there are medical bills on top of this. And the cost of living. (One meal each is included in the four.)

My wife and I are in reasonably good health but there are considerations we find as we grow older that we never thought about before.
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BigDrop
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by BigDrop »

As I type this the ten year yield has fallen to 1.40% and the 30 year is 1.98%. Futures are down more than 200 points ahead of tomorrow’s opening.

It is a very real consideration of how to invest one’s money coming out of the pandemic. And a real concern for inflation. Especially at our age (74-I no longer buy wine with the intention of drinking it ten years later…).

FWIW the market fell 45% in 2008. Even buying BND could result in a 5 to 10% or more loss depending on inflation. Annuities are interesting but I suspect I should have committed when interest rates were higher.

Thanks to everyone for their comments.
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BrandonBogle
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by BrandonBogle »

BigDrop wrote: Sun Jun 20, 2021 9:23 pm
DangerDad wrote: Sun Jun 20, 2021 8:51 pm I’m curious about the impending Alzheimer’s.
Is this something that you personally anticipate?
Or just interested as a hypothetical?

Cheers,
DangerDad
Hypothetical but sincere appreciation for asking. But that was the reason given on the board several years ago.
This subject terrifies me. Almost every member of my parents' families eventually passed from Alzheimers, though my mother's side seems to not really have much of an issue with until their late 70s. I lost my dad to it last year. No siblings and single, so planning ahead would be key for me. Over the last few years, there were a handful of times that I actually felt lost in my city, briefly forgetting where I was -- like I knew where I was going, but for a few seconds I had absolutely no clue where I was, even on streets I travel often. How do I prepare for my own mental health declines and I am not able to manage my non-Bogleheads finances. Sure, leave everything in Vanguard Total US + Total Int + Total Bond, but what about managing RMDs, paying the bills, reviewing credit card charges, that kind of stuff.

As I said, a subject that truly terrifies me.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by lazynovice »

BrandonBogle wrote: Sun Jun 20, 2021 10:34 pm
BigDrop wrote: Sun Jun 20, 2021 9:23 pm
DangerDad wrote: Sun Jun 20, 2021 8:51 pm I’m curious about the impending Alzheimer’s.
Is this something that you personally anticipate?
Or just interested as a hypothetical?

Cheers,
DangerDad
Hypothetical but sincere appreciation for asking. But that was the reason given on the board several years ago.
This subject terrifies me. Almost every member of my parents' families eventually passed from Alzheimers, though my mother's side seems to not really have much of an issue with until their late 70s. I lost my dad to it last year. No siblings and single, so planning ahead would be key for me. Over the last few years, there were a handful of times that I actually felt lost in my city, briefly forgetting where I was -- like I knew where I was going, but for a few seconds I had absolutely no clue where I was, even on streets I travel often. How do I prepare for my own mental health declines and I am not able to manage my non-Bogleheads finances. Sure, leave everything in Vanguard Total US + Total Int + Total Bond, but what about managing RMDs, paying the bills, reviewing credit card charges, that kind of stuff.

As I said, a subject that truly terrifies me.
Could you designate a corporate trustee? Not sure if Vanguard is quite full service enough but maybe? The key would be knowing when to turn it over.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by Dale_G »

I am 84 and already in cognitive decline. For example, I can no longer multiply random 3 digit numbers in my head - except for the easy ones. :D
The easy ones contain 0, 1, 2, and 5 - but for some reason I am adverse to a bunch of 7s. :(

But the portfolio can be left exactly as it is: 70% domestic and international indexed equities and 30% bonds across the yield curve and risk spectrum. The weighted duration is 7.5 years - which approximates my own duration.

Hopefully, whoever disburses money from the portfolio is smart enough to do it in a tax efficient manner. Otherwise, everything is good to go.

Dale
Last edited by Dale_G on Sun Jun 20, 2021 11:19 pm, edited 1 time in total.
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BigDrop
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by BigDrop »

BrandonBogle wrote: Sun Jun 20, 2021 10:34 pm
BigDrop wrote: Sun Jun 20, 2021 9:23 pm
DangerDad wrote: Sun Jun 20, 2021 8:51 pm I’m curious about the impending Alzheimer’s.
Is this something that you personally anticipate?
Or just interested as a hypothetical?

Cheers,
DangerDad
Hypothetical but sincere appreciation for asking. But that was the reason given on the board several years ago.
This subject terrifies me. Almost every member of my parents' families eventually passed from Alzheimers, though my mother's side seems to not really have much of an issue with until their late 70s. I lost my dad to it last year. No siblings and single, so planning ahead would be key for me. Over the last few years, there were a handful of times that I actually felt lost in my city, briefly forgetting where I was -- like I knew where I was going, but for a few seconds I had absolutely no clue where I was, even on streets I travel often. How do I prepare for my own mental health declines and I am not able to manage my non-Bogleheads finances. Sure, leave everything in Vanguard Total US + Total Int + Total Bond, but what about managing RMDs, paying the bills, reviewing credit card charges, that kind of stuff.

As I said, a subject that truly terrifies me.
I wish you the absolute best. I’ve had two close friends who passed with dimentia. This was a hard slap of reality for us.
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BigDrop
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by BigDrop »

Dale_G wrote: Sun Jun 20, 2021 10:49 pm I am 84 and already in cognitive decline. For example, I can no longer multiply random 3 digit numbers in my head - except for the easy ones. :D
The easy ones contain 0, 1, 2, and 5 - but for some reason I am adverse to a bunch of 7s. :(

But the portfolio can be left exactly as it is: 70% domestic and international indexed equities and 30% bonds across the yield curve and risk spectrum. The weighted duration is 7.5 years - which approximates my own duration.

Hopefully, whoever disburses money from the portfolio is smart enough to do it in a tax efficient manner. Otherwise, everything is good to go.

Dale
Thank you, Dale. Appreciate your comments and wish you the absolute best.

About a third of our current investments are in Vanguard Wellesley. I may leave this alone.
Last edited by BigDrop on Sun Jun 20, 2021 11:03 pm, edited 2 times in total.
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BrandonBogle
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by BrandonBogle »

BigDrop wrote: Sun Jun 20, 2021 10:58 pm
BrandonBogle wrote: Sun Jun 20, 2021 10:34 pm
BigDrop wrote: Sun Jun 20, 2021 9:23 pm
DangerDad wrote: Sun Jun 20, 2021 8:51 pm I’m curious about the impending Alzheimer’s.
Is this something that you personally anticipate?
Or just interested as a hypothetical?

Cheers,
DangerDad
Hypothetical but sincere appreciation for asking. But that was the reason given on the board several years ago.
This subject terrifies me. Almost every member of my parents' families eventually passed from Alzheimers, though my mother's side seems to not really have much of an issue with until their late 70s. I lost my dad to it last year. No siblings and single, so planning ahead would be key for me. Over the last few years, there were a handful of times that I actually felt lost in my city, briefly forgetting where I was -- like I knew where I was going, but for a few seconds I had absolutely no clue where I was, even on streets I travel often. How do I prepare for my own mental health declines and I am not able to manage my non-Bogleheads finances. Sure, leave everything in Vanguard Total US + Total Int + Total Bond, but what about managing RMDs, paying the bills, reviewing credit card charges, that kind of stuff.

As I said, a subject that truly terrifies me.
I wish you the absolute best. I’ve had two close friends who passed with dimentia. This was a hard slap of reality for us.
Thank you! At mid-30s I didn't think I would be thinking of this stuff, but 2020. Enough said? :shock:
esteen
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by esteen »

I think it would be a mix of a SPIA and a 3-fund portfolio. What the exact AA would be would depend on how much money (how many multiples of my expenses) I had at the time. I'm far from retirement at this point so my nest egg value at a time when I need to worry about Alzheimer's is quite far away and unclear.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by Gnirk »

OP, I understand your question, and I am interested in the answers. At almost 77 I have similar concerns, and with good reason. My mom died at age 90 from Alzheimer’s disease, after suffering from it for 12 year, 8 of those years in a private care home. Several of her aunts also died of AD after suffering for 20 years.
I personally have a small pension and very modest SS income. My investments, 95% in taxable, are about 40% equities, 10% cash, and 50 % muni funds ( due to my husband’s income) and married filing jointly. Because we have kept our investments separate ( second marriage) I will need my assets to pay for any Long Term Care I may need.

At this point, I have enough to cover 10 years of long term care, and wonder if I should be more conservative at 30/60/10?
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by anoop »

lazynovice wrote: Sun Jun 20, 2021 10:43 pm
BrandonBogle wrote: Sun Jun 20, 2021 10:34 pm
BigDrop wrote: Sun Jun 20, 2021 9:23 pm
DangerDad wrote: Sun Jun 20, 2021 8:51 pm I’m curious about the impending Alzheimer’s.
Is this something that you personally anticipate?
Or just interested as a hypothetical?

Cheers,
DangerDad
Hypothetical but sincere appreciation for asking. But that was the reason given on the board several years ago.
This subject terrifies me. Almost every member of my parents' families eventually passed from Alzheimers, though my mother's side seems to not really have much of an issue with until their late 70s. I lost my dad to it last year. No siblings and single, so planning ahead would be key for me. Over the last few years, there were a handful of times that I actually felt lost in my city, briefly forgetting where I was -- like I knew where I was going, but for a few seconds I had absolutely no clue where I was, even on streets I travel often. How do I prepare for my own mental health declines and I am not able to manage my non-Bogleheads finances. Sure, leave everything in Vanguard Total US + Total Int + Total Bond, but what about managing RMDs, paying the bills, reviewing credit card charges, that kind of stuff.

As I said, a subject that truly terrifies me.
Could you designate a corporate trustee? Not sure if Vanguard is quite full service enough but maybe? The key would be knowing when to turn it over.
I think you can, but it is pricey. They start taking a % of assets from the time they are designated, not from the time when they actually start to execute.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by bikechuck »

Callisto wrote: Sun Jun 20, 2021 8:42 pm My plan once I get (much) older is to buy a cushion of SPIAs. It ensures you do not prematurely run out of money before death, protects yourself from bad financial decisions made due to mental deterioration, and can be configured to easily pass to your spouse upon your death.

For all of these benefits you'd be looking at normally near zero real returns, and in the current climate, possibly even slightly negative. But at some point, I think its just irresponsible and greedy to try for more growth. Fortunately, you seem to have enough to shift gears into wealth preservation mode.
I plan to buy some SPIAS as well with 25 to 33 percent of my portfolio. However I am in my upper 60s and I am not sure when to begin buying them. I do know that payouts will rise as I age and that they will rise if interest rates increase. That said, what age is ideal to begin purchasing them?
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by celia »

It might be harder to figure out what to do when one person comes down with it 20 years before the other. How do you keep from spending more than half your assets when the survivor might need the same care later on? Tough call for someone to make.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by BigDrop »

Good thread. Thank you to everyone for sharing.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by LadyGeek »

This thread is now in the Investing - Theory, News & General forum (general discussion).
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by finite_difference »

50/50 stocks and bonds. You’ll never be wrong. Maybe purchase an SPIA if you need it to help cover annual expenses.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by afan »

As others have suggested, the investment questions are a small part of the issue. The big problem is one would need a person or entity to manage their financial life. This includes mechanical processes such as paying bills. At a higher complexity level, who is going to decide it is time to move to an assisted living facility? Who is going to search for one and sign the contracts? Arrange moving? Determine how to fund the rest of one's life? When to withdraw more than RMD from tax deferred retirement plans, vs using taxable assets or Roth? Whether and if so how much to put in annuities?

High touch banks or trust companies acting as trustee will apparently do some of this but by no means all. As best I can tell, Vanguard will simply sit on an index fund portfolio and make scheduled distributions if someone else tells them when and how much. Not useful for someone with any kind of mental decline.

The person who is facing this future needs an engaged and knowledgeable individual who will serve as attorney in fact under a durable power of attorney. That same person, or someone else needs to be a healthcare proxy. If one has a person who will be engaged but who is not knowledgeable, then the holder of the DPOA should find a financial adviser who can provide the domain expertise. That adviser should not be paid by assets under management. Instead, they should charge per unit of work. Hourly works best for this type of situation where there may be ongoing need for advice. For one-time consultation, a flat fee may be an alternative.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by delamer »

Consolidate investments at one custodian. Maybe even establish banking functions — checking and credit cards — at the same place. This can be done at Fidelity or Schwab, and possibly elsewhere.

Set up automatic withdrawals for any RMDs. Choose an all-in-one fund that meets your needs, like one of the Vanguard LifeStrategy funds. Investment choices shouldn’t be made based in current conditions, but on long-range goals. Except for the very wealthy, any couple having to pay for an extended period of assisted-lving or skilled nursing care for one spouse while the other spouse is still living is likely to face financial challenges

Find a trusted local estates attorney who can provide guidance as needed. Make sure all end-of-life documents are prepared. In addition, find a CPA who can prepare taxes.

If there are adult children, bring them in on your planning. They can best help if they understand what resources are available.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by Angst »

bikechuck wrote: Mon Jun 21, 2021 4:19 am
Callisto wrote: Sun Jun 20, 2021 8:42 pm My plan once I get (much) older is to buy a cushion of SPIAs. It ensures you do not prematurely run out of money before death, protects yourself from bad financial decisions made due to mental deterioration, and can be configured to easily pass to your spouse upon your death.

For all of these benefits you'd be looking at normally near zero real returns, and in the current climate, possibly even slightly negative. But at some point, I think its just irresponsible and greedy to try for more growth. Fortunately, you seem to have enough to shift gears into wealth preservation mode.
I plan to buy some SPIAS as well with 25 to 33 percent of my portfolio. However I am in my upper 60s and I am not sure when to begin buying them. I do know that payouts will rise as I age and that they will rise if interest rates increase. That said, what age is ideal to begin purchasing them?
I cannot answer this question but I recall reading past threads that covered it and I think that one's early 80's might have been the ideal age. There may well have been quite a few caveats. One's life expectancy at any given time surely matters, as well as one's need for the peace of mind afforded through the purchase of an SPIA. With those past threads in mind, I've always assumed that I will eventually buy an SPIA but I figure I will re-evaluate when to buy sometime after I've entered my 70's.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by Angst »

Deleted duplicate post.
Last edited by Angst on Mon Jun 21, 2021 10:21 am, edited 1 time in total.
Colorado Guy
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by Colorado Guy »

BigDrop wrote: Sun Jun 20, 2021 7:53 pm Impending Alzheimer's.....
Definitely understand the desire for financial preparations, and respect that desire.

In preparing for Alzheimer's or anything else, and no longer able to manage your finances, consider having your heirs take POA, with instructions (prepared for today) that will both keep your finances in order as well as maximize their eventual inheritance.

As a corollary, the understanding about Alzheimer's has grown quite a bit recently, providing me hope that it is not inevitable. Without diving into health related advice, you owe it to yourself to spend time now on what preventative actions one can take to decrease their chances of getting this or other health related issues. You may find that quite revealing.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by Toons »

As Others
Stay The Course


:D
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by neowiser »

BigDrop wrote: Sun Jun 20, 2021 9:42 pm
neowiser wrote: Sun Jun 20, 2021 8:57 pm Personally, I would dive into research on assisted care facilities and speak in depth with their consultants to determine financial entry and maintenance requirements. Some high quality continuing care facilities require a buy in of hundreds of thousands of dollars, in addition to monthly fees. Some of the cost is tax deductible since the care is medically necessary.

My mom was in assisted “memory” care for 5 years, and her expenses were covered by a small pension, interest payments from charitable annuities, RMD from an IRA and rental income from her former residence. The rental income alone covered half of her expenses.

A high quality facility provides the best care for Alzheimer’s patients, with continuous entertainment and social interaction. Friends (and family) fall away quickly when they realize they aren’t recognized.
Interesting. There are “resort like” care facilities that charge, say $500,000 for a 1200 square foot two bedroom apartment + approx. $4,000 a month + nursing and medical assistance. 90% of the $500k is returned if you
leave or pass (returned to heirs if any or charity). This can become even more expensive depending on the amount of additional care. Then there are medical bills on top of this. And the cost of living. (One meal each is included in the four.)

My wife and I are in reasonably good health but there are considerations we find as we grow older that we never thought about before.
One thing I realized in my mom's case is that her geographic location became irrelevant after the first year when almost all friends and most family stopped visiting. We opted to keep her in her HCOLA so she could be near friends and live in the same town she had lived in for 30 years. It was very difficult to find good caregivers because the cost of living was so high that few could afford to live in the area. We finally gave up on the idea of keeping in her home and moved her to an expensive facility. Although her facility was good, she did not appreciate or benefit from the resort like environment since she had no autonomy to enjoy the amentities. A better decision would have been to move her to a facility near family members who could oversee the day to day care she received.

At some point I would like to do a nationwide search of assisted care facilities. The quality of staff and affordability are much more important that than geographic location when one is primarily confined to a small living area.
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LilyFleur
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by LilyFleur »

anoop wrote: Mon Jun 21, 2021 12:23 am
lazynovice wrote: Sun Jun 20, 2021 10:43 pm
BrandonBogle wrote: Sun Jun 20, 2021 10:34 pm
BigDrop wrote: Sun Jun 20, 2021 9:23 pm
DangerDad wrote: Sun Jun 20, 2021 8:51 pm I’m curious about the impending Alzheimer’s.
Is this something that you personally anticipate?
Or just interested as a hypothetical?

Cheers,
DangerDad
Hypothetical but sincere appreciation for asking. But that was the reason given on the board several years ago.
This subject terrifies me. Almost every member of my parents' families eventually passed from Alzheimers, though my mother's side seems to not really have much of an issue with until their late 70s. I lost my dad to it last year. No siblings and single, so planning ahead would be key for me. Over the last few years, there were a handful of times that I actually felt lost in my city, briefly forgetting where I was -- like I knew where I was going, but for a few seconds I had absolutely no clue where I was, even on streets I travel often. How do I prepare for my own mental health declines and I am not able to manage my non-Bogleheads finances. Sure, leave everything in Vanguard Total US + Total Int + Total Bond, but what about managing RMDs, paying the bills, reviewing credit card charges, that kind of stuff.

As I said, a subject that truly terrifies me.
Could you designate a corporate trustee? Not sure if Vanguard is quite full service enough but maybe? The key would be knowing when to turn it over.
I think you can, but it is pricey. They start taking a % of assets from the time they are designated, not from the time when they actually start to execute.
But if you have cognitive decline, you could lost a lot more than that. I guess the trick is to select your corporate trustee, and then designate them right when you need them. That is what happened with one of my parents. This parent was exceptionally bright and a CFP and ended up falling for a scam over the telephone. The corporate trustee saved her from herself and made sure all the bills were paid and did her investing. We kept her independent and in her own home as long as we could.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by reln »

BigDrop wrote: Sun Jun 20, 2021 7:53 pm A number of years ago I saw this topic on a similar message board. There were hundreds of responses and I read everyone over and over. Now, 74, it seems timely to introduce it to this board for comments.

If you knew that you would not be able to make any future investments because of illness and your wife/partner had no interest and no knowledge in overseeing your accounts snd, most important, you don’t trust any financial analyst to make a decision either-what would you do with your money?

How would you invest it knowing it may literally be the last investment?

Assume, say $2 million. Perhaps another 100k per year in pensions and social security. And both 74 years old.

Where would you invest your money knowing the decision will have to carry you both for the rest of your lives? This could possibly include the need for income for assisted living for an indeterminate period of time.

I raise this now because of interest rates, the fear of inflation and a stock market at an all time high.

I look forward to others’ thoughts.
Hire a financial advisor (ie, vanguard personal advisor service).
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midareff
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by midareff »

Wellington International... or Balanced International

one and done.
Scooter57
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by Scooter57 »

I would argue strongly AGAINST hiring a Vanguard Advisor for a person with Alzheimers because they are only one step above Robo and won't help with some of the very difficult financial issues that arise.

Dementia comes on gradually and the worst financial problems occur BEFORE the person is certified as not being competent to manage their affairs. This is the point when huge checks are written to swindlers by people who used to be highly paid executives, professors, etc. Unless someone is watching that bank account, you might be bled dry before you even noticed.

A spouse may hide how bad things have gotten because they fear being "put in a home." This is not uncommon. The person with declining facilities may become paranoid and decide that the financial advisor is not to be trusted and end the relationship without telling the spouse. Etc. Etc.

So if you are going to have an advisor I highly recommend paying someone local who will build a relationship with the elders, check on them, keep an eye on the cash balances, etc.

I echo what was said earlier by another poster. If dementia is likely, you need to get into one of the limited number of assisted living facilities that has continual care through dementia and an on site nursing home. Many "nice" assisted living facilities will throw out an elder as soon as they start falling or showing obvious symptoms of dementia. I learned that the fanciest ones in my region did this, exporting the confused elders to a disgusting nursing home after taking $$$$ while they were still in fine health. When a parent became demented I was lucky enough to find a continual care facility across the state line that had continuous care, let the people live in single rooms with their own furniture and compassionate staff and provided 24/7 nursing.

But even then, you have a problem where huge profit hungry corporations and REITs are buying up all the smaller assisted living facilities. The wonderful one we found is now owned by a large, financially troubled company, not the local chain that owned it when we had to rely on it. Another good facility near us which used to have on site lifetime care so a couple where one person was demented could still spend time together every day if one was in the dementia facility moved their dementia facility 35 miles away. This was one of those places where you pay a huge multi-hundred thousand buy in not all of which is refundable if you leave or die. The people who moved in expecting to age in place were screwed.

Getting back to the advisor issue: Dementia can take 5 to 10 years to kill someone and the costs of high quality care are exorbitant. You do NOT want most of your money at risk in stocks if you are going to need $200K a year or more for the care of a couple who could linger on for 10 years. Given that we have a huge bulge of population about to hit the "dementia" years (80 and above) the chances are that quality dementia care is going to cost far far more than it does now due to the lack of beds.

Also, avoid falling for the fantasy that you can hire carers and stay in your home when you become incompetent unless a child or someone with very good cognition is living in that home. Even then it is very dicey. If you hire people and don't keep a close eye on them you may suffer abuse, be robbed, be terrorized into writing big checks, etc, etc. If you do keep a close eye, abuse can still happen and you have the problem that poorly paid carers will quit without warning leaving the demented person alone.

So with all this in mind, a financial advisor you choose should be one who is aware of these kinds of issues and focusses on preserving your capital to cover worst cases, not someone who applies a boilerplate allocation to your finances (a la Vanguard PAS). And you must find someone to keep an eye on the advisor, too, if you don't have children or other close relatives you trust. We had a decent advisor who was very helpful in the early stages of dementia. But their 100 year old firm was bought out by a large, incompetent investment bank who fired the quality staff, replaced them with people working off scripts, and did a poor job managing the finances for the same high fee. We children didn't know enough to deal with this because we were not familiar with Advisors etc back then.

So if you have some friend or relative who is reliable, or failing that, a local lawyer you trust, give them some kind of supervisory power in case your advisor gets bought out or changes how they operate.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by garlandwhizzer »

In that situation, impending AD, it is critical that you identify someone in charge of financial matters who is competent in financial decision making and, more importantly, a fiduciary whom you can absolutely trust to put your interests and your financial welfare ahead of their own financial self-interest. That is a very difficult ask full of risk and the solution must be arrived at before you lose sufficient competence to make a rational choice. Personally, I have serious potential reservations about all choices: spouses, relatives, lawyers, accountants, so called fiduciary financial advisors, etc.. There are the ethically good and the swindlers in all these categories and separating the two can be very challenging. The elderly are easy targets for financial sharks be they blood relatives or "financial professionals." There are no set simple answers to this problem that work for all.

Each of us facing this situation has to consider his/her own personal circumstances and choose as wisely as possible. The goal is not perfection but to limit serious damage. If you're not accustomed to making big financial decisions on your own, its even more challenging which is one reason why it's a good idea in my opinion to gather a lot of experience managing your own finances and investments during your investing career.

There are high end retirement homes that charge a massive up front fixed fee when you enter to care for you as long as you live whatever happens including dementia and all other health issues. That can manage your needs for food, shelter, and medical care very nicely for life. It's very expensive but for some it's worth it. It can take care of you but it does not manage and optimize your portfolio. For that you have to find someone with what appears to be a rare combination-- financial skill and knowledge plus scrupulous honesty and extremely high ethics, someone completely unwilling to take advantage of your vulnerability. Many so called fiduciary financial advisors do not live up to their lofty advertisements.

Good luck.

Garland Whizzer
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by NiceUnparticularMan »

Putting everything into a trust with a conservative choice of professional trustee would be an option. They can be a bit expensive--I think around 1% a year?--but that might be your best bet.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by Makefile »

Something that hasn't been mentioned is the ability to add a "trusted contact" to your account. They have no authority to act on it, but it's just someone the firm has the right to notify if something doesn't smell right with your account activity, if you call in wanting to wire everything to a foreign country, etc. Because they have only been around since 2018, anyone with an account older than that may have never been asked to add one yet.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by esteen »

NiceUnparticularMan wrote: Mon Jun 21, 2021 1:46 pm Putting everything into a trust with a conservative choice of professional trustee would be an option. They can be a bit expensive--I think around 1% a year?--but that might be your best bet.
I haven't sought them out myself, but I heard 1.25% on average, up to 1% for the money management plus .25-.50% for the other trustee duties. To be fair I heard it on a podcast interview, and I can't remember whether it was Rick Ferri's Bogleheads on Investing, or Morningstar's The Longview. So... 2nd (3rd?) hand information.

But I agree that unless you have a perfect personal candidate, and they are okay with being selected trustee, in this particular situation it'd be worth going with a professional trustee.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by achillesheel »

esteen wrote: Mon Jun 21, 2021 1:54 pm
NiceUnparticularMan wrote: Mon Jun 21, 2021 1:46 pm Putting everything into a trust with a conservative choice of professional trustee would be an option. They can be a bit expensive--I think around 1% a year?--but that might be your best bet.
I haven't sought them out myself, but I heard 1.25% on average, up to 1% for the money management plus .25-.50% for the other trustee duties. To be fair I heard it on a podcast interview, and I can't remember whether it was Rick Ferri's Bogleheads on Investing, or Morningstar's The Longview. So... 2nd (3rd?) hand information.

But I agree that unless you have a perfect personal candidate, and they are okay with being selected trustee, in this particular situation it'd be worth going with a professional trustee.
It was on Rick Ferri's podcast, I believe. I'm not sure which episode, however.
George Carlin: “You know how dumb the average person is? Just remember, half of us are even dumber than that.”
esteen
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by esteen »

achillesheel wrote: Mon Jun 21, 2021 1:59 pm
esteen wrote: Mon Jun 21, 2021 1:54 pm
NiceUnparticularMan wrote: Mon Jun 21, 2021 1:46 pm Putting everything into a trust with a conservative choice of professional trustee would be an option. They can be a bit expensive--I think around 1% a year?--but that might be your best bet.
I haven't sought them out myself, but I heard 1.25% on average, up to 1% for the money management plus .25-.50% for the other trustee duties. To be fair I heard it on a podcast interview, and I can't remember whether it was Rick Ferri's Bogleheads on Investing, or Morningstar's The Longview. So... 2nd (3rd?) hand information.

But I agree that unless you have a perfect personal candidate, and they are okay with being selected trustee, in this particular situation it'd be worth going with a professional trustee.
It was on Rick Ferri's podcast, I believe. I'm not sure which episode, however.
I love his podcast! Thank you Rick Ferri (if you happen to read this)!
delamer
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by delamer »

garlandwhizzer wrote: Mon Jun 21, 2021 1:39 pm In that situation, impending AD, it is critical that you identify someone in charge of financial matters who is competent in financial decision making and, more importantly, a fiduciary whom you can absolutely trust to put your interests and your financial welfare ahead of their own financial self-interest. That is a very difficult ask full of risk and the solution must be arrived at before you lose sufficient competence to make a rational choice. Personally, I have serious potential reservations about all choices: spouses, relatives, lawyers, accountants, so called fiduciary financial advisors, etc.. There are the ethically good and the swindlers in all these categories and separating the two can be very challenging. The elderly are easy targets for financial sharks be they blood relatives or "financial professionals." There are no set simple answers to this problem that work for all.

Each of us facing this situation has to consider his/her own personal circumstances and choose as wisely as possible. The goal is not perfection but to limit serious damage. If you're not accustomed to making big financial decisions on your own, its even more challenging which is one reason why it's a good idea in my opinion to gather a lot of experience managing your own finances and investments during your investing career.

There are high end retirement homes that charge a massive up front fixed fee when you enter to care for you as long as you live whatever happens including dementia and all other health issues. That can manage your needs for food, shelter, and medical care very nicely for life. It's very expensive but for some it's worth it. It can take care of you but it does not manage and optimize your portfolio. For that you have to find someone with what appears to be a rare combination-- financial skill and knowledge plus scrupulous honesty and extremely high ethics, someone completely unwilling to take advantage of your vulnerability. Many so called fiduciary financial advisors do not live up to their lofty advertisements.

Good luck.

Garland Whizzer
My experience based in my mother is that the CCRC model means your basic day-to-day needs are met in terms of the activities of daily living — eating, toileting, bathing, administering medications, transportation to health providers. And there is a medical director who monitors residents’ health care needs and they have occupational/physical therapists available.

But, for instance, when my demented mother needed to see a specialist, they arranged the transportation but I had to pay a 3rd party home aide to actually go with her and help her navigate the appointment. (I lived out-of-state.) Not to mention, of course, that the staff doesn’t file or otherwise manage insurance claims.

The CCRC worked out pretty well for my mother, with me as her POA. I’d give the whole thing a B+ (cost aside). But it isn’t a panacea or a replacement for having someone to advocate for you. Finances and major medical issues will require other resources.
Last edited by delamer on Mon Jun 21, 2021 4:15 pm, edited 1 time in total.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by afan »

Just pointing out that many of the things you need will not be performed by a corporate trustee. They will manage the investments and make distributions either on a set schedule or when asked. I gather it will be an extra fee to pay bills, if they do it at all.

Vanguard told me they do not do bill pay. They said one could setup regular transfers to an account managed by someone else who would pay bills.

The corporate trustees will not help with caring for a demented old person. All they will do is some bookkeeping, tax preparation on the trust and those scheduled distributions. They will manage investments but if all your holdings are in a handful of index funds there is nothing for them to do.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by afan »

I helped out one elderly person who went into a CCR . They had identified this place long before they needed it and bought in.years later started using it. They took great care of the person but they did not have anything to do with finances. It was very expensive but the person could afford it and they were happy with the place

I don't recall but I think it may have been a nonprofit, perhaps religious affiliated. Maybe that made it less likely to be bought out.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by ResearchMed »

For those without trusted family/friends, would a local Elder Affairs Agency perhaps have recommendations about such a service? There must be at least occasional others in this same situation (or those who end up there due to loss of the person providing that oversight).

It's very tricky, no question. One would be so very vulnerable, and in so many ways.

RM
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by delamer »

ResearchMed wrote: Mon Jun 21, 2021 3:48 pm For those without trusted family/friends, would a local Elder Affairs Agency perhaps have recommendations about such a service? There must be at least occasional others in this same situation (or those who end up there due to loss of the person providing that oversight).

It's very tricky, no question. One would be so very vulnerable, and in so many ways.

RM
What type of service, specifically?

They might be useful for suggestions for a bill-paying service, a CPA, home health care, or even an attorney.

But probably not for an investment advisor.
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