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

Discuss all general (i.e. non-personal) investing questions and issues, investing news, and theory.
Chester Peake
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by Chester Peake »

Some of these topics are covered in "What to Do when I Get Stupid" by Lewis Mandell, PhD, Point White Publishing, ISBN 978-0-9897427-2-6, c 2013 -- I think that I got my copy through Amazon. Mandell was Dean of Business at SUNY Buffalo.
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by LadyGeek »

I removed a post and reply conjecturing on medical treatments intended to reverse the disease (medical advice). As a reminder, see: Medical Issues
Questions on medical issues are beyond the scope of the forum. If you are looking for medical information online, I suggest you start with the Medical Library Association's User's Guide to Finding and Evaluating Health Information on the Web which, in addition to providing guidance on evaluating health information, includes a list of their top recommended sites.
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Colorado Guy
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by Colorado Guy »

Am deleting this post.
MikeG62
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by MikeG62 »

BigDrop wrote: Sun Jun 20, 2021 7:53 pm
...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?

I look forward to others’ thoughts.
I would get over my distrust of others and find someone capable of managing my money on my behalf. There are lots of competent and reliable people out there. An easy solution would be Vanguad PAS or Fidelity PAS.

The thought that I could find one investment and never need to bother with it seems like wishful thinking to me. After all, who will help with the process of creating a paycheck so you can pay your monthly bills and who will pay those bills? IMHO, there are lots of issues here beyond just finding a one and done investment.
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JPM
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by JPM »

An older colleague had a stroke at 84 and felt his cognition slipping soon afterward. He had a substantial fortune for the time (mid nineties) and from his clinical experience he knew he would become demented as a result of the brain injury, something that often occurs after a brain injury that late in life. His wife had already been in memory care for a few years. He engaged our long-time accountant as his trustee and POA. He remained in a pleasant but expensive nursing home and gradually declined over a year or so before his death. His trustee managed everything in his best interest. He had one child, not financially inclined. I'm sure there was a trustee fee, but I do not know the particulars of the fee arrangement. A lot was asked of the trustee managing funds and paying bills, and only a devoted son or daughter is likely to do it out of love.

Two other friends went into an attractive CCRC in the far northern Chicago suburbs. Pricey, but within their respective means and they were extremely well treated and happy there. Neither had a child and each had a professional trustee. Each passed there in his/her mid nineties in recent years.

If I were to outlive DW or her cognitive powers and feel myself slipping cognitively, a professional trustee is probably my best option.
zwzhang
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by zwzhang »

Vanguard Balanced Index Fund (VBIAX)
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ResearchMed
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by ResearchMed »

JPM wrote: Fri Jun 25, 2021 12:02 pm An older colleague had a stroke at 84 and felt his cognition slipping soon afterward. He had a substantial fortune for the time (mid nineties) and from his clinical experience he knew he would become demented as a result of the brain injury, something that often occurs after a brain injury that late in life. His wife had already been in memory care for a few years. He engaged our long-time accountant as his trustee and POA. He remained in a pleasant but expensive nursing home and gradually declined over a year or so before his death. His trustee managed everything in his best interest. He had one child, not financially inclined. I'm sure there was a trustee fee, but I do not know the particulars of the fee arrangement. A lot was asked of the trustee managing funds and paying bills, and only a devoted son or daughter is likely to do it out of love.

Two other friends went into an attractive CCRC in the far northern Chicago suburbs. Pricey, but within their respective means and they were extremely well treated and happy there. Neither had a child and each had a professional trustee. Each passed there in his/her mid nineties in recent years.

If I were to outlive DW or her cognitive powers and feel myself slipping cognitively, a professional trustee is probably my best option.
How did they use the "professional trustee", and what type of professional was that?

For several years, very elderly MIL was in a very nice facility for several years, from Assisted Living to Skilled Nursing for the last few months. She was treated very well, and we got to know the "inside workings" a bit over those years, enough to get ourselves on their wait list for whenever we are 'ready'.
It's a non-profit, affiliated with our University's Medical School plus another major non-profit.

Nevertheless, our main concern wouldn't be only financial, but care - medical and otherwise - and wellbeing, IF there were no one "else" for general oversight,
Were those professional trustees able to include the general medical care - including expenses for any extra care or equipment/services/etc. - in their oversight? Or was it strictly "just the actual bill paying"?

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

Post by LilyFleur »

ResearchMed wrote: Fri Jun 25, 2021 12:15 pm
JPM wrote: Fri Jun 25, 2021 12:02 pm An older colleague had a stroke at 84 and felt his cognition slipping soon afterward. He had a substantial fortune for the time (mid nineties) and from his clinical experience he knew he would become demented as a result of the brain injury, something that often occurs after a brain injury that late in life. His wife had already been in memory care for a few years. He engaged our long-time accountant as his trustee and POA. He remained in a pleasant but expensive nursing home and gradually declined over a year or so before his death. His trustee managed everything in his best interest. He had one child, not financially inclined. I'm sure there was a trustee fee, but I do not know the particulars of the fee arrangement. A lot was asked of the trustee managing funds and paying bills, and only a devoted son or daughter is likely to do it out of love.

Two other friends went into an attractive CCRC in the far northern Chicago suburbs. Pricey, but within their respective means and they were extremely well treated and happy there. Neither had a child and each had a professional trustee. Each passed there in his/her mid nineties in recent years.

If I were to outlive DW or her cognitive powers and feel myself slipping cognitively, a professional trustee is probably my best option.
How did they use the "professional trustee", and what type of professional was that?

For several years, very elderly MIL was in a very nice facility for several years, from Assisted Living to Skilled Nursing for the last few months. She was treated very well, and we got to know the "inside workings" a bit over those years, enough to get ourselves on their wait list for whenever we are 'ready'.
It's a non-profit, affiliated with our University's Medical School plus another major non-profit.

Nevertheless, our main concern wouldn't be only financial, but care - medical and otherwise - and wellbeing, IF there were no one "else" for general oversight,
Were those professional trustees able to include the general medical care - including expenses for any extra care or equipment/services/etc. - in their oversight? Or was it strictly "just the actual bill paying"?

RM
We used the services of a private-pay social worker specializing in geriatrics. She was very helpful and worth every penny. We also had a corporate trustee doing investing and paying bills. (This was for a parent who lived in the midwest, and my sibling and I live on opposite coasts and were in situations where we could not provide day-to-day oversight except by phone.)
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ResearchMed
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by ResearchMed »

LilyFleur wrote: Fri Jun 25, 2021 12:46 pm
ResearchMed wrote: Fri Jun 25, 2021 12:15 pm
JPM wrote: Fri Jun 25, 2021 12:02 pm An older colleague had a stroke at 84 and felt his cognition slipping soon afterward. He had a substantial fortune for the time (mid nineties) and from his clinical experience he knew he would become demented as a result of the brain injury, something that often occurs after a brain injury that late in life. His wife had already been in memory care for a few years. He engaged our long-time accountant as his trustee and POA. He remained in a pleasant but expensive nursing home and gradually declined over a year or so before his death. His trustee managed everything in his best interest. He had one child, not financially inclined. I'm sure there was a trustee fee, but I do not know the particulars of the fee arrangement. A lot was asked of the trustee managing funds and paying bills, and only a devoted son or daughter is likely to do it out of love.

Two other friends went into an attractive CCRC in the far northern Chicago suburbs. Pricey, but within their respective means and they were extremely well treated and happy there. Neither had a child and each had a professional trustee. Each passed there in his/her mid nineties in recent years.

If I were to outlive DW or her cognitive powers and feel myself slipping cognitively, a professional trustee is probably my best option.
How did they use the "professional trustee", and what type of professional was that?

For several years, very elderly MIL was in a very nice facility for several years, from Assisted Living to Skilled Nursing for the last few months. She was treated very well, and we got to know the "inside workings" a bit over those years, enough to get ourselves on their wait list for whenever we are 'ready'.
It's a non-profit, affiliated with our University's Medical School plus another major non-profit.

Nevertheless, our main concern wouldn't be only financial, but care - medical and otherwise - and wellbeing, IF there were no one "else" for general oversight,
Were those professional trustees able to include the general medical care - including expenses for any extra care or equipment/services/etc. - in their oversight? Or was it strictly "just the actual bill paying"?

RM
We used the services of a private-pay social worker specializing in geriatrics. She was very helpful and worth every penny. We also had a corporate trustee doing investing and paying bills. (This was for a parent who lived in the midwest, and my sibling and I live on opposite coasts and were in situations where we could not provide day-to-day oversight except by phone.)
How well would this have worked, if at all(?), if there had NOT been living relatives on the opposite coast/anywhere?
That's the biggie for many, and it can be quite different than having a living, caring relative overseeing and paying someone else who is closer to the disabled relative.

RM
This signature is a placebo. You are in the control group.
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LilyFleur
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by LilyFleur »

ResearchMed wrote: Fri Jun 25, 2021 12:50 pm
LilyFleur wrote: Fri Jun 25, 2021 12:46 pm
ResearchMed wrote: Fri Jun 25, 2021 12:15 pm
JPM wrote: Fri Jun 25, 2021 12:02 pm An older colleague had a stroke at 84 and felt his cognition slipping soon afterward. He had a substantial fortune for the time (mid nineties) and from his clinical experience he knew he would become demented as a result of the brain injury, something that often occurs after a brain injury that late in life. His wife had already been in memory care for a few years. He engaged our long-time accountant as his trustee and POA. He remained in a pleasant but expensive nursing home and gradually declined over a year or so before his death. His trustee managed everything in his best interest. He had one child, not financially inclined. I'm sure there was a trustee fee, but I do not know the particulars of the fee arrangement. A lot was asked of the trustee managing funds and paying bills, and only a devoted son or daughter is likely to do it out of love.

Two other friends went into an attractive CCRC in the far northern Chicago suburbs. Pricey, but within their respective means and they were extremely well treated and happy there. Neither had a child and each had a professional trustee. Each passed there in his/her mid nineties in recent years.

If I were to outlive DW or her cognitive powers and feel myself slipping cognitively, a professional trustee is probably my best option.
How did they use the "professional trustee", and what type of professional was that?

For several years, very elderly MIL was in a very nice facility for several years, from Assisted Living to Skilled Nursing for the last few months. She was treated very well, and we got to know the "inside workings" a bit over those years, enough to get ourselves on their wait list for whenever we are 'ready'.
It's a non-profit, affiliated with our University's Medical School plus another major non-profit.

Nevertheless, our main concern wouldn't be only financial, but care - medical and otherwise - and wellbeing, IF there were no one "else" for general oversight,
Were those professional trustees able to include the general medical care - including expenses for any extra care or equipment/services/etc. - in their oversight? Or was it strictly "just the actual bill paying"?

RM
We used the services of a private-pay social worker specializing in geriatrics. She was very helpful and worth every penny. We also had a corporate trustee doing investing and paying bills. (This was for a parent who lived in the midwest, and my sibling and I live on opposite coasts and were in situations where we could not provide day-to-day oversight except by phone.)
How well would this have worked, if at all(?), if there had NOT been living relatives on the opposite coast/anywhere?
That's the biggie for many, and it can be quite different than having a living, caring relative overseeing and paying someone else who is closer to the disabled relative.

RM
It is a big concern. When my sister and I would visit my mother in the nicest nursing home in her city, we were usually the only visitors in her wing.
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ResearchMed
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Re: Impending Alzheimer’s: what would be your investment for life?

Post by ResearchMed »

LilyFleur wrote: Fri Jun 25, 2021 1:02 pm
ResearchMed wrote: Fri Jun 25, 2021 12:50 pm
LilyFleur wrote: Fri Jun 25, 2021 12:46 pm
ResearchMed wrote: Fri Jun 25, 2021 12:15 pm
JPM wrote: Fri Jun 25, 2021 12:02 pm An older colleague had a stroke at 84 and felt his cognition slipping soon afterward. He had a substantial fortune for the time (mid nineties) and from his clinical experience he knew he would become demented as a result of the brain injury, something that often occurs after a brain injury that late in life. His wife had already been in memory care for a few years. He engaged our long-time accountant as his trustee and POA. He remained in a pleasant but expensive nursing home and gradually declined over a year or so before his death. His trustee managed everything in his best interest. He had one child, not financially inclined. I'm sure there was a trustee fee, but I do not know the particulars of the fee arrangement. A lot was asked of the trustee managing funds and paying bills, and only a devoted son or daughter is likely to do it out of love.

Two other friends went into an attractive CCRC in the far northern Chicago suburbs. Pricey, but within their respective means and they were extremely well treated and happy there. Neither had a child and each had a professional trustee. Each passed there in his/her mid nineties in recent years.

If I were to outlive DW or her cognitive powers and feel myself slipping cognitively, a professional trustee is probably my best option.
How did they use the "professional trustee", and what type of professional was that?

For several years, very elderly MIL was in a very nice facility for several years, from Assisted Living to Skilled Nursing for the last few months. She was treated very well, and we got to know the "inside workings" a bit over those years, enough to get ourselves on their wait list for whenever we are 'ready'.
It's a non-profit, affiliated with our University's Medical School plus another major non-profit.

Nevertheless, our main concern wouldn't be only financial, but care - medical and otherwise - and wellbeing, IF there were no one "else" for general oversight,
Were those professional trustees able to include the general medical care - including expenses for any extra care or equipment/services/etc. - in their oversight? Or was it strictly "just the actual bill paying"?

RM
We used the services of a private-pay social worker specializing in geriatrics. She was very helpful and worth every penny. We also had a corporate trustee doing investing and paying bills. (This was for a parent who lived in the midwest, and my sibling and I live on opposite coasts and were in situations where we could not provide day-to-day oversight except by phone.)
How well would this have worked, if at all(?), if there had NOT been living relatives on the opposite coast/anywhere?
That's the biggie for many, and it can be quite different than having a living, caring relative overseeing and paying someone else who is closer to the disabled relative.

RM
It is a big concern. When my sister and I would visit my mother in the nicest nursing home in her city, we were usually the only visitors in her wing.
Yeah.....

We were fortunate in that MIL sort of "tested" this particular facility for us. We had moved her close to us to another facility because she was very upset about costs, despite having saved a ton in CDs that had no better use than for her care. When that facility started to go downhill, we just told her that she had the money, and there was a much better place, and moved her to the best in the area (or one of the best; there may be one or two others in the running). By then, she had asked DH to handle all of her finances, and she didn't even bother with much pin money; everything could be billed to the monthly statements.

But in both places, DH made a specific point to have at least occasional visits with NO advance notice; he'd just show up and go to her room, the dining room, or wherever.
Visits that included a meeting of some sort obviously were well scheduled.
[I used to do the same thing ages ago with any new babysitter: Tell them I'd be back at, say, 11:30pm, and return *well* before I was expected, complaining that "the movie had changed or sold out" or some other explanation... In other words, "SURPRISE!!!!" :shock: ]

If one only makes scheduled visits, well.... who knows... and especially if the patient can't communicate well or at all.

So the question remains: How does one get "someone" (person, agency...?) to do the oversight about appropriate care, which directly includes financial decisiona if there are or might be extra or different services/supplies/etc., needed?
Who is making sure those "best" care and cost decisions are being made on behalf of the patient?

Could, or would, that single social worker have handled that, and if so, who would oversee that person?
Or did the agency have any special unit to handle this type of situation? It's likely to become more and more of an issue over time.
It's one thing to make sure that "all the bills are being paid", but it's something else to make sure that the appropriate services are actually being given... and then billed appropriately.
That's not as simple as paying the electric bill or the insurance co-pay (which assumes that the suitable medical care was indeed provided, etc.).
A bit scary.

RM
This signature is a placebo. You are in the control group.
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