Prepare financially for risk of getting dementia

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Forbes

CBS newsman Mike Wallace, who died last night at the age of 93, was a journalist’s journalist. In a career that spanned 60 years, most of it at “60 Minutes,” he confronted Nixon aide John Ehrlichman about alleged Watergate crimes; interviewed Jack Kevorkian, the assisted suicide doctor; and reduced Barbra Streisand to tears.

Announcing his retirement as a regular correspondent in March 2006, he said, “my eyes and ears, among other appurtenances, aren’t quite what they used to be.”

Wallace had also been public about his battle with depression. In 1996, appearing before the Senate’s Special Committee on Aging to urge more federal funds for depression research, he described feeling “lower, lower, lower than a snake’s belly,” and his recovery through psychiatric treatment and antidepressant drugs. Later, he disclosed that he once tried to commit suicide during that spell.

Perhaps that inspired his son, “Fox News Sunday” host Chris Wallace, to reveal in a recent interview with The New York Times, that his father suffered from dementia. “Physically, he’s okay. Mentally, he’s not,” Wallace said. “He still recognizes me and knows who I am, but he’s uneven.”

Advancements in medical science and care may enable us to live fuller, longer lives. The flip side is that more of us, like Mike Wallace, are likely to suffer from a diminished mental state–a harsh reality that’s difficult to accept. Here’s a scary statistic: One in eight baby boomers will get Alzheimer’s after they turn 65. Sure, you hope you won’t be one of them. But the risk of a slow decline and incapacity, meaning that you don’t know what assets you have, what you want to do with them and who your family members are, lurks for us all.

Once you do become incapacitated, it is generally too late legally to make changes in your estate planning documents. And unless you have made other, binding arrangements, your family may need to ask a court to appoint a conservator (also called a guardian) to oversee your finances. This can be an expensive and an embarrassing ordeal, and for many families involves unpleasant, even acrimonious, exchanges.

Maybe you figure you’ll have time to plan after the onset of symptoms. But you could instead suffer a stroke, or get hit by a bus and immediately need someone else to make medical decisions for you. The bottom line is that regardless of your current age or health, it’s crucial to anticipate that at some point you might become physically or mentally unable to manage your finances or make medical choices.

Here are issues to consider.

Who Will Make Health Care Decisions?

Someone needs to be able to make medical decisions if you no longer can. To appoint this person, you will need a health care proxy – known in some states as a health care agent or health care power of attorney. Legally, the health care proxy also automatically gives the agent access to your medical records. (Some states have surrogate decision-making laws that give specific family members the right to make certain medical decisions for others.) Sign four copies of both this document and your living will. Keep one and give one each to your health care agent, your primary physician and a trusted advisor.

What Are Your Final Wishes?

If you have preferences about end-of-life care, you should create a living will (also called an advance directive) – a written statement that anced directives,expresses your wishes. Although it is difficult to address every contingency, living wills typically cover pain relief and whether you would want treatments such as surgery, a ventilator, a feeding tube or resuscitation that might prolong your life but without necessarily ensuring your return to a functional state.

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