After the Diagnosis: Making a Plan for Alzheimer's

In a 2002 interview with Mike Wallace, former First Lady Nancy Reagan said she often reread the love letters written by her husband, former President Ronald Reagan. The letters, which had sustained and enriched their relationship, helped Mrs. Reagan reconnect with her husband and remember the man he was before Alzheimer's claimed him.(1)

An excerpt from her book, I Love You, Ronnie: The Letters of Ronald Reagan to Nancy Reaganreads: (2) "No matter what else was going on in his life, no matter where he was, Ronnie wrote to stay in touch. I found his letters funny, warm, and imaginative. I loved reading them, and found myself looking forward to receiving them. Whenever Ronnie went away, I missed him terribly, and when his letters arrived, the whole world stopped so I could read them."

Alzheimer's is the most common type of dementia. Those who suffer from the disease develop memory, thinking, and behaviour issues.(3) As the disease progresses, the symptoms and challenges intensify. The Alzheimer Society of Manitoba explained: (4) "In the late stage of the disease (also referred to as 'severe' or 'advanced' Alzheimer's disease), individuals experience increased mental and physical deterioration and need 24 hour care."

"Individuals in the late stage: Experience severe impairment in memory, ability to process information and orientation to time and place. Lose their capacity for recognizable speech, although words or phrases may occasionally be uttered; nonverbal communication will become increasingly important. Need help with eating and using the toilet and are often incontinent of urine and stool. Lose the ability to walk without assistance, then the ability to sit without support, the ability to smile, and the ability to hold their head up. The brain appears to no longer be able to tell the body what to do. Progression 1 The term family includes anyone in the supportive network of people with dementia. May have impaired swallowing. May lose weight."

Coping with Alzheimer's can be an extraordinary and often painful journey for patients, families, and caregivers. If you, or someone you love, has been diagnosed with the disease, act quickly to develop a plan of action that encompasses financial, legal, and end-of-life wishes. Creating an Alzheimer's action plan can help restore a sense of control after an unwelcome diagnosis and help protect loved ones from potential uncertainty and conflict in the future.

A good place to begin is by learning more about the disease. Empower yourself. As you experience the gamut of emotions that often accompany a diagnosis, try to be proactive. Educate yourself about dementia and Alzheimer's. Join a support group. Keep a journal. Share information with loved ones. Understanding what may be ahead can help re-establish a sense of order and control. (5) Begin building a care team. An Alzheimer's team may include family members, close friends, neighbors, doctors, professional caregivers, members of community organizations, and others. Building a team means talking with potential team members about what may be needed and when.

In the early stages, people with Alzheimer's may need assistance with: (5)

- Keeping appointments

- Managing money

- Taking medications

- Planning and organizing

- Shopping and preparing meals

- Exercising and relaxing

In later stages, they'll need experienced and patient caregivers who have been well trained. If family members want to provide care, the AARP's Dementia Friends Initiative can offer some insights about how to best interact with and support people who have dementia.(6)

If possible, decide on caregiving options while the individual with Alzheimer's has the clarity to make sound decisions. The care choices you make should include a thorough evaluation of costs so you can make affordable choices. In particular, companies like Realcare, based out of Winnipeg provides greater options and choice for families.

Review Your Financial Plans

Once you have familiarized yourself with care options, take time to review your financial plans. Check in with your insurance provider to ascertain exactly what costs will be paid by insurance and what costs will be paid out of pocket. Once you have a better understanding of potential costs, work with your financial representative to evaluate your budget and decide how to proceed. If your financial priorities and goals have changed, then your investment and allocation choices should reflect that.

Double-Check Legal Documents

Make sure you've dotted the "i"s and crossed the "t"s when it comes to your estate plan. Make sure to review:

- Your will. Make sure you have named the correct beneficiaries for your valuables and guardians for children and also have provisions in place for pets. (7)

- Beneficiary designations. In many cases, the beneficiaries named on retirement plan accounts and insurance policies take precedence over heirs named in a will, so make sure the correct person or people are named. (8)

- Your living will or advance directive. This legal document provides instructions that are implemented if you are unable to communicate or make decisions. An advance directive may include end-of-life wishes. (9)

- Your Power of Attorney. This gives another person the right to act on your behalf if you become incapacitated. (10)

- Your digital executor. If you have digital accounts or assets, name a digital executor to access, manage, delete, or archive digital files after your death. (11)

- Any trusts. Depending on the complexity of your estate, you may have established a trust and a means for funding it after death. (12)

- Put critical financial documents in a safe place, and make sure at least one other trusted individual knows where they are.

Apply for Disability Benefits

It has become easier for people who are younger than age 65 to qualify for benefits than it once was. The disability tax credit can provide significant financial relief. Alzheimer's can be one of the most expensive diseases.  It's critical to put a plan in place to help provide comfort and care for the person with Alzheimer's and protect family and loved ones.

- Grant White, CIM, CFP

Grant White is a Portfolio Manager/Investment Advisor at Endeavour Wealth Management with Industrial Alliance Securities Inc, an award-winning office as recognized by the Carson Group. Together with his partners he provides comprehensive wealth management planning for business owners, professionals and individual families.

This information has been prepared by Grant White who is a Portfolio Manager for Industrial Alliance Securities Inc. (iA Securities) and does not necessarily reflect the opinion of iA Securities. The information contained in this newsletter comes from sources we believe reliable, but we cannot guarantee its accuracy or reliability. The opinions expressed are based on an analysis and interpretation dating from the date of publication and are subject to change without notice. Furthermore, they do not constitute an offer or solicitation to buy or sell any of the securities mentioned. The information contained herein may not apply to all types of investors. The Portfolio Manager can open accounts only in the provinces in which they are registered.

Sources:

1 http://blog.aarp.org/2016/03/06/nancy-reagan-she-helped-lead-fight-against-alzheimers/

2 Book Excerpt from I Love You, Ronnie: The Letters of Ronald Reagan to Nancy Reaganauthored by Nancy Reagan, page 4: https://s3-us-west-2.amazonaws.com/peakcontent/Peak+Documents/Sep_2017_Book_Excerpt-I_Love_You_Ronnie-The_Letters_of_Ronald_Reagan_to_Nancy_Reagan-Footnote_2.pdf

3 https://www.cnbc.com/2017/08/03/dementia-villages-for-alzheimers-sufferers.html

4 https://alzheimer.ca/sites/default/files/files/national/progression-series/progression_latestage_e.pdf

5 https://www.kiplinger.com/article/retirement/T066-C000-S004-build-an-action-plan-for-alzheimer-s.html

6 http://blog.aarp.org/2017/02/27/dementia-friends-initiative-creates-respectful-communities-for-people-of-all-ages/

7 https://www.genworth.com/about-us/industry-expertise/cost-of-care.html

8 http://www.aarp.org/money/budgeting-saving/info-2016/the-ultimate-guide-to-estate-planning.html

9 https://www.nia.nih.gov/health/advance-care-planning-healthcare-directives

10 https://www.rocketlawyer.com/form/power-of-attorney.rl#/(or go tohttps://s3-us-west-2.amazonaws.com/peakcontent/Peak+Documents/Sep_2017_RocketLawyer-Personal_Legal_Forms-Power_of_Attorney-Footnote_11.pdf)

11 https://legaltemplates.net/blog/digital-executor-will-and-testament/

12 https://www.ssa.gov/compassionateallowances/conditions.htm