The Flinchum File

Thoughtful Economic Analysis and Existential Opinions
Subscribe to the Flinchum File
View Archives

Death Planning?

I am comfortable discussing dementia, having seen it so many times in friends and clients over the years. Nonetheless, I attended a two-hour update yesterday.

There are currently about 6.8 million Americans with dementia. 89% are cared for by a family member, 66% of whom are women.

The five most common types of dementia are (1) Alzheimer’s early or late onset, (2) Vascular Dementia, (3) Lewy Bodies (think Robin Williams), (4) Frontotemporal Lobe, and (5) Alcohol-related Dementia.

Because there are numerous types of dementia, there are numerous ways to diagnose it, but only a neurologist can tell for sure. It was at this point I started scratching my head. Since symptoms are almost the same, treatments are almost the same and the prognosis is almost the same, why pay for a neurologist?

I also realized there had been no discussion of assisted suicide. I get email frequently about trips to Switzerland for assisted suicide. Some America states now permit it. There was no discussion as to whether or not living actually makes sense? For whom? Does anybody have the responsibility – the duty – to discuss death with a client/patient?

Lastly, I was surprised that there was no planning discussion of trusts (Special Needs or otherwise), asset titling/probate issues, physician’s directive, living will, long-term care (LTC) insurance, life insurance cash values, Medicare/Medicaid, etc. Oh . . . what about a Will?

This financial planning discussion is important BEFORE any discussion of assisted suicide. Otherwise, legal capacity can be an unwelcome question. My experience is that the assisted-suicide discussion can be a normal part of the funeral-planning process.

Some planners argue that the subject of death by suicide or by assisted suicide should be avoided with clients; that it is somehow disrespectful of their religion. It requires careful probing of a client’s thoughts before proceeding too far or too fast.

Remember: A person has very little control over dementia but has a great deal of control over their financial planning, their funeral planning, and yes, even death-planning.