Login | June 20, 2025
Dementia is not a solo affair
JULIE JASON
The Discerning Investor
Published: June 19, 2025
When it comes to retirement, there may be many plans for your future: traveling, spending more time with family, and pursuing new hobbies or devoting more time to current ones.
What might not be in your plans, but does deserve consideration, is the possibility of cognitive impairment -- including dementia. There are no guarantees one way or another, of course, when it comes to health.
According to the Alzheimer's Association: "An estimated 7.2 million Americans age 65 and older are living with Alzheimer's dementia in 2025," adding that "74 percent are age 75 or older." You can see the 2025 Alzheimer's Disease Facts and Figures report at tinyurl.com/mvkt4t9s.
There are two forms of preparation that should be considered: medical and financial. And the time to prepare is when you are in good health.
If you or a family member is having memory issues, you first need to see your primary care physician, according to Jason Karlawish, M.D., professor of medicine at the University of Pennsylvania and author of "The Problem of Alzheimer's." The physician, in turn, can decide whether a referral to a specialist is needed, and will likely need to talk to the spouse and other family members or friends who have seen changes over time.
"Patients with memory disorders are often poor historians; thus, having other sources of history is critical," according to Matthew McConnell, M.D, a board-certified neurologist and epileptologist with the Neurology and Headache Center of Greenwich, Connecticut. "When focusing on memory symptoms, it is important to establish what the patient and family mean by 'memory,' what kinds of information is the patient forgetting, and over what period of time."
Observation is key.
"Functionality with daily activities can differentiate between mild cognitive impairment and dementia, and an assessment of the time course over which the patient lost independence with activities of daily living provides insights about progression," McConnell adds.
Guidelines can be helpful. The Alzheimer's Association provides a list of "10 Early Signs and Symptoms of Alzheimer's and Dementia" as well as a chart comparing signs of Alzheimer's and dementia with typical age-related changes (tinyurl.com/3rzvmkws). Among the early signs are challenges in planning or solving problems, difficulty in completing familiar tasks, decreased or poor judgment and changes in mood and personality.
From a financial point of view, dementia could require constant care for many years. The Alzheimer's Association points out that the "total lifetime cost of care for someone with dementia is estimated at $405,262 in 2024 dollars." Seventy percent of that cost is "borne by family caregivers in the forms of unpaid caregiving and out-of-pocket expenses."
How will those costs be paid if you have to fund care? Timing will be an issue, as fewer options exist after the discovery of dementia. Long-term care insurance likely will not be an option, leaving only self-funding, unless you qualify for Medicaid.
The AARP's "Long-Term Care Worksheet" can be helpful in considering costs -- see tinyurl.com/4sasxj2y.
A discussion of finances also leads to incapacity planning and estate planning conversations. Family members will need to be involved at some point -- the earlier the better -- not only to discuss the person affected, but also to discuss how family members' lives might change.
Guides are available. For example, the Conversation Project, which encourages people to talk about their wishes for care through the end of life, offers a guide for caregivers of people who have Alzheimer's or another form of dementia (tinyurl.com/3j735avz).
Probably the most important point to remember is this: Dementia is not a solo affair. It's a family affair.
On a related note, if you are involved in fundraising for nonprofits focused on dementia, you may want to attend a presentation I'm giving in Greenwich on Tuesday, May 27. Please email me for more information at readers@juliejason.com.
Seasoned investment counsel (tinyurl.com/52nus8hz) and award-winning columnist and author, Julie Jason, JD, LLM, promotes financial literacy and investor protection. Read her latest book, "The Discerning Investor: Personal Portfolio Management in Retirement for Lawyers (and Their Clients)" (tinyurl.com/4u7h9pjs), published by the American Bar Association. Write to Julie at readers@juliejason.com. While all questions cannot be answered, each email is read and reviewed and can lead to discussion in a future column.
COPYRIGHT 2025 Julie Jason, DISTRIBUTED BY ANDREWS MCMEEL SYNDICATION, 1130 Walnut St., Kansas City, MO 64106; 816-581-7500.