How Family Offices Can Support Aging Adults with Neurocognitive Decline
Sam Van Kalkeren
What are Family Offices?
Family offices are traditionally established to manage the wealth and affairs of affluent families using a combination of financial, legal, medical, and social resources.
How Do Family Offices Help Aging Adults?
As the global population ages, the prevalence of neurocognitive decline, such as dementia and Alzheimer’s Disease, is increasing. Understanding the complex challenges faced by aging adults with neurocognitive decline, family offices are uniquely positioned to provide comprehensive support and assistance. By taking a holistic approach that integrates financial, legal, medical, and social support, family offices can partner with a care manager and play a pivotal role in enhancing the quality of life for aging adults and their families during this challenging phase.
What are the Challenges Aging Adults Face with Neurocognitive Decline?
Neurocognitive decline presents many challenges for aging adults and their families. Cognitive impairments associated with conditions such as dementia and Alzheimer’s disease can manifest in various ways, including memory loss, impaired judgment, confusion, and disorientation. These cognitive deficits can significantly impact an individual’s ability to manage finances, make sound decisions, and maintain independence. Furthermore, neurocognitive decline often coexists with other health issues, further complicating the situation and necessitating comprehensive care and support.
Financial Management for Adults with Cognitive Decline
Financial management poses a particularly significant challenge for aging adults with neurocognitive decline. As cognitive abilities decline, individuals may struggle to manage their assets, pay bills, and make informed financial decisions. This can leave them vulnerable to economic exploitation, fraud, and resource mismanagement. The complexity of economic systems, including investments, taxes, and estate planning, can exacerbate these challenges, requiring specialized expertise to navigate effectively.
Family office professionals can work closely with clients and their families to assess their financial situation, identify potential risks, and develop strategies to protect assets and ensure long-term financial security. This may involve consolidating accounts, simplifying financial structures, and implementing safeguards to prevent exploitation and fraud.
Family offices can assist with estate planning and wealth transfer strategies to ensure that the wishes of the aging adults are carried out effectively. This may include establishing trusts, drafting wills and advance directives, and coordinating beneficiary designations to minimize tax liabilities and facilitate the orderly transfer of assets. By proactively addressing estate planning issues, family offices can help aging adults and their families navigate complex legal and financial considerations, providing peace of mind and clarity for the future.
Managing Healthcare Needs
Aging adults with neurocognitive decline may also face difficulties in managing their healthcare needs. Coordinating medical appointments, adhering to treatment plans, and understanding complex medical information can become increasingly challenging as cognitive abilities decline. Issues such as medication management, safety concerns, and long-term planning add further layers of complexity to the healthcare landscape for aging adults and their families.
Family offices can play a crucial role in advocating for medical needs and supporting the coordination of healthcare services for aging adults with neurocognitive decline by introducing the family to a care manager.
What is a Care Manager?
A care manager can serve as a liaison between family office professionals, clients, healthcare providers, and other relevant stakeholders, ensuring that the individual’s medical needs are met effectively and efficiently. This may involve scheduling medical appointments, coordinating care transitions, and facilitating communication among healthcare team members.
Care managers can support and guide families navigating the complex healthcare landscape, helping them understand treatment options, access community resources, and make informed decisions about long-term care planning. To help with this, family offices should ensure that their clients have a healthcare proxy and a durable power of attorney who knows their wishes if they become incapacitated. In addition to a healthcare proxy and durable power of attorney, a HIPAA release form must be signed so family members can get information about a client if the client is hospitalized. By empowering families with knowledge and resources, family offices can alleviate the burden of caregiving and promote better outcomes for aging adults with neurocognitive decline.
Legal and Ethical Considerations
Navigating the legal and ethical considerations of neurocognitive decline presents significant challenges for aging adults and their families. Family offices can offer valuable expertise in this area, guiding on issues such as capacity assessment, guardianship, and healthcare decision-making. By working with legal professionals specializing in elder law and estate planning, family offices can help aging adults and their families navigate complex legal issues and protect their rights and interests.
Family offices can facilitate conversations about advance care planning and end-of-life decision-making, helping aging adults articulate their preferences for medical treatment and other forms of care. By engaging in proactive planning and documentation, family offices can help alleviate the burden of decision-making for families facing difficult choices during a crisis or transition.
Diminished Quality of Life for Adults with Dementia or Alzheimer’s
Aging adults with Dementia or Alzheimer’s may also experience social isolation, loss of autonomy, and diminished quality of life. The stigma around dementia and Alzheimer’s disease, as well as the symptoms one experiences, can lead to social withdrawal and decreased engagement in meaningful activities, exacerbating feelings of loneliness and depression. Additionally, safety and capacity concerns may lead to autonomy restrictions, further eroding the individual’s sense of independence and dignity.
Family offices can promote social engagement and quality of life for aging adults with neurocognitive decline. By connecting clients with community resources, social support networks, and meaningful activities, family offices can help combat social isolation and enhance overall well-being. This may involve facilitating participation in recreational programs, support groups, and volunteer activities tailored to the individual’s interests and abilities.
Family offices can work with families to create supportive environments that promote independence, autonomy, and dignity for aging adults with neurocognitive decline. This may include implementing home safety measures, arranging transportation services, and providing assistance with daily tasks as needed. By fostering a sense of belonging and purpose, family offices can help aging adults maintain their quality of life and sense of identity despite the challenges of neurocognitive decline.
Resistance to Accepting Neurocognitive Decline in Older Adults
As proactive as family office professionals may be with their clients, they still could face resistance from aging adults with neurocognitive decline. Resistance to accepting help is common. Reasons why aging adults with neurocognitive decline are reluctant to accept help include fear of losing independence, desire not to be a burden, lack of trust, fear of giving up control, and stigma.
To manage resistance, it is essential to learn why aging adults with neurocognitive decline are resistant and what is important to them. Strategies to pierce resistance include:
- Ask for permission to raise a sensitive subject
- “May I raise a sensitive subject?”
- Verbalize compassion
- “I am concerned about your level of stress.”
- Offer help
- “How can I help you with this?”
- Contain fear
- “This must be scary, and it’s a big step that you are taking to reach out.”
- Normalize the situation
- “Every family has its own set of unique challenges; you are not alone.”
- Use crisis as an opportunity.
- “It seems like this experience has left you feeling scared. Let’s discuss your options together.”
Additional strategies to pierce resistance can include engaging willing family members and close friends of the individual and having a list of resources ready to offer if the aging adult with neurocognitive decline and family agrees to help.
To help reduce the chance of resistance, family office professionals should develop and use a form that outlines the proactive need to communicate with a trusted individual if there is evidence of neurocognitive decline in the aging adult they are serving. To support family office professionals, family office firms should create policies and procedures on handling suspected incapacity and reporting, evaluating, and acting on it.
Get in Touch with Intent Clinical for Aging Services
By taking a holistic approach that integrates financial, legal, medical, and social support, family offices can enhance the quality of life for aging adults, preserve their dignity and autonomy, and promote their overall well-being throughout neurocognitive decline. Through proactive planning, advocacy, and engagement, family offices can play a vital role in helping aging adults navigate this challenging phase of life with grace and resilience.
