RECAP: 2019 FOX Family Office Forum

Advisor Briefing: Managing Elder Care, Aging, and Incapacity

Presenters:
Nicholas Van Brunt
Partner, Sheppard Mullin
Daisy Medici
Managing Director of Governance and Education, GenSpring Family Offices
Margalit Tocher
President, Home Care Assistance

Session Description: 

As we age physically and mentally, our ability to care for ourselves and capacity to manage family affairs often diminishes – sometimes unexpectedly and rapidly. This presents significant problems that next generation family members and family office executives must manage under very stressful circumstances that can change dayto-day. In addition to the types of care required, there are myriad legal, financial, and personal matters that must be delicately addressed and thoroughly planned for. This session brought together experts to discuss a multi-disciplinary approach to managing elder care.
 

“Talked a lot about things we hadn’t thought about in taking care of our parents.”
- Attendee Quote
Key Takeaways: 

What happens if I don’t plan ahead?

  • Usually, it is too late, and you will need someone to intervene if a matriarch or patriarch is no longer capable of managing her/his affairs. Typically, this will be a Direction in Trust or Power of Attorney (if outside of court) or a Conservatorship/Guardianship (if inside of court).

Dementia

  • When something is changing cognitively, you may see a change in cognition and typical behavior, and it may be presenting in memory, attention, and language. First step is a medical evaluation to rule out other possible factors (depression, UTI, medicine complications, sensory changes, or chronic conditions like diabetes).
  • Four facts about dementia: (1) it is chemical and structural brain death, reducing brain function by up to 2/3; (2) it cannot be stopped or fixed (but can be slowed down); (3) it is constantly changing, and (4) it is terminal. Dementia is not a diagnosis, but an umbrella term for 85-90 conditions including: Alzheimer’s, vascular dementia, Lewy body dementia, Korsakoff Syndrome, Parkinson’s, and frontotemporal dementia.
  • Create a Decision Roadmap when you are healthy, putting in to place important legal documents (will, living will, advanced healthcare directives, healthcare, and financial power of attorney) and create a roadmap for all family members. Include who can “pull the trigger” on the plan. Review regularly and consider issues of when to remove car keys, transfer powers of attorney, succession plans, and when to change care arrangements.

Planning Ahead: What a Novel Idea!

  • We don’t tend to plan because it is a difficult topic to discuss and privacy issues might prevent disclosure, however failure to plan can undermine how a family works effectively together. Building a comprehensive approach to decisionmaking and communication can help alleviate challenges and unforeseen consequences. Use the three-circle model: Family/Ownership/Business.
  • Decide on a repository, a “just in case” book that includes all pertinent information regarding your wishes, preparations that have been made, location of important documents, all important information regarding insurance, investments, bank accounts, and important contacts for advisors, doctors.

VIEW THE SLIDES AND VIDEO >
(FOX Members only)