Sample Chapter by David Disraeli

Copyright David Disraeli 2010


If your aging parents were to have a medical emergency, could you provide the vital information doctors would need to care for them? Do you know the names of your aging parents’ doctors? Is your mom taking any medications? Has your dad ever had any surgery.  If you are like most people, you don’t have some of this vital information at your fingertips.   The fact is most seniors and their adult children are not prepared for what lies ahead.  In addition, the country itself is not prepared.  Did you know that 3.5 million Americans reach the age of 55 each year?  Or that one-third of our country’s population, or 70,000,000 people will be on Medicare and benefiting from Social Security by 2030 according to the U.S. Census Bureau. Today’s medical infrastructure is (number of geriatric specialists and others with geriatric training) simply not adequate to deal with a mass influx of older patients.  Our government has not been able to articulate a solution to the current and future financial needs of this age group. Individuals are better off relying on their own planning.

It would be nice if we all lived to a ripe old age with no bumps along the way. If you are concerned about aging relatives or if you are a senior citizen, this book can provide invaluable guidance. An old line goes, I want to die like my grandpa “ peacefully in my sleep, not screaming like the other three people in his car. But the end of life likely will involve more complexity.

Consider the following:

1.  The life expectancy of a senior citizen with a fracture is significantly reduced.

2.  The average cost of long-term care nationwide is approaching $56,000 per year.[1]

3.  Among 80-year-olds, 50 % will be afflicted with Alzheimer’s disease.[2]



As a financial planner, much of my profession focuses on investment returns. So why would a financial planner write a book about aging? Heres the answer:  In my career I’ve seen the effects of a financial services industry that plans for the future without taking into account the future mental and physical condition of the individuals it aims to assist. Contrary to popular belief, the greatest risk facing retirees is not the stock market, nor inflation, nor the solvency of Social Security. The future health of a client is the single greatest factor in determining the success or failure of their financial plan.

A stroke, or fall or the onset of Alzheimer’s can eat up almost any size estate, but money is only one contributing factor of this issue. One-third of all senior citizens’ caregivers are relatives or friends who many times put their lives on hold to fill that role. Their labor of love often leaves them exhausted. Decisions regarding the type of care or physical placement of an ailing senior often create a crises environment since the need typically rises without warning. The chaos that erupts when family members are told that an aunt cant live on her own is beyond description.

The impetus for this book stems from a combination of the things I have witnessed in 20 years of giving financial advice and interviews with physicians, social workers and family members of ailing senior citizens.  Amazingly, much of this chaos and stress is almost entirely preventable.

Important note:

This book is packed with information. The most crucial items are in bold type. Rather than stopping to take notes, I suggest you read the material straight through and download our workbook, which will guide you through the planning process. Ive made sure the workbook is thorough enough so that you wont miss anything important.  Throughout this book you will notice that sometimes Im speaking to the child of an aging relative and sometimes Im speaking to the senior themselves.  The reason for this is that this book is intended to be read by both groups.

[1]United Seniors Health Council, a nonprofit group in Washington, D.C

[2] Alzheimers Association of America

Marilyn Meyers was preparing dinner for her family of four when the phone rang. It was her mothers neighbor, Fran.

Marilyn, its Fran, honey, she said with her voice trembling. I was playing cards with your mom this morning when she passed out.”

Mom passed out? Marilyn asked.

Yes, honey,” Fran said. “Im here with her at County Memorial right.  Shes being looked at.

Is she OK? What’s going on? Marilyn asked, starting to feel more frantic.

“Honey, they wont tell me anything since I’m not family,” Fran answered. “The paramedics got her to respond, but she isn’t really saying much. I think you need to come here right away. Here’s the number to the hospital.

Picturing her mother alone in a hospital with complete strangers around her or worse with tubes going all over the place  Marilyn’s heart sank. Marilyn lived in Atlanta with her husband, a successful attorney, and their two teen boys. Her mother lived in Jackson, Mississippi, in the same house Marilyn grew up in.

Her mind was swirling. She already had a full plate with her civic duties and both boys in sports and scouts. She hung up the phone with Fran and called her husband. He rushed home to be with his wife.

Mrs. Meyers, this is Dr. Fortney,” the doctor said when she called the hospital. “I’m the neurologist looking after your mom.

Is she OK? Whats wrong? Marilyn said, trying hard to conceal her panic.

After confirming that Marilyn’s mother’s vital signs were stable, though she had been going in and out of consciousness, the doctor asked for the name of the older woman’s primary physician. The conversation began to reveal the many complications associated with a simple hospital visit.

“Dr. Ben Miller?” the doctor asked. “He just retired. I’ll have to track down who he referred her to. I’ll need you to come in and sign some papers. Are you nearby?”

“No, I’m in Atlanta,” Marilyn replied.

“I presume you have power of attorney for health care?” Dr. Fortney asked.

“Yes, she took care of all that a year ago,” Marilyn said of her mother’s pre-made arrangements. Still, without copies of the document granting her power of attorney and other authorization forms, she was left helpless to aid her mother.

Marilyn’s husband arrived home from work and embraced his hysterical wife without saying anything. With an 81-year-old widowed mother, one would hope a daughter would be prepared for such an emergency. Marilyn and her mom had always been close, and her mom had traveled, played cards, and lived a full, active life until this particular morning.

Bob, Im going to have to fly to Jackson,” Marilyn said. “The doctor says I need to sign some forms, and I want to go right now. By the way where is moms power of attorney and all her other legal documents?

Im not sure,” Bob replied. “I thought she mailed you a copy. 

“I don’t remember receiving them, Marilyn said. “I guess I’ll have to look.”

Both knew a sudden out-of-state trip would disrupt work schedules and plans to attend their son’s playoff soccer games, but the situation had to be taken care of immediately.

Hurriedly, Marilyn caught the first flight the next morning and called Fran from the car to ask her to pick her up at the airport. Marilyn arrived tired, frazzled and wearing one earring.

They rushed to the hospital and found out her mother was being kept in the intensive care unit. A different doctor was on duty, Dr. Parvez Mashti.

Mrs. Meyers please have a seat,” Dr. Mashti began. “Your mother has had a stroke. We wont know the extent of any damage for perhaps a day or two. We’ve sedated her and given her blood thinners to prevent any further damage. It would help to know what medications she’s taking.”

Fran held her hand gently as Marilyn tried to process what she just heard. It happens all the time, but this time it was HER mother. And once again, she felt helpless having no information to give the doctors.

Fran was asked to stay in the waiting room while Marilyn went to see her mother, who was resting comfortably but was not to be excited or agitated, according to the hospital staff. Marilyn held her mothers hand.  She opened her eyes and looked directly at Marilyn but didn’t recognize her.

Later that night, as the two women drove to the house, Marilyn realized she hadnt even called her sister, Cathy, who lived out of state and traveled all over the world. She was single, a free spirit who owned a pottery business. Every few years, Cathy would save up to go on a journey until she ran out of money. She was great fun, but hardly someone you could rely on in a crisis. Marilyn called Cathy and left a message. Meanwhile, Marilyn and Fran searched her mothers house, frantically looking for medicine bottles and legal documents.

One week later, Marilyn’s mom regained her speech but had very little long-term memory and was unable to walk. The doctors felt she would regain most of her physical abilities with months of specialized rehabilitation. Marilyn found the document granting her power of attorney, but it was unsigned. It was in a package, prepared and ready to be executed. She also found six different bank accounts, but only one with both of their names on it.

Unfortunately, without the powers of attorney, Marilyn couldn’t access her mothers accounts or check her into a rehab facility.  In addition, her mother had bills coming due that needed to be paid, her answering machine was full, and Marilyn had no idea who would finance the rehab while keeping up her mothers home.  What if they had to sell it?  What should they do with moms car?  Unanswered questions flooded Marilyn’s mind.  She flew back to Atlanta and collapsed in bed.  The next day her husband explained that if her mother didn’t regain her mental functions soon they would need a court appointed guardianship and that the court would supervise her mothers finances from that point forward.



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