When Betty took her mom to the doctor, she had no idea it would mark a turning point in their relationship. Up to that point, 87-year-old Louise had been showing signs of cognitive decline, but the signs were never anything terribly worrisome.

On this day, when Betty went to the reception desk to turn in the usual array of forms, Louise proceeded to take her blouse off and ask the other people in the waiting room where the gowns were hidden.

Louise’s brain was recalling what she had been told in the past at one of her doctor’s appointments, but it wasn’t recognizing that her current environment and situation were not that environment and situation.

Just like that, Betty went from being a daughter trying to help out to a “caregiver”. Betty laughs about it, now.

Sometimes that is all you can do. When an elderly family member of mine told me she dated Douglas MacArthur, all I could do was smile and tell her that must have been very interesting. By that point, she had such significant cognitive issues, no one tried to correct her anymore. As long as she was happy with her false memories, we were happy that she was happy.

One of the most difficult situations to address in my work as a financial planner is seeing decline in my clients’ mental and physical abilities. I work on the Space Cost of Florida. Some of my clients are or were rocket scientists. The decline can be spectacular in its extent and speed. It can be heartbreaking to see someone with a high level of mental acuity, lose it.

But as tough as it is for me, it is impossible to forget that it is far worse for the client’s family. The journey from forgetful to “gone” is never smooth.

If you spend a lot of time with someone, you will hear the same story from them on multiple occasions. That’s normal. So is misplacing things, forgetting names and failing to recall dates or other details. It is when the stories are retold too frequently or with little recognition that the story could have been told previously that people start to get concerned.

Ideally, of course, before the need arises, we discuss with clients how they want things handled. We put a plan in place that typically involves documentation of who should be responsible for different things should the client be unable to continue to take care of things themselves. 

These trust, powers of attorney and other documents also describe when such control provisions take effect. What has to happen for a successor trustee to take over? The documents can sound simple enough but determining competence is often not so simple. That’s a discussion for another day, perhaps.

In practice, documents are essential but do little to minimize the trauma caused by the decline of a patriarch or matriarch. 

Cognitive decline is messy.