Helping Families Navigate the Financial Challenges of Age Transitions

Category: Medical Issues (Page 1 of 3)

Aging and Implications for The Presidency

The world is keenly focused on our aging president and debating his mental capacity to properly execute the duties of the office. This debate is not new. At least three former presidents of the 20th century also faced questions about their age and capacity to carry out their presidential duties, especially during their later years in office or while campaigning for re-election. Here are some notable examples:

Ronald Reagan:

Age at Inauguration: Reagan was 69 years old when he took office in 1981, making him the oldest president at the time.

Concerns: By his second term, Reagan faced scrutiny over his age and health. In 1984, during a debate with Walter Mondale, Reagan addressed concerns about his age with a well-received joke, saying he would not make age an issue by exploiting his opponent’s “youth and inexperience.” Later, in 1994, Reagan announced he had been diagnosed with Alzheimer’s disease, leading to retrospective speculation about whether he had exhibited early signs of the disease while in office.

Dwight D. Eisenhower:

Age at Inauguration: Eisenhower was 62 when he took office in 1953.

Health Issues: Eisenhower suffered a heart attack in 1955, a stroke in 1957, and underwent surgery for Crohn’s disease in 1956. These health issues raised concerns about his ability to perform his presidential duties, though he continued to serve until the end of his second term in 1961.

Franklin D. Roosevelt:

Age at Fourth Inauguration: Roosevelt was 63 years old when he was inaugurated for his fourth term in 1945.

Health Issues: Roosevelt’s health had been a concern due to his polio and declining physical condition. During his later years, he was visibly frail, and his death in April 1945, just months into his fourth term, intensified scrutiny about his health during his presidency.

Normal Cognitive Decline vs. Cognitive Diseases

As people age, it’s common to experience a gradual decline in certain cognitive functions. This decline is usually mild and does not significantly interfere with daily life. Normal cognitive decline can manifest in several ways:

  • Multitasking: The ability to juggle multiple tasks simultaneously tends to decrease with age. Older adults may find it more challenging to switch between tasks quickly and efficiently, often needing more time to complete activities that require divided attention.
  • Executive Functions: These include skills such as planning, problem solving, and decision-making. Aging can affect the brain’s prefrontal cortex, leading to slower processing speeds and difficulties in managing complex tasks that require these higher order cognitive functions.
  • Processing Speed: Older brains generally process information more slowly than younger ones. This can impact the ability to react quickly in situations requiring fast decision-making, such as driving or operating machinery.

In contrast, cognitive diseases involve more severe and progressive decline. Conditions like Alzheimer’s disease, Parkinson’s disease, and various forms of dementia are characterized by substantial impairments in memory, thinking, and reasoning that interfere with daily activities and quality of life.

Impact on Daily Life and Professional Roles

The cognitive changes associated with normal aging can affect various aspects of daily life, from simple tasks to complex professional roles. For example, older adults might struggle with remembering appointments, managing finances, or learning new technologies. These challenges raise important questions about the capacity of older individuals to continue performing certain activities or holding specific positions, especially those requiring high levels of cognitive function and quick decision-making.

  • Multitasking and Executive Functions: Professions that require the ability to multitask or execute complex plans, such as surgeons or air traffic controllers, might be particularly impacted by age-related cognitive decline. The decreased ability to handle multiple stimuli simultaneously and make quick, effective decisions can pose significant risks in these fields.
  • Processing Speed: Occupations like piloting a commercial airliner demand quick reflexes and rapid information processing. Slower reaction times and decision-making capabilities in older pilots could potentially compromise safety. For this reason, the Federal Aviation Administration (FAA) has set specific age regulations for commercial pilots, setting the mandatory retirement age for airline pilots at 65.

Ethical Delemmas

Determining whether normal age-related cognitive decline should restrict older individuals from certain roles or activities involves complex ethical considerations. On one hand, it’s essential to ensure public safety and maintain high standards in professions where cognitive performance is critical. On the other hand, imposing blanket restrictions based on age can be seen as discriminatory and fail to recognize the individual variability in cognitive aging.

  • Balancing Safety and Fairness: One of the main ethical dilemmas is finding a balance between safety and fairness. It’s important to evaluate individuals based on their actual cognitive abilities rather than their age alone. Regular cognitive assessments and performance evaluations can help determine whether an older person is still capable of performing their duties effectively.
  • Respecting Autonomy: Older adults have the right to make decisions about their lives, including their careers. Ensuring that they are treated with respect and given the opportunity to continue contributing to society is crucial. Any policies or practices should aim to support and accommodate older individuals rather than exclude them arbitrarily.
  • Societal Impact: The aging population is growing, and older adults play an increasingly vital role in the workforce and community. Addressing the challenges posed by cognitive decline requires societal efforts to create supportive environments, provide adequate resources, and promote lifelong learning and cognitive health.

Implications of Aging on the Presidency

Beyond the constitutional and legal requirements, there are several capabilities, skills, and aptitudes implied as necessary for effectively carrying out the duties of the presidency, at least some of which can be affected by normal cognitive decline; however there are also adaptive measures that a president can use to mitigate the effect of aging on his or her skills.

  • Leadership and Decision-Making: The president must possess strong leadership qualities and the ability to make critical decisions, often under pressure. This includes the capacity to guide the nation during crises and set strategic directions.
    • Impact: Normal aging may slow down decision-making processes and reduce the ability to quickly process information and respond to crises. Cognitive decline can impair judgment and the ability to weigh complex variables effectively.
    • Adaptation: A well-structured team of advisors and a robust decision-making framework can help mitigate these effects, ensuring decisions are still sound and timely.
  • Diplomacy and Communication: Effective communication skills are vital for addressing the public, negotiating with foreign leaders, and working with Congress. Diplomatic acumen is necessary for managing international relations and representing the U.S. on the global stage.
    • Impact: Aging can affect verbal fluency, making it harder to articulate thoughts clearly. Hearing loss and other sensory declines can also impact communication abilities.
    • Adaptation: Using clear and concise communication tools, relying more on written communication, and ensuring supportive environments for important discussions can help maintain effective diplomacy.
  • Understanding of Government and Policy: A thorough understanding of the U.S. government, its functions, and the policy-making process is essential. This includes knowledge of domestic and foreign policy issues.

    • Impact: Memory decline may affect the ability to recall detailed policy information or past decisions. Executive functions, including the ability to plan and organize complex information, can also decline.
    • Adaptation: Regular briefings, detailed notes, and the support of knowledgeable aides can help an aging leader stay informed and organized.
  • Ethical Judgment and Integrity: The president is expected to uphold high ethical standards and demonstrate integrity in both personal conduct and official duties. This includes avoiding conflicts of interest and acting in the nation’s best interest.

    • Impact: While ethical principles are generally stable, cognitive decline can affect complex decision-making and the ability to foresee the long-term consequences of actions.
    • Adaptation: Relying on trusted advisors and maintaining transparency in decision-making processes can help uphold ethical standards.
  • Management and Delegation: The ability to manage a large executive branch and delegate responsibilities effectively is crucial. This includes appointing capable individuals to key positions and overseeing their performance.

    • Impact: Aging can affect multitasking abilities and the speed of processing information, making it harder to manage a large team effectively.
    • Adaptation: Delegating more responsibilities to trusted team members and focusing on high-level oversight rather than day-to-day management can help maintain effective leadership.
  • Problem-Solving and Adaptability: The president must be adept at problem-solving and adaptable to changing circumstances. This includes responding to unforeseen events and crises with appropriate strategies.

    • Impact: Cognitive decline can reduce creativity and the ability to think outside the box, making it harder to develop innovative solutions to new problems.
    • Adaptation: Encouraging a culture of collaborative problem-solving and seeking diverse perspectives can help compensate for any decline in individual problem-solving abilities.
  • Mental and Physical Stamina: The demands of the presidency require substantial mental and physical stamina. The ability to handle the stress and long hours associated with the role is critical.

    • Impact: Aging naturally reduces physical stamina and can also affect mental endurance, making it harder to maintain the long hours and high-stress environment of the presidency.
    • Adaptation: Ensuring a healthy work-life balance, regular health check-ups, and a supportive environment can help maintain stamina.
  • Vision and Strategic ThinkingA clear vision for the country’s future and the ability to think strategically about long-term goals and challenges are important qualities for a president.
    • Impact: Strategic thinking requires both a long-term perspective and the ability to synthesize complex information, both of which can be affected by cognitive decline.
    • Adaptation: Regular strategic planning sessions with a diverse group of advisors can help maintain a clear and forward-looking vision.


Aging and cognitive decline are natural processes that affect everyone to varying degrees. While it’s essential to differentiate between normal age-related changes and cognitive diseases, it’s equally important to consider the ethical implications of restricting older individuals from certain roles or activities. Normal aging and cognitive decline can also impact the aptitudes and skills necessary for the presidency, necessitating various strategies and adaptations to help mitigate these effects. By leveraging the support of a capable team, utilizing clear communication tools, and maintaining a focus on health and well-being, an aging president can continue to perform their duties effectively. 


When It’s Time for Dad (or Mom) to Give Up Driving

If our parents live long enough, there will be many conversations we’ll need to have with them that may make us very uncomfortable. One conversation that we all dread is discussing the possibility of our parent giving up driving. This sensitive topic can be challenging to broach, but it’s a crucial one for the safety and well-being of both our parent and others on the road. In this post, we’ll explore the reasons behind this necessary conversation, provide strategies for discussing it with your parent, and touch on the issue of liability exposure in certain situations.

Why Is This Conversation Necessary?

First and foremost, safety is the primary concern when it comes to aging parents and driving. As your parent gets older, their physical and cognitive abilities may decline, which can make them more susceptible to accidents. Slower reaction times, decreased vision, and other age-related changes can put them and others at risk on the road. According to the CDC, drivers aged 75 and older have the highest death toll in car accidents, primarily attributed to age-related factors such as diminished vision, cognitive decline, and physical changes. Furthermore, the death rate per thousand crashes is notably higher among drivers aged 70 and above when compared to middle-aged drivers, who fall in the 35-54 age range.

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How a lawyer can respond to diminished capacity.

Confidentiality is one of the hallmarks of the attorney-client relationship. Clients expect their attorney to uphold the confidential nature of their discussions, and attorneys must adhere to a strict code of conduct to protect the public they represent. But what happens if the attorney questions the capacity of their client?

Capacity can be a complex legal doctrine, but legal capacity is required by parties of a valid contract.  Moreover, standards of capacity can also vary by they type of contract entered into as well as by different states in which the contract is governed. For example, capacity to create a valid Last Will and Testament requires the one creating the will to know the general nature of their possessions and who their legal heirs are. Another standard may be applied to a more complex legal transaction.

Attorney Mark C. Palmer, Chief Counsel at the Illinois Supreme Court Commission on Professionalism, addresses how attorneys can work with clients that are demonstrating cognitive decline. In his article,
Diminished Capacity of a Client: How Should a Lawyer Respond? | Q&A, Palmer discusses three questions an attorney needs to consider:

  1. How does a lawyer know if the client has diminished capacity?
  2. How might this change how a lawyer represents a client?
  3. What protective measures can the lawyer take while meeting ethical obligations?

If you have concerns about the capacity of your aging loved one to execute a valid legal contract, consult with a qualified legal professional, preferably a Certified Elder Law Attorney (CELA) as well as your loved one’s medical provider. It is these professionals’ responsibility to independently determine whether your loved ones have the required capacity to act in their best interests.


Mark C. Palmer is Chief Counsel at the Illinois Supreme Court Commission on ProfessionalismMark writes on civility, professionalism and future law for the Commission’s 2Civility blog and delivers statewide professionalism programming, including a lawyer mentoring program, to attorneys and law students across Illinois. Follow him @palmerlaw.

Source: Diminished Capacity of a Client: How Should a Lawyer Respond? | Q&A

Negotiation Techniques for Adult Children of Aging Parents

In an insightful article published on by Judith Graham, titled “Negotiate with Resistant Aging Parents: Applying Business Strategies,” researchers at Northwestern University explore the application of negotiation and dispute resolution techniques from the business world to defuse conflicts arising from caregiving and financial decisions involving elderly parents. As we strive to provide the best care for our aging loved ones, this article sheds light on strategies to navigate complex situations while respecting their autonomy and dignity. The article delves into a training curriculum designed to help professionals and family caregivers approach caregiving as a collaborative effort and offers valuable insights for fostering productive conversations.

Reaching an impasse with aging parents in their late 80s who resist the idea of receiving home assistance can be frustrating. Negotiation and dispute resolution techniques commonly employed in the business world have shown potential for resolving such conflicts, according to a group of researchers at Northwestern University.

The team has developed a specialized training program focused on negotiation and dispute resolution. Aimed at social workers, care managers, and healthcare professionals working with resistant older adults, this curriculum encourages professionals to engage in collaborative caregiving approaches that honor the individual’s preferences, rather than imposing decisions.

Lee Lindquist, the chief of geriatrics at Northwestern University’s Feinberg School of Medicine, who leads this initiative, highlighted the prevalence of conflicts among older individuals and emphasized the program’s goal to de-escalate such situations, ensuring older adults receive the necessary support while maintaining their dignity.

A significant component of this project is the development of a computer-based training program for family caregivers dealing with mild cognitive impairment or early-stage dementia in their loved ones. Dubbed “NegotiAge,” this program employs avatars of older adults to simulate negotiation scenarios. Through practice, caregivers can refine their negotiation skills and techniques.

This project, funded by the National Institutes of Health with nearly $4 million, strives to make NegotiAge widely accessible after evaluating its effectiveness.

For family caregivers seeking to navigate conflicts with aging parents, the article outlines several proactive steps:

1. Prepare: Before entering negotiations, thorough preparation is vital. Jeanne Brett, a member of the NegotiAge team, suggests addressing fundamental questions, identifying issues, involved parties, their positions, motivations, and potential consequences if an agreement is not reached. Document your goals for the upcoming conversations.

2. Identify Common Interests: Finding common ground among the parties involved is key. Emphasize shared goals and interests, such as maintaining the older adult’s independence, safety, and social connections.

3. Ask Questions: Avoid making assumptions about the reasons behind a parent’s stance. Engage in open-ended discussions to understand their perspective. Show empathy and genuine concern.

4. Brainstorm Strategies: Emotions can run high during negotiations, particularly within family dynamics. Shift focus from conflicts to collaborative problem-solving. Encourage creative thinking and explore multiple potential solutions.

5. Third-Party Involvement: If resolution remains elusive, consider involving a neutral third party, like a mediator or healthcare professional. External input can provide a fresh perspective and facilitate productive discussions.

Applying these strategies can lead to more effective communication, allowing families to navigate challenging decisions while preserving relationships and respecting the autonomy and dignity of aging parents. As the Northwestern University research advances, caregivers and professionals alike stand to benefit from enhanced tools and approaches to address the complexities of eldercare.

To read the full article by Judith Graham on, visit: Negotiate with Resistant Aging Parents: Applying Business Strategies.

A Guide to Recognizing Common Health Issues in Aging Parents

As our parents age, it becomes increasingly important for us to be vigilant about their health and well-being. While aging is a natural process, it often brings about specific health challenges that may require attention and care. Recognizing common health issues in aging parents can enable us to provide timely support and improve their quality of life. In this guide, we’ll explore some prevalent health concerns faced by seniors and offer insights on how to identify and address them.

Cognitive Decline and Memory Loss:

One of the most common health issues experienced by aging parents is cognitive decline, which can include mild memory lapses or more severe conditions like dementia and Alzheimer’s disease. According to the Alzheimer’s Association, approximately 5.8 million Americans age 65 and older are living with Alzheimer’s in 2021, and this number is expected to increase significantly in the coming years. To recognize cognitive decline, observe any noticeable changes in memory, confusion, or difficulty performing daily tasks. If you notice these signs, consult a healthcare professional for an evaluation and proper diagnosis.

Chronic Conditions:

Aging often coincides with an increased risk of chronic health conditions such as diabetes, heart disease, arthritis, and hypertension. According to the Centers for Disease Control and Prevention (CDC), about 80% of older adults have at least one chronic condition, while 77% have two or more. Pay attention to your aging parent’s symptoms, medication management, and any changes in physical abilities. Regular medical check-ups and adherence to prescribed treatments are crucial for managing these conditions effectively.

Mobility Issues:

With advancing age, seniors may experience reduced mobility due to joint pain, muscle weakness, or other factors. Falls are a significant concern among the elderly, with one in four Americans aged 65 and older falling each year, as reported by the National Council on Aging (NCOA). To mitigate the risk of falls, ensure that their living environment is safe and free from hazards. Consider installing grab bars in the bathroom, providing adequate lighting, and encouraging the use of assistive devices like canes or walkers if necessary.

Vision and Hearing Impairments:

Vision and hearing loss are common age-related issues that can significantly impact daily life. The National Institute on Deafness and Other Communication Disorders (NIDCD) estimates that approximately one in three people aged 65 to 74 have hearing loss, and nearly half of those over 75 have difficulty hearing. Regular eye exams and hearing tests can help detect and manage these impairments early, leading to improved communication and overall well-being.


Being proactive in recognizing common health issues in aging parents is vital for providing them with the care and support they need. Regular communication with healthcare professionals, attentiveness to changes in their physical and cognitive well-being, and maintaining a safe living environment are essential steps in promoting their overall health and quality of life. By staying informed and observant, we can be better prepared to navigate the challenges of aging together with our loved ones.

Are you responsible for the financial care of a loved-one?

Learn how to be an effective and honoring financial caregiver.

Article on the Importance of Human Connection

A recent study by Harvard Medical School found that older adults who had in-person interactions with friends, family, and healthcare providers during the first months of the COVID-19 pandemic experienced fewer mental health problems than those who relied on digital connections. The study suggests that digital technologies may not be suitable for the needs of older adults and may cause anxiety and depression. 

Another study by Harvard’s Joint Center for Housing Studies found that older adults living with a spouse or partner during the pandemic had fewer functional difficulties and disruptions to their finances or personal assistance than those living alone. 

The studies emphasize the importance of in-person interactions and better technology to meet the needs of older adults. Seniors over 75 were found to require more assistance with daily living. Click here to read the full article.

Being Social May Be Key to ‘Sense of Purpose’ as You Age

Researchers from Washington University in St. Louis found that positive connections with other people were associated with a sense of purposefulness in older adults. Having a sense of purpose is defined as the extent to which a person feels that they have personally meaningful goals and directions guiding them in life.

Source: Being Social May Be Key to ‘Sense of Purpose’ as You Age – Consumer Health News | HealthDay

Most People Are Confused by Medicare

Financial Planners are failing big time to educate their age 65 or over clients about one of the most significant financial decisions they will make. Medicare applicants are confused about which health plan is right for them. Many seniors do not know enough about plan components, are bombarded by Medicare advertising, and lack the knowledge to choose a plan that meets their needs.

These are the conclusions of a newly released study by Sage Growth Partners, a national health care consultancy. Key findings in the study include:

  • Only 20% of Medicare-eligible individuals have a good understanding of Original Medicare; only 31% have a good understanding of Medicare Advantage.
  • 63% are “overwhelmed” by Medicare advertising; only 31% of respondents “strongly agree” that they can make effective selection decisions.
  • More than half (58%) stay in their current Medicare plan each year rather than reviewing their plan options and enrolling in the best plan for their evolving needs.
  • 33% have a financial advisor, but only 2% use that advisor to help with plan selection.

Source: New Report Reveals Significant Gaps in Medicare Knowledge Among Older Adults

Regarding their experience with working with Medicare as an institution, respondents to the survey rated their experience with Medicare as “poor to terrible.”

Respondents who were newly eligible for Medicare (those aged 64) give
their experience the lowest possible score (-50). The only age group to give it a positive score were those aged 76 and older. By comparison, cable TV providers, notorious for low customer approval, have an average NPS (Net Promotor Score) score of +2.

Check out our 2022 Flipbook Guide to Medicare for a comprehensive explanation of Medicare Parts A, B, C, & D as well as the Medicare Supplemental policy options.

Most Have No Plan for Long Term Care

HGC, an Aging-In-Place research and product development company based in Connecticut partnered with non-profit Arctos Foundation to survey Americans’ preparedness for long term care.

Key findings:

  • 70% of respondents have no advance directive in place, and just one in ten have long-term care insurance.
  • Most respondents have not spoken with a family member or loved one about wishes for Long Term Care.
  • Those with a spouse or partner are more likely to expect a need for long-term care services and supports, but are no more likely to have long-term care insurance in place.

Source: Independent Research | HCG Secure

To help families understand and discuss the issues surrounding planning for long term care, we have two excellent flipbooks on the topic of Essential Estate Planning, and Understanding Long Term Care.

Social Isolation Affects Heart Health, Cognition

Two new studies show the effects that social isolation and loneliness can have on cardiovascular health and cognitive decline.

The two studies provided several compelling links between social engagement and mental or physiological health. Some of the findings include:

  • Social isolation and loneliness are common but are under-recognized as contributing to cardiovascular and brain health.
  • The lack of social connection is associated with an increased risk of premature death from all causes, especially among men.
  • People who experience social isolation or loneliness are more likely to experience chronic stress and depression. Depression can also lead to social isolation.

Source: Social Isolation Affects Heart Health, Cognition

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