In 2024, Alzheimer's was the fifth-leading cause of death among U.S. adults ages 65 and up according to the Alzheimer's Association. Yet, when it comes to financial planning, over three-quarters of adults with some
For advisors, adopting more holistic planning approaches now means serving the whole client and preparing clients for life's difficult transitions. This includes cognitive decline symptoms related to diseases
Although cognitive decline is not a pleasant topic, a willingness "adds to the advisor that's willing to sort of 'go there' with the client," said Bryan Walls of Atlanta-headquartered HB Wealth. "It's another great tool in the toolkit and a great way to show your worth."
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Early signs of cognitive decline advisors should notice
The best way to stay ahead of any potential fallout is to know your clients well enough to spot that something might be amiss.
"Maybe it's a weird request [or the client forgetting] things they normally wouldn't, or they can't remember directions," said Jennifer Raess, product counsel and estate strategist of the estate planning platform Vanilla.
Other early signs include clients:
- Asking the same questions repeatedly
- Struggling to follow the conversation
- Making impulsive or out-of-character decisions
- Taking unusual investment risks
- Frustration with understanding documents
- Constantly locking themselves out of their accounts
These point to a potential need to have a conversation with the client and their family about planning for cognitive issues.
Advisors who are accustomed to how their clients go about their lives can create behavioral baselines to return to after interactions. They can also craft updates and check for anything that is out of character or that might need more attention.
The avoidance problem
On a typical visit, clients often already arrive in some form of a heightened state, which, in turn, can lead to a more nerve-wracking experience.
"Money is typically an area that's fraught with anxiety for most people," said Walls.
Add the potential for a tough conversation about the client's well being, health or mental state, and, "some people don't like to talk about how they may have a decline in their abilities or capabilities," said Walls.
Loved ones and advisors who potentially spot a cognitive issue also need to stay vigilant, which poses the dilemma of when to bring things up. Timing matters because if documents and plans aren't in line while the client is sound in mind, they risk needing court involvement or guardianship proceedings.
Rather than go straight to the issue, reframing the conversation as a more practical one to tackle lower-stakes hypotheticals can help.
"I don't start a conversation over 'what happens if you develop dementia,'" said Megan Slatter, a wealth advisor at Crewe Advisors in Salt Lake City, Utah. "It starts with — 'hey, if you were hospitalized tomorrow, who's going to continue to pay your bills? Who can find your insurance information? Who's allowed to talk to your banks?"
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Advisor becomes coach
For families, a loved one's vulnerability also brings with it the potential for them to fall prey to a scam.
In its 2025 annual report on elder fraud and abuse, the U.S. Department of Justice reported it enforced actions on over 1 million scammed elderly victims to the tune of over $2 billion. Of that, $1.8 billion was scammed from seniors under the guise of investment opportunities.
"It's very challenging because artificial intelligence has created a lot of scams," said Walls. In addition to spoofing or phishing, now, "you could get an email that says, 'hey, this is your bank, you have an alert on your account.' Anybody could be subject to that."
For Slatter, one client going through a cognitive decline planned ahead by implementing safeguards around her accounts. When scam notices rolled in, the client was then protected by those same safeguards.
"There's so many people out there to take advantage of our seniors with scams and fraud, and she would have been, I think, subject to that had we not implemented some of that [protection]," said Slatter. "I know she would have, because we still navigate it all the time."
In addition to scambusting, advisors can prepare clients for cognitive decline by taking on the role of coach. In that instance, fluency in providing long-term plans is of the utmost importance.
Clients will need to know their options around long-term care and whole life insurance as well as what means-testing Medicaid signifies for them if they qualify. They will also need information about projections for their future care costs and future care outflows. Providing full balance sheet visibility is critical at this moment to help give them peace of mind or vet out anything that needs addressing.
Wise advisors also know when a need falls outside their expertise. When it's time to join forces with other professionals, advisors can let them take the lead to help provide a full-circle plan.
"Usually, you would have an estate planning attorney for sure if there's documents that need to be revised," said Raess.
For Medicaid planning, "a lot of services are just by state," Raess said. "And even by county where you live as to finding additional care that can either come into the home or if you are looking for a facility at some point in time."
Explaining where vulnerabilities lie and how to avoid them upfront is another way advisors can showcase their expertise and cement their places as critical members of the family's team. It's the advisor's "job and responsibility," said Walls, "to at least highlight that risk, to make sure that they know the optionality around providing for that risk if it were to present itself."
