Getting real about getting old

This week I visited Enid, one of my elderly clients.  Enid is 83, and widowed.  A few years ago, her husband, in the early stages of alzheimers' disease, walked out onto the dual carriageway and was tragically but mercifully killed outright.

Since then, Enid has struggled with a series of significant health issues, made all the worse by the absence of her husband whom she misses terribly.  My input feels pitifully inadequate, but it seems to be a help:  perhaps as a byproduct of her sense of increasing frailty, Enid worries about paperwork.  So when bank statements, half yearly investment summaries and even utility bills arrive, she hoards them so that I can deal with them.  All my financial planning expertise finds its application mostly in telling Enid what she should keep, what may be thrown away, and what needs actioning.  As many of my clients advance through the phases of old age, it is this kind of role which seems to be most appreciated by them.

On this occasion, we talked a little about the future.  For an elderly person, particularly one battling with a serious health condition, talking about the 'future' is not an easy thing.  However you dress it up, the 'future' is going to involve some tough decisions, and it's going to require some realism about the human condition - thankfully, in this case, Enid was up for it.  We began to talk about timescales for selling the house, to enable a move into some kind of sheltered accommodation.  As we planned for a year ahead, aside from the implications for access to savings, I began to realise that anything might happen in the interim to render such plans irrelevant.

It is entirely feasible that we will plan for one model of living, only to find that a deterioration in health, or general weaknesses might move things on to the next phase.  It occurred to me, again, that for an IFA to be able to be of real help, there needs to be a very high degree of trust in place, and that the adviser must not only know his/her subject (LTC) intimately, but must have a similar kind of understanding of his/her client.  Anything else misses the mark widely when it comes to assisting those who are increasingly vulnerable.

Vulnerability in the elderly is an inevitable product of the ageing process, but unfortunately it is also a product of the way in which the 'care' system operates.  Nothing appears to be joined-up anymore.  The bureaucracy surrounding care is now so complex, and so all-encompassing that it requires an expert to penetrate it.  The fragmentation of the apparatus of care is a product of the way our society thinks and operates, although when deficiencies are pointed out to providers, invariably they will cite funding issues as the reason.  This is a disingenuous and inaccurate explanation: the lack of integration between agencies has little to do with money, and everything to do with the new philosophical basis for 'care' which sees it as dispensing a piece of equipment, or a drug, or fixing a blocked catheter, rather than supporting the individual.

It seems to me (again) that IFAs concerned about their elderly clients, who pursue their LTC qualifications, are in an admirable position to help join up the dots.  The devil may be in the detail, but for those IFAs who see their role as managing the network of professional contacts with the ultimate aim of supporting the client, there is much good that may be done here. 

For this to happen, we need to be 'real' with our clients about the reality of getting old in a society which, frankly, no longer cares, and probably cannot afford to care any longer.  In this connection, you may find this article by Lionel Shriver of use, published in the April 2011 edition of Standpoint Magazine.