My siblings and I had always gotten on quite well, but we feared a breakdown in overall family dynamics if we weren’t careful, even as we were desperate to act fast to protect our dad and his wife as best we could. The living needed at least as much help as the client who was dying. To the three of us, at least, feelings were going to matter just as much as finance.
But on the most primal level, we were simply reeling in those first few months. A.L.S. is an unpredictable disease — one that could progress rapidly and remain challenging for a while, draining away assets that took a lifetime to accumulate. We didn’t quite know which task to tackle first.
A financial planner’s first course of action, though, is often rejiggering and simplifying investments while developing an all-new cash-flow plan. This was especially necessary in my father’s case. Years earlier, I’d had “the talk” with him: Don’t let a nice stranger sweet-talk you into a suite of proprietary, expensive, underperforming, actively managed mutual funds. But it didn’t take, and he’d done it anyway.
Any illness that might mean a precipitous decline — whether A.L.S., Alzheimer’s or certain cancers — involves countless questions as the worlds of medicine and money collide. A good financial planner can answer them off the top of her head.
Some of these questions are immediately evident, even if some of the details vary. When do you start or stop a Medicare Advantage plan? When do you call in hospice, what do its workers do, and who pays? In this case, there were questions about navigating the Veterans Affairs system, a bureaucracy as befuddling as it can be generous. (Seriously, to whoever arranged the benefits for veterans with A.L.S., thank you. You might have kept Dad from zeroing out his assets altogether.)
Then there were things we never could have imagined. He gave up his car keys voluntarily, but would we have to ban his beloved red wine? Does it make sense for an A.L.S. patient to have a colonoscopy? And what about that feeding tube?