Clients come to you for your expertise and guidance. Are you prepared to help families dealing with Alzheimer’s disease or another cognitive impairment?

People in this position, especially caregivers, can often feel overwhelmed. Combine this with the responsibilities of financial planning, and it’s not surprising many are left wondering where to start.

With help from researchers at the Massachusetts Institute of Technology (MIT) AgeLab, you can help clients begin the process. While these conversations won’t necessarily be easy, The MIT researchers have created a framework of five topics to help you encourage clients and give them confidence when trying to create a financial plan for a person living with dementia.

The following five topics, taken from the Transamerica-MIT AgeLab Advisor’s Field Guide to Dementia, will help you guide the conversation.

1. Assets

When meeting with a client and family dealing with dementia, you should have a complete view of your client’s assets and how they are managed. It is also important to clearly understand your client’s real estate holdings, especially with respect to home ownership.

Many older adults incorrectly believe Medicare will cover their long-term care expenses. In reality, Medicare covers care in a skilled nursing facility only for the first 100 days, so people often need Medicaid to cover long-term costs. Unless assets have been transferred or gifted to other parties five years before applying for Medicaid, a home and any other assets could be confiscated after the client passes to recoup Medicaid or nursing home expenses.

Before clients make any decisions, you or an attorney should examine each situation on its own merits.

2. Income and insurance

Next, the focus should shift to your client’s income status and insurance policies. You should identify all of your client’s existing income sources, including benefits, where more income could be generated—such as disability payments, Social Security, annuities, and pensions—and how these payments could be affected by other changes in family circumstances such as the death of a spouse.

Also, review your client’s insurance plans to ensure they fit current and future needs, and discuss whether additional policies should be considered to fill coverage gaps.

3. Intentions

It is difficult for most people to think about disease progression, but talking about this early after diagnosis, in the mild stage of cognitive decline, can help family members learn their loved one’s wishes and help reduce stress later.

That’s why it is imperative to understand your client’s wishes and how to ensure they are fulfilled. This can involve legal arrangements that people with dementia make with their families.

These arrangements include where your client wants to live as the disease progresses, how the person wants care to be managed and delivered, and how the individual wants to ensure his or her finances will be safe.

4. Banking administration

As your client’s health declines, he or she will need more help managing day-to-day financial affairs, including tracking expenses and paying bills. Though family members may have taken over these responsibilities, you should ensure your client’s banking and fiscal responsibilities are being met, both practically (e.g., bills are being paid on time) and legally.

5. Care management

Finally, your client and family must discuss how to finance and facilitate care, especially when the disease progresses and caregiving demands intensify. You should talk with your client about his or her preferences for long-term care (in-home care, nursing care, assisted living, etc.) and how to pay for it.

Your client may be involved in these decisions in the mild stage of cognitive decline; however, you may need to make these suggestions to the individual’s family if the disease has advanced to the point where the person can no longer participate in discussions.

To learn more about these five topics in greater detail, download the Transamerica-MIT AgeLab Advisor’s Field Guide to Dementia.

No one wants to talk about Alzheimer’s or dementia because this is not an easy discussion. The reality is clients and families dealing with cognitive impairment need an advisor to start the conversation so they will be prepared for the financial ramifications associated with this horrible condition.