Spend Some Money To Make Money, Or The Opportunities Of Whealthcare

The more I care for patients with cognitive impairment caused by Alzheimer’s disease as well as cognitive aging, the more I understand how America is missing opportunities to improve their and their families’ well-being, and to strengthen our liberal democracy. One of these is to better integrate the distinct and separated systems that care for their health and wealth, or, in a word, to create a system that promotes “whealthcare.”

The bank and investment house of today is not the firm of tomorrow. As I listen to the leadership of some firms, I’m learning. Some very big firms are living according to some very small ideas. They’re failing to adapt, take a risk, and to change.


A missed bill payment, fraudulent cash transfer, or inappropriate investment purchase, these common events are not someone else's problem. They're not just problems for risk management. In the practice of whealthcare, they're opportunities. You can help your client (and their family, aka "future client") before a problem escalates into a crisis.

Problems like these will be detected and, like a smoke alarm, signal to the firm, a trusted contact and a physician that they must collaborate. They need to figure out what, if anything, might be wrong. Because individuals often have assets spread across multiple institutions, this network will cross-talk so that Bank A knows to be on the alert because of problems at Investment House B.

This system will learn from itself and it will adapt. It will produce data so that the nation can better estimate the size and contours of the problem of financial fraud, errors and cognitive impairment. This system will provide more intensive whealthcare to clients at risk for developing Alzheimer’s and other brain diseases.

When America accomplishes goal #1 of its National Alzheimers Plan, I’ll be diagnosing and treating people before they're disabled. My lab studies the experience of being at risk for Alzheimer’s disease. Many of these cognitively unimpaired adults are still working and volunteering and driving grandchildren to soccer games, but they’re not feeling “normal” (whatever that means) because they have a new sense of self and a mind at risk. Money is among their concerns.

Employees need to learn new skills like KYTC (“know your trusted contact”). When a client has a problem, does your employee know how to talk to this contact as well as the customer? Research on decisional capacity shows how a person's expressed choice may be grounded in little understanding and gross misappreciation. Investment houses, do your employees know how probe understanding and appreciation? They better, because new FINRA rules requiring “hold and report” and “connect with the trusted contact” intensify the need to do this. This isn't about checking boxes. It’s about talking.

Many of these ideas were presented at “Aging, Cognition, and Financial Health: Building a Robust System for Older Americans,” a two day conference organized by the Penn Memory Center and the Philadelphia Federal Reserve Bank. We opened this November 2017 event with an overview of the perilous landscape of elder finances. Each year, as pensions disappear and individual retirement plans grow, more and more money is at risk, and declines in financial literacy are among the earliest signs of brain diseases. People need this money for long term care, especially if they develop Alzheimer’s disease.

We closed with a vision of an integrated, learning and caring system that sees financial health and wealth as two sides of, pardon me, the same coin. I recently said at the New York Academy of Medicine conference “Financial Wellness for Longer Lives,” a smart firm will understand and appreciate how there’s coin to be made hereThe word from the Dance Party in Davos is that Wall Street is really quite rich now. But the true measure of a nation's wealth is its health and well-being. Our aging nation is in trouble. Extremes of wealth and poverty threaten our liberal democracy. It’s time to spend some money to help an aging America.