The Costs No One Warns You About in End-of-Life Planning

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This series of blog posts is a candid look at how I view end-of-life planning as a financial advisor.

There is a meaningful difference between learning something in theory and understanding it firsthand. End-of-life planning is often discussed in abstract terms. It looks orderly on paper. In practice, it rarely is.

I have been fortunate to have loving grandparents throughout my life. I have always admired their strength, both physical and mental, and the care they showed for each other and our family. Their 66-year marriage has been a personal definition of partnership and stability.

Recently, the wheels of life have caught up to them. Bodies that once felt strong and reliable have begun to fail. The same physical strength that carried them through decades of life now limits independence.

Below, I highlight costs that are rarely discussed when planning for the end of life. Not just the financial ones, but the human ones that surface quietly and linger long after decisions are made.

The Emotional Cost

The emotional cost is both the easiest and the hardest to bear.

It is easy because there is no invoice attached to it. No line item. No sticker shock. No one tells you what it will cost to absorb a diagnosis or to watch a loved one decline.

It is hard because the price is paid internally. In optimism. In peace of mind. In emotional energy.

This cost is especially difficult to reconcile because life does not pause around it. Bills still need to be paid. Work still needs to be done. Daily routines continue. And yet, the reality of what lies ahead sits quietly in the background, present in moments when it is least expected.

For many families, this is the first cost they experience. Unfortunately, it is rarely the last.

The Relationship Cost

There is no bond thicker than blood.

Every family member sacrifices in different ways during end-of-life care. Some take on financial responsibility. Others give time, energy, or emotional support. From emergency room visits to quiet conversations, everyone contributes in the way they can.

During this stage, attention naturally focuses on the person receiving care. It is easy to overlook the relationships supporting that care.

What helps is remembering that everyone is doing their best. Expressing gratitude. Staying aligned. Reminding one another that you are on the same team.

The Liquidity Cost

In the early and middle stages of retirement, expenses tend to be predictable. A good advisor helps define a sustainable withdrawal strategy that supports long-term goals.

End-of-life expenses are different. Not just because they are expensive, but because they arrive all at once.

In-home care can cost $40 to $80 per hour. Nursing care can range from $10,000 to $30,000 per month depending on the level of support needed. Even Medicaid planning and related services come with costs.

What makes this stage especially challenging is uncertainty. It is hard to know how long care will be needed or how quickly circumstances will change. Planning for liquidity is less about precision and more about flexibility.

How Planning Helps

If you do not already have a plan, it is a good time to start. Like planting a tree, the best time may have been years ago. The second-best time is now.

The plan my grandparents had in place was imperfect. What they did have was a strong family they knew they could rely on. Ultimately, much of the responsibility fell on my dad, who stepped away from work to care for them full time.

Some families may not have that option. These are a few questions worth discussing early.

Where do you want to live if you can no longer live independently?

Preferences matter. Staying at home and living in a community setting carry very different costs and support structures.

Who do you expect to care for you?

If someone comes to mind, it is important to communicate that expectation clearly and early.

How much can you afford?

Understanding potential care preferences helps clarify how much flexibility and liquidity is needed. Medicaid is often part of this conversation, and it is a complex process I will address in a future post.

Powering Through

Despite the emotional and financial weight, my family is moving through this together.

Our north star has been simple. Provide the best care we can afford, with dignity and compassion. I am proud of how my family has shown up for one another during this time.

I would not wish this experience on anyone. But it is far more common than most of us realize.

I am sharing this not to alarm, but to educate and to remind you that you do not have to navigate these moments alone. If these questions arise for you or someone you love, our team is here to be a sounding board to make planning decisions.

Good planning does not remove emotion from these moments. But it does give us steadier ground to get through it.

Scott H. Tonai CFP®

Wealth Manager, Director of Retirement Plans

Investment advisory services offered through Andrews Advisory Associates LLC, a registered investment advisor. This blog is not meant to give investment advice. Before investing in any advisory product please carefully read any disclosure documents, including without limitation, the firm’s Form ADVs. The information herein is provided for informational purposes only, and does not constitute an offer, solicitation or recommendation to sell or an offer to buy securities, investment products or investment advisory services. Nothing contained herein constitutes financial, legal, tax, or other advice. These opinions may not fit your financial status, risk and return profile or preferences. Investment recommendations may change, and readers are urged to check with their investment adviser before making any investment decisions.