Don’t skip this planning conversation: How to address stroke and disability

May is Stroke Awareness Month, offering a timely reminder that stroke remains a leading cause of long-term disability around the world.

For many families, a stroke is not only a health event. It is a financial and legal inflection point that can expose gaps in even well-constructed plans.

When Health Events Disrupt the Plan

Stroke can occur suddenly, often without warning, and its effects can be immediate and lasting. In practice, advisors may encounter clients who are temporarily or permanently unable to make financial or legal decisions, creating an urgent need for designated decision-makers to act. In these situations, even minor oversights can result in significant complications.

Common challenges include outdated or incomplete incapacity documents, insufficient liquidity to address care needs, and estate plans that no longer reflect a client’s current circumstances or intent. Families are often left navigating complex decisions under stress, sometimes without clear guidance from existing plans.

These situations underscore the importance of proactive, coordinated planning.

Understanding Risk as a Planning Trigger

Many of the underlying risk factors for stroke are identifiable and, in many cases, manageable.

From a planning perspective, the presence of known risk factors can serve as a prompt to revisit key elements of a client’s financial and estate plan before a crisis occurs. According to the American Heart Association, high blood pressure is a leading risk factor for stroke, along with diabetes, high cholesterol, smoking, obesity and physical inactivity. Some factors, including age and family history, are not modifiable, while others can be addressed through medical care and lifestyle changes.

For advisors, this presents a practical opportunity. When clients disclose that health changes or known risk factors are present, it can serve as a natural entry point to revisit core planning considerations.

Rather than waiting for a crisis, these conversations can be incorporated into proactive planning.

Planning Considerations to Revisit

Stroke Awareness Month provides a useful framework for revisiting key elements of a client’s plan and confirming they are positioned for the unexpected.

Incapacity Planning

Confirm that durable powers of attorney and healthcare directives are current, properly executed, and aligned with the client’s intent. Particular attention should be given to the individuals named to serve in fiduciary roles and whether those designations remain appropriate.

Long-Term Care Planning

Evaluate how extended care needs would be funded. This may include insurance, dedicated assets, or other strategies designed to preserve flexibility and protect the broader estate.

Beneficiary and Estate Alignment

Review beneficiary designations and dispositive documents to ensure consistency with the client’s overall objectives. Changes in health status often prompt reconsideration of priorities, timing and distribution structures.

Family Communication

Encourage communication among family members and designated decision-makers. Clarity in advance can help reduce both uncertainty and potential conflict during periods when decisions must be made quickly.

Where Philanthropy Enters the Conversation

Significant health events often influence how clients think about legacy. For some, a stroke experience, whether personal or within the family, can become a catalyst for considering the role of philanthropy within an overall estate plan.

These discussions are typically driven by an individual’s values and may arise alongside broader planning updates. Advisors are well-positioned to help translate charitable intent into structured, tax-efficient strategies.

In practice, philanthropy may be introduced when:

• A client expresses interest in supporting research, prevention or care related to stroke or cardiovascular health
• A family seeks to memorialize a loved one through a charitable component
• A client looks to integrate charitable giving within broader estate or tax planning objectives

Planning options may include bequests through wills or trusts, beneficiary designations on retirement assets, and split-interest arrangements such as charitable remainder trusts or charitable gift annuities. Donor-advised funds may also provide a flexible mechanism for ongoing charitable engagement.

When appropriately structured, these strategies can align philanthropic intent with broader planning objectives.

A Resource for Advisors and Their Clients

Organizations such as the American Heart Association can serve as a resource to advisors and their clients in structuring charitable gifts, offering both informational events and technical guidance.

You can see the Association’s list of upcoming events, including a June 30 webinar on the topic of “Planning for the Unexpected: The Advisor’s Role in Disability and Incapacity Planning,” here.

In addition to programmatic impact, the Association and similar nonprofit organizations provide technical support, including guidance on gift structures, sample language for estate documents, and coordination with advisors to ensure charitable intent is clearly documented and properly implemented.

Providing clients with a clear understanding of the potential impact of their gifts can also support informed decision-making, particularly when philanthropic goals are tied to personal experience.

A Timely Opportunity

Stroke Awareness Month is not only a time for awareness. It is a practical opportunity to revisit planning conversations that are often deferred.

By addressing incapacity planning, care considerations and legacy objectives in advance, advisors can help clients and their families navigate uncertainty with greater clarity and confidence. These discussions, while sometimes difficult, are among the most important services that advisors provide.

About the Author

Jeff Gilchrist is a Senior Charitable Estate Planning Advisor at the American Heart Association. He is based in Phoenix, Arizona and works with clients who live in the western United States.

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