Life After Full-time Work Blog

Learn about preparing for life after full-time work through posts from Don's upcoming book.

#157 How To Plan If You’re In Uncertain Health

I’ve avoided the subject so far


You’ll have noticed that my blog posts often include the phrase “assuming you’re in at least average health.” I’ve been lucky enough that that has always applied to me. I’ve never had to think in other terms, and nobody has asked me to – until very recently. A reader sent me this:

“Hi! I discovered your blog through your session with [X]. You always provide such great advice and a clear point of view. I am wondering what you suggest for people that have ‘uncertainty’ surrounding their health. I am about to retire. I don’t think I have enough to retire but I want to enjoy life while my health still allows it. However, at 51, having a rare disease that left me paralyzed for two years. What is the use of saving money for age 60 and beyond … if I don’t know whether my health will last that long? Any thoughts or suggestions?”

This sobering note made me think about retirement in a new light. If this were my situation, I’m not sure I would have the courage to think calmly. But my reader inspires me, and I express my thanks for the inspiration and my congratulations for the reader’s ability to face the issue.

After some time, I’ve come up with this response. I’d be very grateful if readers could offer reactions and thoughts.


I start with four “big picture” thoughts, before getting to specifics.

My first thought is that we’re all likely to react differently to facing these circumstances, so there’s no “right” approach. I can only suggest things to think about, questions we can ask ourselves, to help us come to a course of action that works for each of us separately.

My second thought is that the reader may not be the only person affected by those circumstances. There may be a partner and/or family also affected. Actions chosen will then also affect them, and that needs to be taken into account.

My third thought is that there are (at least) a couple of dimensions that are relevant. One is psychological: how to live life. The other is financial: how to afford life.

My fourth thought is that, for those of us lucky enough not to be facing these circumstances, there are lessons for us to prepare in advance in case we do face them one day.


Now let’s get to the questions.

In a way the most important one is the most difficult to ask, and I have friends and relatives who definitely would not ask it; but my reader inspires me, so I think I would ask it if I were in those circumstances. And it’s: how long have I got? There probably isn’t a definite answer (I hope!), but some idea of the likely lifespan and the likely state of health during that lifespan would form a basis for planning. And without any idea of the range of possible answers to the question, any actions take place in a sort of hit-or-miss context, virtually on a day-to-day footing.

The answer then becomes the basis for further decisions, for both the psychological and the financial dimensions.

One more “big principle” that would underlie my approach is a lesson I learned a long time ago, over many years of interacting with major pension plans, and it’s a principle that, since then, I have also applied to life. It’s simple: “First survive, then thrive.” By that I mean that it’s important to lay down a base that enables you to do what’s essential for survival, both psychological and financial. Once that’s in place, you then have the freedom to do what makes you feel that you are thriving and happy and successful. If you don’t do that, you may one day suddenly find that your survival is threatened by something you could have anticipated but didn’t, and the opportunity to thrive has gone.

So that suggests four sets of questions: how to survive financially, to thrive financially, to survive psychologically and to thrive psychologically.


To survive financially:

What are your assets, and what income can you look forward to, over your expected future lifespan? For a planning horizon I’d add a few years to whatever time estimate you’re given, partly for safety and partly for hope; and by “your” assets and income I mean also the assets and income from your partner and/or family. This establishes the financial base.

And it permits at least a first estimate of an answer to the question: is there enough for my planning horizon?

The other is: is there more than enough, so that I can consider both my own thriving and leaving something to those who survive me?

Very often these levels are referred to as Needs (to survive) and Wants (to thrive).

In answering this question, it may be useful to talk to a financial advisor about potential benefits (which obviously vary not only from country to country but also from one jurisdiction to another, hence the need for expertise) that governments make available in the event of health impairment, or the possibility of drawing on future benefits early for the same reason, or the option to “unlock” some locked-in assets. It may also be that early retirement has a negative impact, if it causes disability benefits to be reduced or cease. And of course you may have forms of coverage through your employer or personally.

It is probably useful to also seek tax advice, because it may be that some of these cash flows are taxable if taken in one form and non-taxable if taken in a different form.

All these topics should give you a base to decide if there’s enough for you to survive financially for your planning horizon. If there is, you may still have the option of continuing to work and save. If there isn’t, continuing may be not so much an option as a necessity. Regardless, you may want to consider if you have another dimension of choice: continuing your current work, doing something part-time, or freelancing.


To thrive financially:

When you’ve done that analysis and decided about future work and saving, you may now have the luxury of thinking of what to do with the surplus over what’s required for your Needs. And essentially there are two beneficiaries from any surplus: you yourself, and your partner and/or family.

I have no guidance there. Personal circumstances and feelings will guide each of us differently. But it should be a comfort simply to know that you’re in a thriving situation.


To survive psychologically:

I think of this as involving both physical and mental health.

As far as physical health is concerned, this is for your doctor to advise on. When I go for my annual medical, my doctor reminds me that we’re a team and plan together – but I’m the only one who can carry out the plan.

For mental health, it may be that you’re fine on your own. For my reader, the mere fact of emailing me with that question suggests to me that the reader is in pretty good shape mentally – better than I would have been in the circumstances – but I’m not a professional, and my opinion carries no weight.

If you need mental support, your partner and/or family typically are the first to turn to. In addition, there are often medical, social and government sources to turn to.


To thrive psychologically:

This is where the fun comes into consideration! And I hope that, when you get to this point, you’ve checked the previous boxes and are eager to find as much enjoyment as possible in your life.

In fact, the answers to the financial questions, and those on mental and physical health, will at least partially answer the scope that you have for enjoyment. In which case, the big issue becomes one of deciding and prioritizing what to do.

For that, I’m inclined to turn to three sets of questions that I’ve found useful in a different context, one that I think of as answering the identity question: who am I?

The first is from the Life’s Abundance Portfolio concept originated by Ed Jacobson.  Ed reminds us that life gives us an abundance of so many things. I can’t remember the names he uses, but the names I give them I can remember in pairs: family and friends, work and play, physical and mental (including spiritual) health – and yes, money. The basic idea is that life’s abundance is a portfolio with those seven asset classes!

Ed’s idea is simple. Rate your life on a scale of 1 to 10 under each heading. There’s no right or wrong answer, and only your own judgment is relevant. Then ask yourself: which of those is a number I’d like to raise? And then: what is within my power to raise it?

That exercise gives you a sense of purpose and motivation and prioritization.

There’s also George Kinder’s three big successive questions. You have all the money you need – how would you live your life? You’ve just been told you have 5 to 10 years to live – how would you change your life? You’ve just been told you have 24 hours to live – what are your regrets? Powerful things to take your time thinking about, leading to the identification and prioritization of what gives you happiness.

I’ve also used an idea of Stephen Covey’s at a time when I felt very low – yes, I’ve been there. Covey asks you to think about your memorial service, and what you would like a family member, a friend, a fellow worker and a member of your community to say about you. How does this suggest you should live your own life? That was the exercise that changed me the most, because it made me realize that there was no chance that any of them would say any of those things unless I changed myself.

And it also made me realize that the legacy that I leave that’s most important to me is my emotional legacy – how people will honestly think about me after I’m gone – far more important to me than any financial legacy I may leave.


I don’t know if all of that is of any help to my reader or to you, if you find yourself in that situation. I hope it at least starts you thinking, and reaching conclusions about the questions you ask.

And again, I say to my reader: I thank you for making me confront an angle I’ve avoided so far, and I wish you all the best for the most thriving future possible in the circumstances.

And I also thank you for giving me permission to publish this as a blog post.


I said up front that this gives us lessons to prepare in advance if we’ve been lucky enough not to be facing my reader’s circumstances.

And to me the financial lessons are to save for the future, to find out whether you have any group coverage, and what form and amount of group coverage you have, from your employer and your government as regards disability insurance and critical illness insurance (or whatever those plans may be called), and to explore whether you’d like to add to those coverages personally.

The psychological lessons come from doing at least one of the Jacobson/Kinder/Covey exercises periodically, perhaps every five years or when there’s a big change in your life. You’ll feel much more in control of who you are.



It’s scary to confront ill-health that seriously affects your future. But here I’ve outlined some principles to start you thinking, if you’re ever in those circumstances, about how you can live your future psychological life and your future financial life, not only to survive but also to thrive.


I have written about retirement planning before and some of that material also relates to topics or issues that are being discussed here. Where relevant I draw on material from three sources: The Retirement Plan Solution (co-authored with Bob Collie and Matt Smith, published by John Wiley & Sons, Inc., 2009), my foreword to Someday Rich (by Timothy Noonan and Matt Smith, also published by Wiley, 2012), and my occasional column The Art of Investment in the FT Money supplement of The Financial Times, published in the UK. I am grateful to the other authors and to The Financial Times for permission to use the material here.

6 Responses to “#157 How To Plan If You’re In Uncertain Health”

  1. Fra klyn says:

    Thanks, Don, very deep and inspiring.
    You wrote to me once regarding my retirement plans, but this is a whole different perspective as we enter our twilight years

  2. Ted Harris says:

    Don, I think you covered things well. To me, key considerations of “first survive, then thrive” include whether or not there are dependents and what their ongoing (financial and psychological) needs may be and what government and employer benefits are available to the writer and their dependents. I’d also encourage a concept of “Life Two” which could include staying on with the employer in some modified fashion, be it fewer days or remote working. If it can be done, it can help cash flow, life & health insurance and gives enough time to do things like fulfilling a (prioritized) “bucket list”. Speaking of insurance, if travel is part of the plan, be sure there is adequate travel insurance – which may cost a bit more if there is a pre-existing condition within a given period before a trip.

    Two life experiences I can offer are that I, and many “retired” people I know, prefer to continue with some form of (paid) work (consulting?) rather than pursuing “classical” retirement, and most people I know who’ve been given a life expectancy estimate actually live longer – so check the stats and probabilities.

    As for psychology, I think the writer has a good attitude about understanding reality and moving forward in the pursuit of positive experiences.

    For credibility, I might also add that I’m a 76 year old cancer survivor and still going strong.

  3. Ted Harris says:

    Don, one additional point on the technical side. In the event that our condition eventually requires a PoA, as an addendum to one’s “Power of Attorney for Property”, I recommend an Investment Policy Statement as a prudent guide for the attorney.

    • Don Ezra says:

      Thanks, Ted — good point. One’s own thoughts, formed at a time when clear thinking and expression are possible, are always a good guide to those who have to look after one.

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