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Forbes - Healthcare

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How Decision Fatigue Affects Financial Decisions
John Samuels · 2026-06-02 · via Forbes - Healthcare
Overthinking, too much worried, stress or anxiety, self doubt, fear or indecision, obsession thoughts, mental exhaustion or negative emotional, overload concept, businessman overthinking mess head.

Financial planning assumes clarity. Real life often operates under exhaustion.

getty

Some financial mistakes are not really about money. They are about exhaustion.

They happen after a day filled with decisions that may seem small on their own but add up quickly: What time is the doctor’s appointment? Did the prescription get refilled? Who is picking up the kids? Should you call your mother’s specialist back? What’s for dinner? Did you pay that bill? Is your child struggling? Why is the insurance claim still unresolved? Can you squeeze in work, answer the texts, handle the schedule, remember the forms?

Researchers estimate that adults make roughly 35,000 decisions a day. For someone managing a family, a career and caregiving responsibilities, many of those choices are not trivial. They involve health, money, logistics, emotional labor and other people’s well-being — often before noon.

Then, the time for a bigger decision arrives. It may involve retirement planning, healthcare costs, insurance coverage, an aging parent’s care or a major financial move. Then what happens? Many people are no longer making that choice from a place of mental clarity.

They are making it from a place of depletion.

We Even Have A Name For It: Decision Fatigue

It’s what happens when a steady accumulation of choices, responsibilities and mental demands begins to erode decision quality, making it harder to think clearly, weigh long-term consequences and make thoughtful decisions.

While this affects everyone, it can be especially pronounced for women, who often spend their days managing children, aging parents, schedules, healthcare decisions, household logistics and the hundreds of smaller choices that come with holding family life together. The intensity can be significant. A 2025 caregiving report found that nearly 1 in 4 caregivers provide 40 or more hours of care per week, essentially the equivalent of another job.

Caregiving itself is no small phenomenon. According to AARP and the National Alliance for Caregiving, roughly 1 in 4 U.S. adults is now a caregiver, and 23% of the adult population are part of the Sandwich Generation, supporting both children and older adults at the same time.

Financial planning assumes people are making decisions from a place of calm rationality. But real life is messy and doesn’t care about your schedule. Many people are making critical financial choices while cognitively overloaded, emotionally depleted or simply exhausted — and for many individuals, that cumulative strain can make clear thinking even harder.

When the Brain Is Overloaded, Financial Decisions Become Reactive

When I ran hospitals, I had to make decisions all day long, many of them with real consequences for patients, staff and operations. What I came to understand is that decision-making is not an unlimited resource. The more mental strain accumulates, the harder it becomes to think clearly, prioritize wisely and make thoughtful choices.

Research has shown that chronic stress and cognitive overload can impair executive functioning, emotional regulation and long-term planning. Under strain, people are more likely to delay difficult decisions, default to the status quo, prioritize short-term relief, avoid ambiguity and seek simplicity over optimization.

In financial life, that can look like delaying estate planning, ignoring insurance gaps, failing to revisit outdated strategies, avoiding healthcare planning discussions, emotional spending or panic-selling during market volatility. The issue is not intelligence — it is capacity. Ironically, many of the financial decisions that matter most require exactly the kind of calm, deliberate thinking that chronic stress erodes.

Why Decision Fatigue Hits Some Families Harder

Decision fatigue affects everyone, but some people carry a disproportionate cognitive load.

This is particularly visible among those managing multiple caregiving, family and household responsibilities at once, often while navigating careers, finances and their own health concerns. The Sandwich Generation is one example. Adults simultaneously caring for children, aging parents and themselves often find themselves making an endless stream of decisions related to healthcare, education, family logistics, finances, scheduling and emotional support.

But caregiving is only part of the story.

For many women in particular, decision fatigue can become especially pronounced because they often serve as the default managers of invisible labor within families — even in households where responsibilities appear shared. They may be coordinating children’s schedules, aging parent care, family healthcare decisions, insurance issues, household logistics, emotional support and financial planning conversations, all while managing their own professional and personal responsibilities.

These tasks may not seem directly related to wealth management, but they all draw from the same cognitive reserve.

“The added cognitive and caregiving load women may carry doesn’t just affect their time,” said Evelyn Pepe, Managing Director at RWA Family Office. “It can limit their capacity for engagement in complex financial decisions. Over time, that disengagement can compound just as powerfully as any financial variable, which is why advisors should anticipate these potential pressures and create clear and simple pathways for action that allow clients to stay confident, engaged, and in control.”

Dr. Sadi Fox, a psychologist at Flourish Psychology who works extensively with overwhelmed caregivers and families, sees similar patterns. She recommends using financial resources strategically to reduce burdens that may seem small on the surface but create an outsized impact on mental load.

“People who are caregiving are giving it all,” Fox said. “They often forget to put their needs anywhere on the table, let alone first.”

By the time many people — particularly women balancing caregiving and other high-responsibility roles — sit down to make financial decisions, their mental bandwidth may already be depleted. This is not simply stress. It is cumulative cognitive load, and it changes how decisions get made.

Health transitions can further complicate the picture. Poor sleep, chronic stress, anxiety, caregiver burnout, ongoing medical uncertainty and even menopause-related cognitive symptoms can all affect concentration, emotional regulation and mental clarity.

A person navigating family health issues, work pressures and household demands may not be operating from a position of strategic thinking. They may be operating in survival mode. And this matters because health stress rarely stays in one lane: it quickly becomes a financial issue, a legal issue, a work issue and a family-system issue all at once. Healthcare costs rise, work gets disrupted, caregiving demands expand and emotional strain compounds.

Health and financial stress are often deeply intertwined.

Advisors Need To Recognize Decision Fatigue

Many advisors assume overwhelmed clients simply need more education, more data or more options. But people operating under cognitive strain do not always benefit from more complexity. In many cases, additional choices only deepen paralysis.

Sometimes the highest-value support is not another spreadsheet or simulation. It is helping clients simplify choices, prioritize decisions, sequence problems appropriately and preserve decision-making capacity during stressful periods.

That requires recognizing something often overlooked in financial planning: cognitive bandwidth is an asset.

Mental Bandwidth May Be A Financial Asset

We often think about wealth preservation in terms of investments, taxes, insurance and estate planning. But decision-making capacity matters too.

A chronically overwhelmed person is more vulnerable to delayed planning, emotional spending, missed risks and reactive choices. The people who navigate complexity best are often not the ones with the most information. They are the ones with systems, support and trusted guidance that reduce unnecessary cognitive burden.