Sound decision-making is important for success and well-being in all stages of life but is critical in old age, when many complex and influential decisions are made and opportunities to correct mistakes are limited. Decisions related to financial and health matters are of utmost importance for older adults and have far-reaching implications. Older adults control most household wealth in the United States and face a host of difficult financial decisions related to Social Security distributions, asset decumulation, intergenerational transfers of wealth, and more. Older adults also suffer a disproportionate burden of disease and face complex medical decisions related to chronic disease management and end-of-life care. Adding to the complexity of late-life decision-making, many choices older adults face involve novel considerations and inherent uncertainty; for example, effective management of limited retirement funds requires an estimation of one’s own life expectancy. Despite a lifetime of experience with decision-making, accumulating evidence suggests that many older adults struggle with financial and health decision-making. Older adults often take Social Security distributions too early (resulting in a significant long-term financial disadvantage), engage in unsound investments and risky credit/spending behaviors, and fail to take advantage of financial and health-care benefits. Perhaps even more alarming, older adults are highly vulnerable to financial exploitation and lose more than $30 billion annually in the United States alone. Further, recent Federal Trade Commission survey data suggest a disturbing increase in losses, with adults >60 years losing more than younger adults and considerably higher dollar amounts than their peers in prior years. Losses nearly doubled from 2019 to 2020 among individuals >80, the fastest-growing segment of the population. Further compounding the economic challenge is a looming public health crisis. Financial exploitation is associated with a range of adverse health outcomes, including depression, hospitalization, and early mortality. Indeed, the National Council on Aging dubbed scams against the elderly the “crime of the 21st century” and the Centers for Disease Control and Prevention and other federal agencies have called for immediate and intense efforts to address financial exploitation among older adults.