National Healthcare Decisions Day kicks off on April 16th with a week of planned events to “inspire, educate and empower the public and providers about the importance of advance care planning.”

As a financial professional, you may find clients turning to you for information, especially as they approach retirement or, more likely, when they face issues with aging parents. In order to guide them wisely, it is essential that you are educated on advance directive documents.

In broad terms, an advance directive is any document that allows a person to state “in advance” how they wish to be treated if they are unable to make those choices themselves. The most common advance directive is a living will. Contrary to what many people think, living wills do not always limit treatment or “pull the plug”; they can also be used to request every medical intervention available.

Also, if someone is conscious, capable of making decisions, and able to sign permission forms, there is no need to consult the living will. Living wills only take effect when a patient is unconscious, demented, or otherwise incapable of making their own decisions.

The living will should be the clearest description possible of the person’s desires. Clients often list their wishes based on various situations, as they may want different treatments when imminently dying of cancer than when in a coma from which recovery is likely.

 The advantages of living wills:

1. They keep people in greater control of their lives and deaths, even in cases where they are unable to speak for themselves.
2. They can promote honest conversations within families.
3. They can help prevent legal battles and courtroom fights.
4. Survivors of a loved one’s death grieve with fewer regrets and guilt when they do not have to make treatment decisions without clear instructions from the dying person. 

Common problems of living wills:

1. Only a small percentage of people complete one, and when they do, over half do not give copies to anyone. A living will kept in a safe deposit box or desk drawer is inaccessible when decisions need to be made.
2. The perspectives of a healthy, active person can change dramatically when they actually become ill, and too few people update their documents as they age or diminish.
3. Living wills are not legally binding upon healthcare professionals, and uninformed family members sometimes override them. Family should be informed of the person’s desires, so they can support those desires with medical providers.
4. Each state has their own form, so clients who use the standard living will must complete the form from their state of primary domicile.

But just because there are a number of valid concerns about living wills doesn't mean that financial advisers should discourage their clients from creating the documents. Instead:

1. Strongly encourage clients to write their desires in as clearly and specifically as possible.
2. Consider giving your clients a living will form called the Five Wishes document. It is available at www.agingwithdignity.org for $5 per copy, or $1 per copy when purchased in quantities of 25. The form includes everything found in a standard living will as well as names of healthcare proxies; additional directives such as comfort measures a person desires in their room (music, lighting, blankets, religious items); messages to leave with loved ones, and wishes for services.
3. Schedule a follow-up to ensure clients actually do complete a living will/Five Wishes, and that it is properly signed and notarized.
4. Guide clients to distribute copies to their family members and to any person or institution involved in their care, including primary doctors, specialists, nursing home, hospice, rehab center, and hospitals. Offer to keep a copy in the client’s files at your office, in case a family member needs one and cannot locate it.
5. Add the updating of all advance directive documents to the agenda for your annual review meeting, so your client’s wishes are kept up to date.

When you educate your clients and prompt them to complete a living will, you ease their fears that someone else will dictate their medical decisions. You keep them in greater control and take a burden off their family members. You help them have valuable discussions with those they love. The resulting peace of mind is invaluable to your clients and consequently good for your business.

The Cobbler's Shoes

Perhaps you have noticed that those who most effectively teach skills and protocols to others are sometimes the most remiss in their own recommendations. For example, I know a doctor who ignored her own early warning signs of cancer, and an insurance agent who left his wife with nothing because he let his life insurance policies lapse. While it’s easy to roll your eyes, consider yourself as a financial professional and whether you have your own house in order.

• Do you and all the adult members of your family have an updated will and power of attorney for finance?
• Do you have accessible and complete copies of your healthcare advance directives, including your healthcare power of attorney?
• Is your personal retirement plan on track?
• Do you have a firm succession plan in place should you retire, die, or become disabled?
• If you died last night, would your family know what to do today, including where to find all your important documents?

The president and CEO of a prominent asset management firm recently proposed that although sex was a taboo subject for a long time, the last remaining taboo in our society is money.  I’d like to take issue with that assertion.

It does seem that sex is no longer taboo, at least in the public arena. Sex is used to sell everything from clothes to vacations, sex education  is required in schools, and sex is the subject of more web sites than any other topic. There are a number of gurus dispensing advice on sexual matters, and in recent years companies selling remedies for sexual dysfunction have recruited prominent politicians and entertainers as spokespeople. Indeed, sex is no longer taboo.

Yet money seems to be in a similar category.  It is the subject of endless conversations, speculation, and media coverage.  Well-known pundits spout opinions and give advice on all things financial. Morning news shows regularly interview investment experts.   Magazines, newspapers, and online columns wax eloquently about economics, savings rates, the best stock picks, and IRA’s. Political candidates consider money – who has it, who spends it, and where it is spent – to be a central issue. Money hardly seems a taboo subject.

What, then, IS the final taboo?  What issue has no talk show pundits or advice columnists offering tips?  What is generally pushed out of our collective consciousness, suppressed, denied, and avoided?

Check your own response when you read the word "death".  If you are like most people, you recoil at the very thought of it. There are no key spokespersons giving information and advice about the process and how to deal with it.  Elisabeth Kubler-Ross was long recognized as an expert, but her book On Death and Dying was published in 1969 and Elisabeth herself died several years ago. She temporarily opened the topic, but most of us simply avoid talking about death or facing its inevitability.

The interesting thing is that death used to be familiar. In generations past, grandparents lived with or near their kids and grandkids.  When elders got sick, the family cared for them at home.  When they died, family members lovingly washed and clothed the body, and the wake occurred in the living room. Children were exposed to death as a natural and normal part of life as the entire clan gathered to remember the one who died.  

In recent generations, families began to scatter and both spouses started working. With no fulltime caregivers at home, sick and dying people were moved into hospitals and nursing homes.  Medical technology prolonged life, often seemingly conquering death. Once death did occur, care of the body was shifted to funeral home personnel who quietly performed their duties out of sight. 

As a result of these changes, public perception shifted. Death was no longer considered a normal, natural, and expected part of life.  It became the unexpected and unnatural interruption to normal life.  In modern society, we seem to believe that death is not inevitable, that it won’t happen to us or to anyone we love (at least not until we’re 99 years old and ready to die anyway).  We actively avoid talking or even thinking about it. When death happens, we are shocked and look for someone to sue.

The last taboo, then, is not sex or money.  It is death.  This means most people you encounter, both professionals and clients alike, are unconsciously ignorant about what to say, what to do, and how to support someone who is facing death or grieving the death of a loved one.  The flip side of the equation is that if you do know what to say, what to do, and how to support grieving people, you immediately distinguish yourself in the field.  You serve your clients more compassionately, genuinely, and effectively, and build a reputation for understanding a client’s experience in a way that few other professionals do. 

It is very good for your clients, and consequently it is very good indeed for your business. 

When a client or colleague receives  serious diagnosis or needs to undergo surgery, chemotherapy, or other treatments, people often rally around with support. They offer to bring food, provide rides to doctor’s appointments, watch the kids, etc. While grateful for all the offers, most people are still overwhelmed by trying to keep their network informed of medical progress, juggling responsibilities at work, and coordinating the needed help, all in the midst of the intense emotional and physical drain of the situation.  

You can help alleviate that stress. There are several ways you can provide support that is different than what most people do. For example,  

1. Create a hospital “care package.” Families are often reluctant to leave their loved one’s room when they visit, even if the patient is asleep. Yet hospital air is dry and there is little to do. Create a care package that includes bottles of water and juice, and snacks like protein bars, almonds, chocolates, and pretzels. Add puzzle books like crosswords or Sudoku (with a couple of pencils), and two or three magazines for light reading. If the patient is well enough for visitors, make a brief visit yourself and deliver the package. If not, call a family member to get a time when you can drop it off at the home.
2. Form a team to do errands or work that needs to be done. Examples: Mow their lawn. Pick up dry cleaning. Arrange for house cleaning. Make phone calls. Anything the family needs that you can provide.
3. Create a one-page listing of resources for the patient’s family to use. Do research to find local resources, and also include services such as these free web sites:
   
   •    www.TakeThemaMeal.com  This is a comprehensive meal organization site. The family creates a private online sign-up sheet, friends sign up for specific days and times, and they receive automatic reminders. The site includes a range of recipes for foods that transport well. It also has the option of purchasing items from their store of prepared meals and foods that can be sent directly to the family.  Similar sites include www.Mealtrain.com and www.caringmeals.com.
   
   •    www.CareCalendar.org This is a donor-supported ministry whose site is used to coordinate meals as well as other types of help, such as taking children to their activities or doing yard work. One person or team takes charge of monitoring the calendar. The family lists what help they need and when, and those who can assist sign up. The site sends reminder emails and allows the family to upload photos and post update messages.  Similar sites include www.LotsaHelpingHands.com and www.CareFlash.com
   
   •    www.CaringBridge.org  This provides a way to communicate with many people at once. After the family creates their private personalized Caring Bridge site, a process that takes only a couple of minutes, friends, co-workers, colleagues, and family register on it. Everyone who is registered receives an email whenever the family posts something – i.e. the results of the latest tests, how it’s going that day, or whatever they wish to communicate. Everyone at work and in the friendship circle is updated without the necessity of making countless phone calls or repeating the story endlessly. Those who are registered can then reply on the site if they choose, and the family can read the messages when it is convenient, saving or deleting them as they desire. 

Spare your client or colleague the legwork by providing resources like these. Depending on your relationship, you may even wish to participate in offering practical help to the family. Regardless, let them know you care by providing concrete assistance at a tough time

Mid-winter can be a difficult time no matter your life circumstances. The weather is colder, days are darker, and it can seem like life retreats for a while. This is especially true when you enter a new year without a beloved person who died. How do you cope? Here are ten tips for finding comfort in 2017. 

1. Get outside. Studies show that nature is calming to human brains, and being outside can help reset your mindset. Schedule regular appointments with yourself to go for a walk, snow-ski or ice skate, hike, or do something outdoors. 
2. Drink plenty of water. Staying hydrated is a great way to curb appetite, boost immunity, and maintain energy levels. 
3.  Avoid excess caffeine. A cup of Joe in the morning is fine, but avoid it in the afternoon. Caffeine’s effects last for hours and can interfere with the sleep you so desperately need to maintain your equanimity. 
4. Drink green tea. It has more anti-oxidants than blueberries along with metabolism-boosting benefits that help you maintain your weight, all with less caffeine than coffee or black tea.
5. Help someone else. Even when you're sad, you have something to give that can make someone else's life more enjoyable. Consider simple things - donating an old coat, smiling at every clerk you encounter in the store, or paying it forward in the coffee or fast food line. Mix in volunteer opportunities like serving in a soup kitchen, tutoring kids at school, working on a charity fund-raising event, or anything that gets you outside of yourself to make a difference in someone else’s life. 
6. Find time to relax. Take a bath with Epsom salts and essential oils. If a bath isn’t your thing, get a massage. Or just take a few minutes to breathe deeply and consciously relax your mind and body. 
7. Exercise. Even moderate exercise releases “feel-good” endorphins, focuses your mind, reduces depression, and helps you process your post-holiday and new-year feelings. In fact, some researchers are proposing exercise in place of anti-depressant medication, with studies showing that it can be just as effective.
8. Take time to socialize. Don't assume your friends know how you feel or what you need. Take the guess work out by letting them know what would be helpful. At the same time, it’s OK to ignore all their well-meaning but misguided advice. Actively reach out and work to retain old friends even as you build new ones with people who understand your grief and offer hope. 
9. Break up the usual routine by taking a day trip. Choose a place you've never been, explore a museum at your leisure, attend an interesting seminar, or learn something new. 
10.  Practice gratitude and graciousness. Every evening list at least three things for which you are grateful from that day. Let go of hurts from the past and forgive those who don’t understand or who have hurt you. Carry a thankful attitude into the new year. Any of these things can help. Do as many of them as your energy level allows, and commit to doing more as the year progresses. Even in the midst of loss, life is worth living. It holds surprises and yes, even joy, for those who choose to engage. Don’t let death win. Choose life. May your new year hold healing, peace, growth, and hope.

It’s almost time to send out holiday greetings to your clients. Yet what if your client’s family member died this year? If you send them a card wishing "Happy Holidays", then at best you tell them you treat your clients generically, sending the same card regardless. At worst, it lets them know you don’t understand at all and, like the rest of society, expect them to paste on a smiley-face and “be happy for the sake of the season”. In either case, the card heads straight to the trash, never to be remembered. 

It is never a good idea to wish “Happy Holidays” to people going through the toughest time of their lives. Instead, you can offer authenticity and genuine comfort, distinguishing yourself from everyone else and helping your client at the same time. The first step is to choose a card that does not say Happy Hanukkah, Merry Christmas, Happy Holidays, etc. Choose one that either has no words or that wishes peace or hope. Then include a hand-written note inside and consider including a gift card for a cup of coffee, a movie, a massage, or something else comforting.  

Here are some possibilities: 

• “Wishing you Happy Holidays at a time like this seems hollow. Instead, I wish you peace. I wish you healing. I wish you hope.”
• “During the holiday season, [name]’s absence is sure to be painful. It may be made even worse because most of the people around you will be afraid to say [his/her] name for fear of making you sad. I know I can’t make that void disappear, but I hope you can at least catch a moment of respite with the enclosed gift card. I am thinking of you and remembering <name>, especially now.” 
• “The holidays will bring a mix of emotions as you remember the happy times with [name] and yet mourn [his/her] absence. I hope you can allow yourself to experience it in your own way, acknowledging the happy and the sad, so you can come out on the other side with greater hope and peace. I’ll call you soon to check in and see how it’s going.”
• “During this holiday time, I wish you moments of lightness in the midst of the pain. I wish you companionship of beloved people in the midst of the loneliness. I wish you healing as you learn to survive these days. Most of all, I wish you peace.”

Imagine a client’s daughter was in a bad car accident and is now in the hospital for what looks to be an extended stay. You call your client and spend 30 minutes asking questions and listening as the client pours out the story. As you hang up, you promise your continued contact and support. Then what? How do you best fulfill that promise? Here are three effective steps you can take that are different than what most people do: 

1. Create a hospital care package. Families are often reluctant to leave their loved one’s room when they visit, even if the patient is asleep. Yet hospital air is dry and there is little to do. Create a care package that includes bottles of water and juice, and snacks like protein bars, almonds, chocolates, and pretzels. Add puzzle books like crosswords or Sudoku (with a couple of pencils), and two or three magazines for light reading. If the patient is well enough for visitors, make a brief visit yourself and deliver the package. If not, call the client to get a time when you can drop it off at the home. 
   
   
2. Offer to do errands or work that needs to be done. Examples: Mow their lawn. Pick up dry cleaning. Arrange for house cleaning. Drive children to activities. Make phone calls. Anything the family needs that you can provide. 
   
   
3. Plenty of people will bring cooked meals to the house. If you wish to bring food, be aware of the family’s food allergies and preferences. Then concentrate on items that are less frequently offered - fresh foods like fruits and bananas, yogurt and/or cheese, milk or other beverages, eggs, salsa, hummus, spinach dip, etc. Also consider packaged goods that will keep for a long time if they aren’t consumed currently, such as peanut butter, crackers or tortilla chips, packaged popcorn, pretzels, or cereal. 

These items give families a range of foods for breakfast, lunch, and snacks. Each of these steps offers concrete, tangible benefits for the family of a hospitalized loved one. At the same time, they are things that fewer people will do, making your contribution even more notable. Use or modify these ideas to allow you to do the right thing for your client at a very difficult time.

We do a lot of training at Corgenius in choosing appropriate cards and knowing what to write in them, especially when there has been a loss or life-changing transition. Countless times, people have asked me why I don’t just create a line of cards. That’s not something I have time or interest for, but today I offer you the next best thing.

I met Anne Kertz Kernion a couple of years ago and now I buy a majority of my cards from her company, Cards by Anne (www.CardsByAnne.com). These hand-designed cards are thoughtful, beautiful, and high-quality. Most agree with the principles I teach at Corgenius. And they are an incredible bargain at only $1.25 each. 

Another benefit - you can now get a condolence card with one of my quotes on the cover. Recently, Anne encouraged me to submit quotes for her consideration in designing cards. She then sent a mailing to her very large database and asked them to vote on a wide range of submitted quotes, promising that the top three vote-getters would be incorporated into cards. One of my quotes won by a landslide. (I even out-ranked Pope Francis! I don't imagine that will happen again!)

Of course, Anne's cards still don't solve the problem of what you will write inside. To learn more about this sometimes thorny issue, consider checking out my book “No Longer Awkward”, which contains over 100 texts that you can modify and use for various purposes.

So when you go to the Cards by Anne web site, you will see my card displayed there. Hopefully there will be more in the future. I encourage you to peruse Anne’s other cards as well. I suspect you’ll find yourself returning there again and again for both personal and professional purposes.

Picture this scenario, which gets repeated all too frequently: 

A young man goes to college. Two months later he is rushed to the hospital and into the operating room for an emergency appendectomy. His mother calls the hospital in a panic and asks to know what is happening with her son. The hospital says, “I’m sorry; I cannot give you that information.” She says “But I’m his mother!” The response: “That doesn’t matter. For all of our adult patients, we can only give information to those authorized to receive it, and you are not authorized.” 

You’ve educated your clients on the need for a Power of Attorney for Healthcare (aka healthcare proxy) for themselves, listing who can make their medical treatment decisions if they are unconscious or incapable of making those decisions. Clients may also be aware that HIPAA forms, which they regularly fill out at the doctor’s office when they have appointments, detail who can have access to their medical records.

What most clients don’t realize is that their kids need to have these documents in place as soon as they turn 18. Then they are legal adults, and no one gets access to their medical records or treatment information without express permission. 

To avoid nightmare scenarios, take the following steps: 

1. Ensure all of your clients complete the Power of Attorney for Healthcare, listing a trusted person and at least one alternate in case the designee cannot serve. Also remind them that when they update their HIPAA forms with their doctors, they need to include those same trusted people and perhaps other family members as well. 
2.  Keep track of clients’ children as they age. Offer to start educating the children about financial matters as soon as they are old enough, so that over time they learn about building a budget, the value of compound interest, the cost of long-term debt like a mortgage or lengthy car payment plan, the benefits of regular savings, and the realities of paying for college. Then, as soon as they turn 18, make sure the now-adult children have a Power of Attorney for Healthcare, hopefully naming the parents as their healthcare proxies, and that they fill out the HIPAA forms at their doctor’s office.
3. When an adult child goes to college, recommend that parents ensure the child fills out a HIPAA form at the Student Health Service and at the hospital in the town, listing the parents and perhaps other trusted family members as people who can have access to medical records.

If the aforementioned young man had these documents in place, his panicked mother would have been given full access to his medical records and the details of his situation. She would also have had the right to make treatment decisions on his behalf while he was unconscious and unable to make them himself. 

Especially given the state of our healthcare system, your clients and their family members need to take control of assuring who has access to medical information and the right to make treatment decisions. Addressing these areas with your clients helps you protect them and also extends your reach into the next generation. Any client who encounters such a situation will be forever grateful for your wise and prescient guidance.