Ideas. Lessons Learned, and Occasionally, Opinions
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:
Common problems of living wills:
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:
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.
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.
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,
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.
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:
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:
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:
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.
A salesperson called me a few days ago. He was so convinced of the value of his product that after our initial pleasantries, he praised its attributes for several minutes. I asked one question and he talked on for several more minutes. His mistake was that he didn’t stop talking long enough to find out why I might need his product or how it could best serve me. He lost the deal because he knew how to talk about what he was selling but he didn’t know how to listen to me.
How does this relate to serving clients experiencing loss or transition? Like the worst salespeople, the least supportive advisors are those that don’t know how to ask good questions and listen.
There is often a chorus of objections at this point. Usually they sound like these:
Sound familiar? Let’s look closer.
First of all, consider the flip side. What are the consequences of refusing to ask questions? If you carefully avoid the topic and do not bring your client’s grief into the room, there is a big white elephant sitting on the table between you. You both know it’s there but you are trying to ignore it, look over it, slide it to the side, or otherwise pretend it’s not there. It adds a level of tension as you participate in the game of mutual deception.
This feels very familiar to grieving clients, because they encounter it everywhere. Most people, from family to casual acquaintances, don’t know what to say so they say nothing at all. They talk about anything and everything except the person who died. They try to cheer grievers up, hoping to make them feel better. The bereaved people, not wanting to make others uncomfortable, go along with it, but it feels inauthentic and they walk away alone, isolated, and unsupported. Is that how you want your clients to leave your office?
The minute you acknowledge the truth, the big white elephant disappears. For instance, you can ask something simple such as: “What do you wish people knew about what it’s like for you now, a month after Paul died?” or “What has surprised you about the experience of going through Paul’s death?” When you ask an invitational, open-ended question like these, the big white elephant disappears and the tension evaporates. They know you care enough to ask, whether or not they choose to accept your invitation and talk about it. They know you aren’t avoiding the topic or hiding behind your spreadsheets.
Additionally, if they do choose to tell the story and you listen with care, you offer them support they aren’t getting from others. You genuinely help and comfort them, and at the same time you distinguish yourself in the field. You build a level of trust and loyalty you can’t get anywhere else. It’s good for your clients, and it just happens to also be good for business.
The bottom line: You have a lot to lose if you don’t ask; you have nothing to lose if you do.