Ideas. Lessons Learned, and Occasionally, Opinions
The holiday season is laced with minefields for grieving people, especially if they are facing the first holiday season without loved one. Homes get decorated with sentimental ornaments, candles, and trimmings. Songs carry unbidden emotions. There are countless gatherings of friends and family where the empty chair is all too evident. And because expectations for joy and cheer are so high, these mourners often feel lost, alone, and sad. Your employees, clients, and associates will never forget it if you reach out compassionately during this time, letting them know you understand how hard it is.
Remember not to write cards and notes wishing a “Happy” or “Merry” holiday. Instead, choose texts that wish peace or hope. Then include a hand-written message acknowledging their reality. Here is one possibility: “Wishing you Happy Holidays at a time like this seems hollow. Instead, I wish you peace. I wish you healing. I wish you hope.”
Or: “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.”
Or: “You may find that few people understand what you experience during this holiday season. Try to be patient with yourself and others, as you find your way through the ups and downs it will surely bring. In the meantime, do what seems right to you and take care of yourself. Concentrate on what is most important, and know that I am here for you.”
You may also wish to give or recommend these helpful books:
You may wish to give one or both books to your grieving employees, clients, or associates. These books are small, easy to navigate, cost less than $15 each. With the different formats, the recipients and everyone in their families will be able to find understanding, consolation, and practical help in these pages.
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:
In the past, the holiday season was a time of warmth, surprises, celebration, and hugs. Yet for grieving people, these days are cold and bleak. Hearing holiday songs, reading the ads, and walking into festively decorated stores only serves to rub the scab raw and thrusts the cold spear deeper into broken hearts.
The worst thing you can do is ignore your recently bereaved clients in this painful time. The second worst thing is sending them the same “Happy Holidays” card that you send to everyone else. Do something a little extra for a grieving client that acknowledges the loss. Send a card wishing Peace instead of Happiness. Consider sending a small gift with a card that reads: “Nothing could make up for Jim’s absence this season. Still, I hope you can enjoy this small gift from someone who cares. We are thinking of you, especially at this time of year.” Or “A single rose in memory of Karen. Her love for you and for so many people lives on in our hearts forever.” Or “It may feel out of place as everyone raises a glass in celebration this holiday season. We hope that in your own way, you can use this little bottle of Nate’s favorite wine to toast the memories of past holidays with him and the love that you carry with you through all the holidays yet to come. We’re raising a glass in his honor with you.”
If you really want to make a long-term impression, consider organizing an event early in December for clients whose loved one has died. You can segment if you’d like, i.e. by inviting your widowed clients. Host them for a breakfast or brunch, and do it up right. Have a nice meal, an attractive centerpiece, and attentive staff, so they feel pampered. When all are seated, welcome the group, saying you know the holidays can be difficult for grieving people and you wanted to give them something fun to anticipate along with the pain the coming weeks are sure to bring.
Print a list of questions for discussion and have them placed at each table to break the ice and get them sharing with each other. Introduce it by saying that everyone grieves in their own way, so what one person finds helpful may not be helpful to someone else. However, most grieving people do find some comfort in sharing experiences. Invite them to pick one card at a time and go around the table with answers, accepting whatever someone else has to say.
Examples for the questions: Tell one thing you loved about the person who died, and one thing that drove you crazy. Tell one well-meaning thing that someone said to you after the death that was unintentionally hurtful to you. Tell one thing you wish people would do or not do around you this holiday season.
After the meal, thank everyone for coming and tell them you plan to make this an annual event so they can return the next year. Perhaps have a drawing for the centerpieces at each table. Tell them you will call after the holidays to see what they liked best and if they have any suggestions for how you could improve the event next year. Then, of course, do call and take their feedback seriously.
These suggestions bracket the range of possibilities. The important thing is to be there for your clients in ways that most other people aren’t. When you demonstrate that you understand their grief and you care about more than just the money, you gain a client for life. And when their friends and associates experience a death in the family, what will your clients tell them about their uncommonly wise and compassionate advisor?
When Bill Gates pledged $100 million for research on controlling or curing Alzheimer’s disease in our lifetimes, it focused much-needed attention on this dread disease. At Corgenius, when we teach about preparing for it, signs to watch for, and protocols to follow, we often ask the audience how many have a family member affected by Alzheimer’s. Well over half of the hands in the room go up; often it’s nearly unanimous.
Statistically, 1 in 8 people aged 65 and above have Alzheimer’s disease. Every five years after the 65th birthday the chance of diagnosis doubles. Nearly half of people at age 85 have Alzheimer’s, and one of every three seniors dies with the illness. This epidemic has profound implications for all of us, and especially for financial advisors, who are charged with guiding clients through their elder years in ways that protect their best interests and their financial viability. Here are some resources to help.
For your own education: Our vote for the best recent resource is “In Pursuit of Memory: The Fight Against Alzheimer’s” by Joseph Jebelli. This British neuroscientist has carefully crafted an understandable and comprehensive examination of the history of the disease, causes and characteristics, past and current research, and currently available treatment options. He details the major drug testing failures in the past several years, but ends with hope that in 10 years we reduce Alzheimer’s to a manageable chronic disease like diabetes rather than the debilitating fatal illness is currently is. If you want the best education on the subject and if you appreciated “The Emperor of All Maladies” (which was published in 2010 and examined cancer in the same way), this book is for you.
For your clients with a diagnosis in the family: “The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer Disease, Related Dementias, and Memory Loss” by Nancy Mace and Peter Rabins is a comprehensive listing of what to expect from someone with Alzheimer’s disease along with a wealth of information, tips, skills, and language. The authors incorporate humor, compassion, and realism as they help caregivers and family members cope with the progression of cognitive and physical diminishment while maintaining as much communication and life as possible. Give it to clients and their families as a reliable and highly practical guide.
For everyone: The Alzheimer’s Association. This dedicated organization offers a wealth of resources and services for anyone concerned about or affected by Alzheimer’s disease. They provide in-home care consults, tracking programs for those who wander, free brochures you can provide in your office, a trial match so clients or their family members can be enrolled in appropriate clinical trials, and more. Check out what your local chapter has to offer.
Beta amyloid plaques, or build-up of “sticky” proteins on the neurons, is one characteristic of the disease. Not all people who have beta amyloid plaques have Alzheimer’s, but every person with Alzheimer’s has beta amyloid plaques. With the aid of improved brain scan techniques that more accurately detect them plaques, one focus of research is to prevent, slow, or dissolve the proteins.
Many antibodies have been in clinical trials for some time. Crenezumab, for instance, is showing some promise in early-onset Alzheimer’s. But recently another antibody called Solanezumab became the first one proven to show definitive results in slowing beta amyloid plaque build-up on neurons, at least temporarily.
We are still a long way from a cure. There is no drug or treatment, including Solanezumab, which is capable of preventing or curing Alzheimer’s. All we can do is slow the progression of symptoms for anywhere from a few months to a few years. There is no “fix”. Sooner or later the disease takes over again. Yet every step helps.
What can you do?
When we talk about medical decision-making, especially in the later stages of life, there is a huge disconnect in our society between attitudes and implementation.
In fact, according to the American Journal of Preventive Medicine, only 26% of Americans have living wills or advance directives, even though 86% says it’s important to have their wishes written down.
As a financial professional who cares about your clients’ lives and the impact of healthcare on their finances, make it a part of your practice to recommend advance directives for every client, and offer the following basic information as a guide.
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 have to limit treatment or “pull the plug”; they can also be used to request every medical intervention available. It is up to your clients to state what they wish.
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, in the recovery room after surgery, highly medicated, or otherwise incapable of making their own decisions.
Rather than a cursory document with a couple of boxes checked off, the living will ideally is the clearest description possible of that 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. Because perspectives change with age and state of health, these documents should be revisited at least once a year.
The advantages of living wills:
Common problems of living wills:
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 strongly encourage clients to write their desires as clearly and specifically as possible.
Some of these concerns are addressed by another form of living will. Consider giving your clients a form called The Five Wishes. It is available at www.agingwithdignity.org for $5 per copy, or $1 per copy when purchased in quantities of 25. It’s a very inexpensive way to provide real value to clients and their families.
The form includes everything found in a standard living will from the states. It also includes one legally binding part: The appointment of power of attorney for healthcare. Additional directives include comfort measures a person desires in their room (music, lighting, blankets, religious items), messages to leave with loved ones, and wishes for services. It is a more comprehensive form than the states provide, and almost all states accept it in lieu of their standard form. The only exceptions are AL, IN, KS, NH, OR, OH, UT, and TX, which accept it as long as it is attached to that state’s standard form.
In other words, The Five Wishes is a more complete form that addresses several concerns rather than only one, and it is accepted in every state (given the minor restriction in the eight states named.) If you are working with estate planning attorneys in your COI network, inform them of The Five Wishes and of your desire to have all of your clients use that form. Then there is less chance of discrepancies and overlap between your work and theirs. Like all forms of this nature, the latest one that is signed, notarized, and dated supersedes all previous copies, so it is not a problem to complete the more comprehensive form even for clients who completed the state’s standard form already.
Regardless of what form clients choose, schedule a follow-up to ensure they actually do complete a living will/Five Wishes, and that it is properly signed and notarized. Encourage them 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.
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. The resulting peace of mind is invaluable to your clients and consequently good for your business.
Let me be clear at the outset: it was Terrance's prerogative to make his end-of-life decisions as he saw fit. It was his prerogative to include his wife Amanda in those decisions apparently as co-equal partner during the long final chapter of his life. With that firmly in mind, let's consider what she has to say about that journey.
In this Ted Talk film (“We need a heroic narrative of death”, October 15, 2013), Amanda Bennett is a fine story teller, occasionally poetic in her own voice and concluding with a quote from and for the ages. There are nuggets of utility in here and her final thesis -- there is a way to have a courageous and graceful goodbye -- is imperative to absorb. Her narrative has an almost connect-a-quote corniness about it despite its obviously heartfelt and sincerely sorrowful nature. However, because most of us know that a long and gradual decline is how we will die, Ms. Bennett's notion of "hope” is flawed, despite some utility.
She says "hope is part of our DNA as humans" but inaccurately and unhelpfully conflates acceptance of her husband’s approaching death with "you're prohibiting me from hoping." Her statement, "it's not a bug, it's a feature," is an intellectual sleight of hand that serves no one because she and her husband were, in fact, in profound denial that Terrance would soon die until the final six days of his life.
Again she says, "[I hoped], you might say irrationally, that I could keep him alive forever." I do say "irrationally" because hoping for what one can reasonably know is impossible is denial. That circle can't be squared. Although Bennett insists she was “redefining hope", in reality she kept extending a singular definition of hope (in this case a cure) until it was long-past possible. There is nothing in her narrative to suggest she was "redefining" hope.
She continues by asserting that "what the experts call denial I call hope." False. Once again intellectual and emotional sleight of hand. "Redefining hope" actually means that hope exists until we take our last breath or until our loved one takes her last breath. But, and this is the necessary and essential notion, hope changes. Initially we hope for a cure. Then, when we know that a cure is impossible, we hope to live until our daughter's wedding or our trip to Norway is complete or we finish painting the boat, or . Then, when that hope is fulfilled, or becomes impossible to realize, our hopes change again, until the final hope is to die in the presence of our most treasured loved ones in peace and in as little pain as possible.
That is what redefining hope looks like.
Here is one more example of the sleight of hand she practiced on herself: She claims "our system isn't built to accommodate it [hope and a graceful goodbye]." Actually, there were systemic accommodations available for Terrance and Amanda and they proactively chose to reject the most obvious one, the services of hospice. That's a textbook, Brittanica-grade example of denial.
Amanda and Terrance's correct response to his oncologist's assertion that "better days are ahead" was "I'll discuss that with my rabbi or priest or spiritual leader. As for you, medical profession, tell me the truth, please. Do so with warmth, compassion, humility, and sorrow for me and what you cannot achieve, but just do it."
Indicting an entire group of people is seldom efficacious and never fair but for expediency I do so here: The medical profession is flagrantly wrong to use phrases like "there's nothing more we can do for you” (the dying person) because there is always more we can do for a dying person. It may be true that there is nothing we can medically do but there is always something we can do to achieve Ms. Bennett's goal for each of us "… bid her farewell the Alexandria you are losing."