Ideas. Lessons Learned, and Occasionally, Opinions
When a parent with young children is diagnosed with a life-limiting illness, the emotional devastation disrupts every facet of a family’s life. It is a nightmare all of us hope we never have to face. But, at this very moment, you may well have this occurring in your corner of the world.
Do you know what to do when this nightmare strikes one of your clients?
Beyond financial advice, how can you do more to serve these clients? One way to start is by learning to ask thoughtful, open-ended questions and following their lead on how much they’d like to talk. Excellent questions are things like:
For the kids themselves, there is a relatively new resource on the market that you can give as a gift. It is titled “Sammy’s Story” by Erica Sirrine. This simple, 25-page book is a tenderly written and colorfully illustrated read-aloud book for children ages 3 – 7 who are facing a parent’s death. It sensitively conveys concepts about illness and death, including what children can expect as the illness progresses. It also thoughtfully gives ideas on how the child can maintain a continued bond with the parent even after the death. Intended as a resource to be read with caring adults, it is perfect for family members or other adults as they support children through this most difficult anticipatory grief and what will follow.
Don’t let your own discomfort keep you away. Be there for your client and the family. You will make more of a difference than you know.
Advisors are increasingly faced with deaths among their clients and the clients’ families. In large firms, there may be more than one a month. If you can serve clients really well in those most difficult times, you create a bond of loyalty with the client and with the family members. Those who don’t know how to talk with grieving people are going to lose clients to those who do. Here are a few ideas to consider when communicating with a client after the death of a loved one:
Welcome the client
When a client comes into the office for that first appointment after the funeral, you can recognize the reality that is right in front of you and yet genuinely make them feel welcome with something like this: “I’m so glad you were able to make it in today. I only wish it were under better circumstances. Still, there is so much we can do together and I’ll do everything I can to make this very difficult process just a little easier for you and your family.”
Then, before you get to business, remember that grieving people hunger to talk to anyone who is willing to listen. So invite clients to tell you about their experience. They will let you know if they don’t want to talk and you always follow a client’s lead, but most of the time telling the story is the most healing and cathartic thing they can do.
So ask an open-ended question such as:
Even if you had a similar grief experience, do not say “I know how you feel” or “I understand just what you’re going through.” Doing so is a sure way to alienate grieving clients because you are always wrong.
Instead, let them know you’ve had a similar experience or have some knowledge of the grief process, but then allow for their unique situation by asking a question such as “How is it different?” or “But what is it like for you?”
For instance: “When my mom died, I kept picking up the phone to call her before I remembered there wouldn’t be an answer on the other side, and that was one of the hardest things for me to accept. Is it like that for you? What do you struggle to accept?” This so much better than “I know how you feel” because you don’t.
Tell your clients that some things have to happen on a timeline, such as estate tax filings and trust funding deadlines. Show the list of those things and reassure them that you will make sure they get done without letting anything fall through the cracks.
Other than that, most financial professionals understand that it’s not a good idea to make major decisions too soon, especially if they are irrevocable. In practice, though, this too often means advisors leave clients alone until they call to say they’re ready to talk. That is a mistake, because surely clients will be inundated with ideas from others about what they should do with their money, who they should talk to, or how they should handle things.
Instead, after reassuring about the timeline, say something like: “Did you know that both science and financial regulations say that it’s better not to make major decisions right now? Physiologically, your brain just isn’t ready yet. So this is my recommendation. Take some time to breathe, take care of yourself and your family, get the estate settled, and just put one foot in front of the other. I will be calling you every week or two just to check in and see whether you have any questions or ideas you’d like to talk about. In fact, if someone offers you an idea that sounds good, bring them in. I’ll help you objectively look at whether that’s the best thing to do, and whether it’s best to do it right now. We’ll work together to make sure we’re protecting your loved one’s legacy and your financial future.”
These are just three examples of skills that distinguish you in the field and build lifetime loyalty. Remember, when deaths occur, as they inevitably will, survivors have their choice of hundreds of thousands of financial professionals who do a really good job investing money, insuring people, advising on retirement plans, and more. What is the differentiator clients want? They look for relationship and a financial advisor who understands their lives and knows how to support them in their grief. That is who will get their business.
We sometimes hear advisors assert that they don’t need training in grief support because their client base skews younger. Nothing could be further from the truth.
First of all, remember that grief is triggered by any break in attachment. In other words, any life transition. So a client or a client’s child will grieve when they go to college, break up with a significant other, don’t make the sports team or get knocked out of a competition earlier than hoped, have a pet die, lose a job or get hired for a new one, get married, move to another part of the country, and so much more. In addition, over 1/3 of college students are within two years of the death of a family member or friend, and just over 30% of college students experience a death each year. This figure has always been partly due to accidents, but is increasing due to the rise in suicide rates and opioid overdoses. It is not just elderly parents or grandparents who die; it is too often classmates, friends, or siblings.
As advisors, ignoring these facts serves no one. Acknowledging and addressing them places you front and center with your clients as the go-to resource for the entire family, not just the parents. So what do you do?
Consider developing a program for teens in your office. Hold a one-hour session on financial literacy periodically and invite the high-school-aged children and grandchildren of all your clients. (Need more than information to attract them? Try pizza. It seems to be the Universal Attractant for teens!) Cover how to set up a budget, the facts about compound interest and how that affects both student loans and savings programs. Talk about accounts to begin putting money aside now, and teach them how to use the Wolfram Alpha Retirement Calculator. The quants in your crowd will especially love it, and best of all, it's an app. What’s not to like?
Then include a brief segment on the grief. Acknowledge the many grief triggers, and the fact that so few people learn how to help themselves or each other get through it. Consider giving them the Corgenius book “A Friend Indeed: Help Those You Love When They Grieve,” telling them to keep it with them so they know what to say and do when a friend is going through a loss or transition. (Of course, it will also help them in their own grief, but it’s easier to put the focus on what is often so important for young people – helping their friends.) Among others, another potential resource is the Young Adult Grief Camps, which are specifically intended for ages 18 -22 and hosted by Actively Moving Forward.
Finally, let the teens know they can always come to you with questions. If the questions or situation is non-financial and out of your sphere of expertise, you will help them get the answers they need.
Following a protocol like this helps build your business for the future, ensures better retention of assets when they pass to the next generation, and builds personal satisfaction as you know you are making a difference in young people’s lives.
Our speaking engagements put us in contact with many of you smack dab in the mayhem of one of the stock market’s most volatile 60-day periods in memory and the worst December since 1929. Clients have a "relationship" with their money, and when that deeply personal relationship ends or takes a unilateral relational break, they grieve. So when this period happened, and when it inevitably happens again, what do you say to frightened, angry, grieving clients?
Many advisors told us they said (in language that was sometimes more colorful to emphasize the point): "I know how you feel. My portfolio is doing the same thing, and it hurts!" We saw similar words in various sources, but the gist of the message was the same: "I get it. I know exactly what you're going through because I have money in the market, too."
I understand the good intent. You want to reassure clients they are not alone in their sorrow over wild volatility and steep market declines, since your portfolio took the same proportional hit. Still, the basic grief support principle holds: each person’s grief is unique, even it’s a similar loss. Saying “I know how you feel” during market volatility is as unhelpful as saying it when your client’s parent dies.
Seek First to Understand
The old saw "seek first to understand" is precisely the correct tool to use here. It is fine to acknowledge that you have a similar experience, but don’t stop there. Allow for each client’s uniqueness by asking questions that allow them to tell their story and get you on the same team.
One option could be something like this: “I’m a financial professional, but when things like this happens in the market, everyone gets twitchy. I know it's not rational when I feel that knot in my stomach. I know it’s not going to last because I always allocate every client’s portfolio just like my own, in ways designed to withstand these market swings. But logic doesn't dictate emotions, and so I still feel it. Do you feel it that way when you hear the market news, or how is your reaction different?” This helps allay the fear and blame, because you are treating the client’s portfolio as if it were your own. It also creates a sense of teamwork and problem-solving.
If you rode out the 2008/2009 mayhem with clients, you can include: "In your mind, how is this one similar or different from 2008? Are there things we did or discussed then that might be helpful for us this time?"
Then you can follow up with: “So tell me, what is the worst that you could imagine happening to you financially right now?” Keep asking “What else?” and saying “Tell me more” until you have all the major fears on the table. Then ask, “Since these are your worst fears, what can we do together to keep you safe? I think we’ve done good work together to set you up to weather the storm, but we can always tweak things if you want. Perhaps we should stay in closer touch during this time, too. What seems right to you?”
When you ask open-ended questions like these, you find out what's going on in their heads. Knowing those things doesn't make money come back. It doesn't mean you haven't got work to do to help them sort out their choices and stay the course. But it might make the difference between clients switching away from you vs. ensuring that you are moving in lock-step together through frightening times.
We teach about grief and transition, and usually our focus is on helping you to support and communicate with your clients. There is another aspect, though, because it’s not just clients who are aging. So are your co-workers and colleagues. As data from Cerulli Associates suggests, the average age of a financial advisor in the U.S. is now over 50. Only 23% are under 50.
As a result, you need to learn the skills of grief support for your team as well as for your clients. A few things to look at:
Do you have a compassionate bereavement leave policy? There is no federal law requiring one, but most firms give three to five days for an immediate family member. Consider expanding that to allow at least a week, and to include any relationship that is very important. For some people, for instance, an aunt was more influential than their mother, and her death has great impact. A best friend’s death, especially if it is sudden, can be as difficult as a sibling’s. Be as generous as you can with bereavement leave in your office.
When someone returns from bereavement leave, don’t ignore what just happened. Hug. Have a big box of tissues and a card on the person’s desk, perhaps with a little comfort food like a small box of chocolates. Ask what it’s like now, a week after the funeral, and listen to the stories.
Give more flexibility and support than usual for at least a month or two, recognizing the normal lack of focus and the up-and-down nature of grief. Allow a more flexible work schedule, more breaks, and a back-up person to catch errors that may occur (with assurance that performance reviews won’t suffer during this time).
Continue to check in regularly, saying the name of the one who died. Be particularly mindful of days like a birthday or wedding anniversary, and do something such as taking the grieving person to coffee or bringing in a cake. Acknowledge the void of such a day, while trying to make it a little easier to bear.
You can get more information on how to support your colleagues by reading this article that appeared in the Chicago Tribune in which I am interviewed.
Resolve that in 2019, you will learn to better practice effective, compassionate grief support for your clients, your team, and all those who are important to you. Make a difference when they need it the most.
The holidays are over and now you face winter with its longer, darker days. If you have recently lost a loved one, here are some ideas to help you get through and come out on the other side with greater hope and peace.
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 2019.
Financial expertise alone is insufficient to gain and retain clients. Clients expect more. They want you to understand their personal experience, and be equipped to walk them through whatever life throws at them. Can you?
Welcome to our new complimentary podcast series, Clients for Life. Click here to listen to our inaugural interviews. Each of these short interviews features an advisor who completed the Corgenius Master Class on guiding clients through the most difficult transitions of their lives. They describe the skills and best practices they implemented in their firms, both large and small, that are having the most impact on client satisfaction, loyalty, and referrals.
Take a few minutes to listen and pick up some new ideas on how you, too, can more confidently serve clients through the toughest times of their lives. The podcast series is also available here as an RSS Feed and on iTunes via the Podcast app (Search for "Clients for Life").
We’d love to hear what you think of our new series. Please email us with your comments and ideas.
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.
Instead, here are other possibilities.
Consider text like the following along with a gift card for a cup of coffee, a movie, a massage, or something else comforting:
Too much wisdom is lost every day in this country because we devalue our elders. When we highly value them, and take the time to listen and learn from the wealth of their life experience, it can be eye-opening, informative, and quite a delight for the storyteller and listener alike.
My sister and I recently embarked on a project to capture more of my Mom’s life story before it was lost to us. Over a period of several visits we asked her many things - what it was like growing up in a household with six brothers, what stood out about her Mom’s death from cancer at the too-young age of 52, her happiest and most troublesome memories, how people who knew her as a young woman would describe her, and what she hopes people will remember about her after she dies. Together we laughed, cried, and grew closer. We also learned many things we had never known. For example, we were surprised to find out that she’d had two dogs as a teenager, and she was not very fond of Frank Sinatra, even though all of her friends and classmates swooned over him!
In addition to passing on wisdom and life lessons, these stories are important for another reason. As we age, we are increasingly susceptible to the diseases that cause dementia, including Alzheimer’s disease. When people have Alzheimer’s, they lose their short-term memory first. Family members who gather long-term memories build a way to maintain their relationships, because even if their beloved elder can’t remember what she had for lunch, she may well remember that dog or the kind of music she loved in high school.
So, as you meet with clients to close out the year, encourage them to take time over the holiday season with the older generation, asking for their wisdom and life lessons, and gathering their stories and memories. Your clients will often learn things they never knew before, and may deepen their relationship with parents or grandparents. In the process, they may find themselves wiser, more tolerant, and with greater appreciation for those who comprise their heritage.
Of course, if your clients ARE the older generation, encourage the same thing in reverse. Recommend that they write or record their own memories and stories, along with the wisdom, hard-won lessons, and messages they wish to pass on to their families. The compilation could be a welcome gift of lasting value. Regardless of which direction the information flows, it is an exercise your clients will likely never regret. While you’re at it, perhaps you can do it in your family as well. Give the gift of time, curiosity, memory, and wisdom this holiday season. It costs so little, yet it is priceless.
Christine Olson, a mother in Florida, experienced a nightmare. Her 22-year-old daughter died in a motorcycle accident. After her son found out there’d been an accident, it took 6½ hours of calling hospitals and frantic searching for Christine to receive confirmation that her daughter had died. The pain continued when she was told her daughter’s body was in the morgue, but it was closed for the night, and she would have to come back the next day to see her. She later found out that according to the National Association of Emergency Medicine, the average time nationally that it takes to notify the next of kin is 6 hours, and sometimes it takes up to a day. In her case, her daughter’s address was outdated on the driver’s license, so police had no idea who to contact
This mom used her excruciating experience to found a non-profit organization aimed at preventing other families from experiencing the horror she endured. The organization is called TIFF – To Inform Families First. It provides a secure way that people can enter their next-of-kin contact information into a database that is only accessible to law enforcement personnel. When there is an accident, the police use the driver’s license or state ID numbers to scan the database, and they contact next of kin immediately.
TIFF is currently is available only in six states – Florida, Colorado, Illinois, New Jersey, Ohio and Tennessee. Over thirteen million people are registered in Florida, and the organization is working to get the database active in every state.
For clients or their family members who live in these six states, let them know about TIFF now. For those who don’t, keep track of how the database is spreading across the country so you can notify clients and their families as soon as it is in force where they live.
In the meantime, encourage clients to have ICE (In Case of Emergency) information in their phone, in a wallet or purse next to their driver’s license, on a tag that can be attached to car keys, in the glove compartment of the car, on a Road ID tag attached to their shoes or watchband, etc. The more readily accessible the information is, the more quickly family can be notified of a crisis.
When you educate clients about resources like this, you let them know you care about more than just their money. You care about them and their lives.
One relatively less labor-intensive way to support grieving clients is to create a dedicated page on your website to share online resources on coping with loss. We’ve collected some links that we recommend to get you started on your list.
Alliance of Hope provides healing support for people coping with the shock, excruciating grief and complex emotions that accompany the loss of a loved one to suicide. Also, check out The American Foundation for Suicide Prevention. They provide education and prevention, but also provide support groups and after-care when a suicide occurs.
The Trevor Project is designed for the LGTBQ community. It focuses on prevention, providing a suicide hotline, as well as information, education, and support after a suicide occurs. Suicide rates are much higher in this community.
Grief Share provides in-person support meetings in a number of places around the country. They describe themselves as “a friendly, caring group of people who will walk alongside you through one of life’s most difficult experiences.” They offer the option of a daily “encouragement email”.
The Caring App is aimed at caregivers who provide home care to family. Whether young or elderly, dementia or other physical or mental conditions, this app serves as a how-to-guide that recommends high quality, low-cost products, services, and strategies.
Compassionate Friends is a national organization organizes support groups around the country for parents whose child has died. All leaders have been through it themselves, and the group offers comfort, acknowledgment, and hope.
Family Caregiver Alliance (FCA) an unmoderated email-based support group and participants must register. Many people caring for a loved one who is disabled, ill, or living with dementia, find support and understanding in the conversations with others in similar situations. For support specific to Alzheimer’s, check out the Alzheimer’s Association at www.alz.org
We hope your clients find these resources helpful and healing as they go through their journey, generating gratitude and loyalty to you. If you know of other resources that your clients have benefitted from, please email us at email@example.com and we will be sure to share them.
When your client dies, who owns the pictures on their Facebook page? Who has control of their electronic bill-payment sites or Bitcoin account? Who is responsible for shutting down or memorializing social media sites? Digital rights ownership is an increasingly complex issue as our online lives continue to expand. Are your clients prepared to safeguard these assets after they die?
If your client does nothing in advance, disposition of digital assets goes according to the TOS (terms of service) of each individual site, which vary widely. In fact, many survivors have been shocked by sites that do not allow transfer of ownership or access upon death, or that complicate the settlement of the estate. Rules have been more flexible for minors in states that allow parents or guardians to manage deceased children’s accounts. Yet some families have had to get court orders to obtain rights to their loved one’s digital accounts, a process that can take months or years.
The Fiduciary Access to Digital Assets Act
Several states began to take action by passing a Fiduciary Access to Digital Assets Act. This gave the executor access to all digital accounts and allowed digital assets to pass according to the decedent’s will. However, it ran into legal trouble based on privacy. Some people, for instance, did not want their executor to see highly personal information such as their history of emails and texts, and lawsuits ensued.
The acts were gradually amended to resolve these issues until finally, in 2017, states began passing the Revised Uniform Fiduciary Access to Digital Assets Act (RUFADAA). (http://www.uniformlaws.org/Act.aspx?title=Fiduciary%20Access%20to%20Digital%20Assets%20Act,%20Revised%20(2015). Forty states have now made it law, and it’s pending in five more plus Washington D.C. It will soon be nationwide. What does this mean for financial advisors and estate planners? Digital property now needs to be part of the estate planning process, and you need to help your clients prepare now for their digital afterlife.
Access to Digital Assets
RUFADAA allows the executor or another fiduciary appointed in the will to have access to any electronic or digital sites “necessary” to settle the estate. The necessary sites are largely those involving finances or financial assets, including shopping accounts, automatic bill-paying, online banking, etc. That very narrow provision protects privacy, as it does not allow the executor to access texts, emails, and more private information.
Yet RUFADAA allows for further permissions if the decedent clearly states so in the will. These permissions can cover desires such as whether a Facebook page is closed or maintained as a memorial page, whether a blog is deleted or archived and kept, and all your client’s other desires for digital sites.
Sites that fall under RUFADAA are required to give access to the named fiduciary or executor, but that process can take time and involves proving to the site that the client died. If usernames and passwords are accessible immediately, airline miles can be transferred, sites can be closed, and other desired actions can happen with less complication. It is important to note, though, that clients should never include usernames and passwords in the will, as it becomes a public document upon death.
Your Two-Step Process
There are two crucial steps to take with your clients:
1. Ensure the will includes your client’s intent for the executor or another named fiduciary to have access to digital accounts, how broad those permissions are, and your client’s wishes for disposition. Example: Can the named person see all the tweets, emails, and private personal information, or does access only extend to closing such accounts? What are your client’s desires for each site or each category of sites?
2. Ensure that your client completes another document giving more specific instructions (i.e. to whom they wish to transfer their airline miles and hotel points), and including usernames and passwords. This document should be signed, dated, and preferably notarized, and kept with the will so instructions are accessible to the executor.
To facilitate this, recommend that clients use one of the available services (i.e. LassPass.com) that generate secure passwords for every site and store the entire array of information necessary for access. The document then only needs to include the master password to that service, plus instructions for any two-factor authentication, so the named fiduciary can easily open the entire vault of usernames and passwords. Since the password storage service is dynamic, it also allows clients to maintain security by changing passwords regularly, without having to re-do the document.
Instead of allowing individual sites to determine disposition, take these steps to keep your clients in control and remove at least some post-death headaches. They will never forget it!
We have an unprecedented crisis happening in our country. Every day, 115 people die of an opioid overdose. From 1999 to 2016, 350,000 people have died. A recent survey by the AP and Center for Public Affairs Research found that 1 in 10 Americans know a relative or close family member who died of an opioid overdose. In April, the Surgeon General issued the first national health advisory since 2005, urging families and friends of addicts to carry naloxone, the drug that can reverse the acute effects of an overdose and give a greater chance of survival.
Clearly, we have a huge public health problem with more people dying per day due to opioids than were dying of AIDS at the height of that epidemic. Just as we found the will and resources to combat AIDS over 30 years ago, we need to do it now for opioids.
In addition to scope, there is another aspect of these two epidemics that is similar. When people died of AIDS, their family members were often reluctant to tell others the cause of death because of the stigma. The same is true with the opioid crisis, leaving families unsupported and isolated. It’s bad enough that our society knows so little about how to effectively support the survivors of a loved one’s death; with a stigmatized death, the situation is exponentially worse.
Many people don’t realize that opioid addicts generally begin taking the drugs to relieve intense pain from a medical condition, not to get high. Yet one of the ways opioids work is to increase the levels of dopamine in the body, resulting in a feeling of euphoria while relieving some of the pain. Even if all the pain is not relieved, that which remains seems tolerable because of the underlying “high”.
Addiction begins when the drug rewires the reward centers of the brain, causing the person to perceive anything less than the euphoria as being painful and creating a physiological craving for more of the drug. Tolerance requires higher doses, the euphoria increases, the drug continues to affect the brain, and the addict sinks into an ever-deepening need for opioids just to feel normal. For those who try to reduce or quit, withdrawal symptoms are intense, and they often give up, relapsing into drug abuse to eliminate the pain. It reaches the point where an addict will do anything to get the next hit.
How to Help
After an overdose death, the grief is profound. The family loses a beloved family member. They lose the future they hoped for with that person and the unique place that person held in the family structure. They have exhausted themselves with worry and attempts to help. There are feelings of guilt and inadequacy that the loved one couldn’t be saved. These reactions are combined with anger at the lack of resources for addiction and resentment towards the addict who wasn’t able to kick the habit despite whatever help the family could offer. At the same time, rather than the outpouring of support they would receive if their loved one died of something like cancer, the support is muted, tentative, or absent, replaced by judgment or simply the would-be comforter’s inability to know what to say.
Here are a few suggestions on how you can help a client, friend or family member dealing with this kind of loss:
When I was a young widow, there was no such thing as a support group to help me through. There was no such thing as online resources. There were no retreats for widowed people to share their experience. I sometimes thought I recognized the sadness in another person’s face, but I didn’t dare ask if we had a common thread of grief between us. Despite all the well-intentioned people who loved me, I felt alone and lost. I had to figure out this grief thing by myself and find some way to put the pieces back together, heal, and refashion my life.
No widow should grieve alone -- nor do they have to. While there is now a wide variety of places to help widows get counsel, sympathy and share their feelings, one of the most healing is the non-profit organization Soaring Spirits International. Founded by a young widow, Michele Neff-Hernandez, the group offers Camp Widow®, a weekend this program for widowed persons rebuilding their lives, in different parts of the country as well as a variety of other resources. The value this organization offers is inspiring and I am now a member of their Advisory Board and I teach at their events.
If you have a client who is widowed, I encourage you to tell them about Soaring Spirits. Suggest they chat on its forum, get a pen-pal, read the blog posts of other widowed people, find a regional meeting, check out the long list of recommended resources, register for Camp Widow, gain hope, and know that they are not alone.
And there are other ways you can help, too.
You have the financial expertise to help your clients, now raise the bar in other areas by learning how to do more to support a client through difficult life transitions. Serve your clients well through the toughest times of their lives, and you help them as well as your business.
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.
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."
There is so very much we don’t understand about dementia. Yet every study contributes valuable information that may be crucial in the future as we work to develop prevention and cure. Recently, there were two developments – one on sense of smell and one on personality changes - to which you can alert your clients.
Regarding smell, scientists studied several factors in reasonably healthy people and then followed them for five years to see who developed dementia. They found that when combined with baseline cognitive function at the start, the most important factor was sense of smell. They specifically studied five scents – orange, leather, peppermint, rose, and fish. The greater number of scents that created difficulty and the more poorly a person could discern these smells, the more likely they were to exhibit dementia five years later. Researchers noted that this can’t be relied on as a singular test, but rather as a realization that sensory function is closely related to brain function, and may be among the first areas to exhibit deficiencies.
Another study focused on the long-recognized fact that personality changes are an early sign of Alzheimer’s disease, especially becoming uncharacteristically angry, aggressive, paranoid, or inappropriate. Now researchers have developed a 34-question quiz that can help determine the breadth and depth of behavioral changes, and they are proposing an intermediate diagnosis of mild behavioral impairment. You can see the quiz here. Note that these changes should persist for 6 months and be fundamental changes in behavior in order to indicate problems.
An older test, developed in 2014 by The Ohio State University Wexner Medical Center, is called the SAGE test. You can download a copy here and take the test. Then take the results to your doctor for evaluation and to see whether further tests are justified.
These are all items that you can include in your newsletters for your clients. Let them know you are keeping up to date with this growing issue. Guide them through every transition of their lives.
February is upon us, and a significant number of your clients are dreading it. No, it isn’t the cold, or the dreariness of winter. It’s Valentine’s Day.
In the past, this holiday of love was a day or warmth, surprises, celebration, and hugs. Spouses anticipated receiving a special card, candy or a carefully selected gift, extra attention, and reassurance of their lovability. Yet for widowed spouses, the day is cold and bleak. Hearing the ads and watching couples make goo-goo eyes at each other rubs the scab raw and thrusts the cold spear deeper into broken hearts.
The worst thing you can do is ignore your clients in this painful time. Remember, many people avoid calling on days like Valentine’s Day. That leaves them feeling even more alone and isolated. At the very least, send a card with a small gift. For instance: “No gift could make up for Jim’s absence. Still, I hope you can enjoy a few chocolates from someone who cares. We are thinking of you today.” Or “A single rose in memory of Karen. Her love for you and for so many people lives on in our hearts forever.
If you really want to make a long-term impression, consider organizing an event early in the day for widowed clients. Invite them to 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 Valentine’s Day can be difficult for widowed people and you wanted to give them something fun to anticipate along with the pain the day is sure to bring. Print a list of questions for discussion and place it at each table to break the ice and get them sharing with each other. Examples: Tell how you and your spouse met each other. Tell one thing that drove you crazy about your spouse. Tell one well-meaning thing someone said to you after your spouse died that was unintentionally hurtful to you.
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. As your guests leave, give them a small token such as a real or chocolate flower. Tell them you will call in a week or two 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 are widowed, what will they tell them about their uncommonly wise and compassionate advisor?
New FINRA regulations that passed in 2017 will take effect on February 5. One major provision requires every broker-dealer to make a good-faith attempt to keep on file an alternate contact form for every client. This will function somewhat like the medical HIPAA forms, giving permission for a specific person who can be called if the client can’t be reached or there is an emergency. I’m delighted to see this development, as I’ve been calling for this protocol for many years as a way to protect both your clients and your firm.
I believe, however, that the FINRA rule is only a start. As you may recall, I developed a Corgenius Diminishing Capacity LetterTM. It goes beyond the minimum required for compliance with the FINRA rule, since it allows clients to name more than one person plus the powers of attorney and it gives broader permissions for contacting those in the client’s trusted circle when there is a potential problem.
My simple template is as follows:
“I, [client name], give [advisor names] of [company name and location] permission to call my Durable Powers of Attorney and the following people if they suspect any diminishment in my physical, cognitive, mental, or psychological capacity.”
The form then has space to list at least three people, with their names, addresses, relationship to the client, and contact information. Your clients sign and date it, and you keep it in their files. Every year, you revisit the form to see whether names or items of contact information need updating.
With this form, you have greater leeway, as an emergency or inability to reach the client is not the triggering factor. If you have noticed worrisome signs and suspect a problem in any of these areas, you have explicit permission to call others, including those the client designated as having decision-making power over financial and healthcare matters.
In that call, of course, remember not to make a diagnosis, i.e. “I think your mom might have dementia” or “Your dad appears to be in a serious depression.” Instead, list what you see. “I’m calling to let you know I observed some disturbing signs in my appointments with your mom. She asked the same question three times in 25 minutes, even though I’d answered it each time. She has been unable to follow multi-step directions and forgets decisions we made at the last appointment. There may be an underlying medical cause, and I want you to be aware of it so you or other family members can watch for similar things and take appropriate steps. In the meantime, I am contacting my compliance department to make sure we are protecting your mom’s financial well-being in case there is an issue with her capacity.”
Be sure to document your observations and the phone call itself as evidence that you are doing everything you can to protect your client. This may also help you connect to other family members, who see you as a comprehensive advisor who cares about more than just your clients’ money. Be a wise guide for your clients, even in cases of diminished capacity.
Life is fragile. We truly never know how long we will have on this earth. It is not true that my parents will surely die before me. It is not true that my children will not die before I do. It is not true that good and deserving people will live long lives. It is not true that “til death do us part” means we have unlimited time. Death always comes too soon. It is not logical, and it is never fair when it is someone you love.
Once I comprehend this reality, I have to choose how to respond. I can become a cynical complainer - Life is not fair, it’s too cold outside, the sun doesn’t shine enough (or the sun glares off the snow when it does shine), nobody appreciates what I do, etc. I can become withdrawn and unwilling to invest in life or relationships – after all, everyone I love is going to die anyway so I may as well save myself the hurt by not loving in the first place.
Or I can respond with unconditional investment in life and love. I know that when I do so, I risk everything. There is no love without hurt, no attachment without loss, no life without death, no summer without winter. But the alternative is to die myself. What do I choose?
Bard Lindeman was a nationally syndicated newspaper columnist for years. After his wife died, he wrote the following in his column:
“As a 41-year-old widower, father to three motherless children, I surely knew loneliness and rampant confusion. However, when someone suggested joining a support group, I balked…I was stupid, mistakenly believing in macho self-reliance, for the way back leads through the community, the world around you.
When you’re ready, you need to get up, get out, and get going. Get with people. Find a hobby, take a class at a community college, become a library regular, learn something new, adopt a pet, find a gym and get regular exercise, volunteer to deliver Meals on Wheels, escort a young relative to a baseball game, write letters, plant a tree, subscribe to a newspaper (be informed; your conversation will improve), join a choir, feed the birds, rejoin your veterans association…
You get the idea: Construct an action plan that fits your ‘new life’ and stop trying to reclaim the past. Invent a future.”
It is hard to get the energy and motivation to change your life. It takes time to get comfortable being alone without always being lonely. It takes a certain amount of healing before you can envision a future different than what you had planned before. But those are exactly the things that lead to renewal, happiness, and a life well lived.
Today, decide one thing you can do to invest in a new future. You don’t know how long your life will be;
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.
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 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.
Imagine a scenario: In the course of a regularly scheduled meeting, you notice that your normally astute and proper client has grown visibly thinner and isn’t dressed to the usual standard. You also observe disturbing memory lapses and mental mistakes, including trouble understanding the concepts you explain.
You express concern, ask the client about it, and encourage him or her to make an appointment for evaluation or medical assistance, but then what? Can you call a family member? How do you avoid violating privacy and confidentiality while still taking action you believe is in your client’s best interest?
There is a simple but highly effective way to resolve this dilemma that goes one step farther than the usual emergency contact forms that are standard issue in business: Ensure that each of your clients signs a Diminishing Capacity LetterTM. A simple template is as follows:
“I, [name], give [your name(s); company name; location] permission to call the following people in case of illness, emergency, or if they suspect any diminishment in my physical, cognitive, mental, or psychological capacity.”
The form then has space to list at least three people, with their name, address, relationship to the client, and contact information. Your client signs it, preferably in the presence of a notary public, who dates and notarizes the document. Every year, you revisit the form to see whether names or items of contact information need updating.
Once the Diminishing Capacity Letter is in place, you no longer need to worry about violating privacy or confidentiality. The client has explicitly given you permission to call specific people, not just for emergencies or medical illness, but also if you are concerned about their cognitive or mental state.
Making the Call
When you call, remember not to make a diagnosis, i.e. “I think your mom might be heading toward dementia.” While it is typical to think diminished capacity is related to aging or dementia, remember that there are other reasons for cognitive difficulty that have nothing to do with dementia, such as interactions of medications, infections, a vitamin B12 deficiency, emotional trauma or grief, and more. Regardless of the cause, it is always important to first talk to your client and then to follow up with their contacts if the client does not respond promptly and appropriately.
So rather than suggest a cause, simply list what you see. “I am calling to let you know that I have observed some disturbing signs when I am in contact with your mom. She asked the same question three times in 25 minutes, even though I’d answered it each time, and had trouble following a conversation that normally would be no problem. She also had to think for several minutes before she remembered her grandson’s name. I want you to be aware of what I’m seeing in case you or other family members observe similar things, and you may wish to get her to a doctor for evaluation of the cause.”
Be sure to document your observations and the phone call itself as evidence that you are doing everything you can to protect your client in all aspects of life. Be a wise guide for your clients in all the situations they may encounter.
Have you ever seriously worried about having to live on the streets? Interestingly, that is one of the most common fears of a widow, even if she has more money than she’s ever had due to insurance proceeds. She is afraid it will somehow disappear and she will become a bag lady. In some cases, her situation is precarious enough that the fear is justified and you have to work carefully to preserve whatever funds she has. In many cases, though, the fear is irrational
Allow me a parallel example. My son Steven threw fits at bedtime, because he was convinced the ghosts in the closet would come out at night and “get” him. I used all the logic at my disposal. We turned on the lights and examined every square inch of the closet without finding any ghosts. I sat with him for hours in the dark waiting in vain for ghosts to appear. I garnered the testimony of his older brothers. Nothing worked.
Finally, instead of trying to talk him out of his belief, I acknowledged it as if it were true. “OK, Steven, since there are ghosts in the closet who could come out at night and get you, what would help you feel safe?” We brainstormed ideas until he decided he needed two things: a night light by his bed, and an adult to firmly close the closet door and tell the ghosts they had to stay put until morning. When I implemented his simple solutions he peacefully drifted off to sleep.
With a widow or with any other client with irrational fears, then, do not try to talk her out of being afraid, no matter how compelling the evidence of her safety. She will not feel heard or understood by you unless you acknowledge her fears and find ways to help her feel safe.
This strategy may help:
When you follow this simple procedure, you provide something for a fearful client that few others ever do. You hear her, take her fears seriously, and develop effective strategies for coping with them. That is a sure way to build long-term trust and lifetime loyalty.
At the opening session, I sat with over 300 other widowed people. The diversity amazed me – all ages, cultures, sexual orientations, and length of marriage (including several who were engaged or unmarried but committed to being together for life). I saw significant numbers in their 20’s, along with the grey-crested faces of older age. Some had young children, many had older kids or adult children, while others had no children at all. For some, the death was sudden, unexpected, and tragic; for others, it had been a long struggle with cancer or illness that finally took their spouse. A few were widowed only weeks before they came; for others it had been months or years.
Throughout the weekend, tissue boxes were everywhere and, for some, tears sometimes flowed like rain, as one expects and welcomes without reservation. But there were also lots of hugs, and it was anything but a sorrowful cry-fest. In fact, I’ve never been around so many widowed people and had so much fun! People were eager to share their stories and honor the love they had, but their main purpose was to gain wisdom and support as they grappled with the challenges of building lives that would be very different from what they had planned. It was comfortable and comforting, and people walked away with new friends plus a good dose of hope.
All of this is made possible by a non-profit organization titled Soaring Spirits International. Founded by a determined young widow, Michele Neff-Hernandez, the group now offers three Camp Widow® events a year (Tampa, San Diego, and Toronto), online support, a packet for newly widowed people, and a host of other resources. I am so impressed with this organization that I am now a member of the Advisory Board.
In my professional and personal spheres, I work to shine a light into the darkness of grief, to educate those who want to support the people they care about when they are grieving, and to help people heal. That is also the mission of Soaring Spirits. If you have widowed clients – men or women, young or old – feel confident in referring them to www.soaringspirits.org for resources and help. Perhaps I’ll even see them at an upcoming Camp Widow ® weekend!
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.
Grief hurts—psychologically, emotionally, and physically. A duo of psychiatrists (Thomas Holmes and Richard Rahe) created the Social Readjustment Rating Scale (SRRS) after research with over 5000 patients. They found a high correlation (0.118) between stressful life events and physical illness, and their results were validated in subsequent studies. On this scale, the two most stress-inducing events are death of a spouse and divorce. This comes as no surprise, since these two events change every moment of one’s life.
What is surprising, though, is that three of the top ten are positive transitions, including marriage, retirement, and marital reconciliation. Likewise, the top twenty includes positive events like pregnancy, gaining a new family member, a change in financial state (for worse or for better), and changing to a different line of work (whether unwanted or, more often, a positive choice). Outstanding personal achievement ranks as 25th in stress-inducing events. We think of these as happy occurrences, worthy of parties and celebrations. Yet each one carries a high level of stress and grief as people move from one state of life to another.
In other words, your clients grieve when they go through positive transitions as well as negative. Can you be the wise advisor who recognizes their mixed emotions? Distinguish yourself by asking good open-ended questions so clients know you understand in ways that others don’t.
A few examples:
Picture a scenario in which your client’s father dies after a lengthy illness. Countless people come through the services and say to the family, “At least he’s no longer suffering.” They intend to be comforting, to help the family feel better and focus on the positive. But that’s not what happens. Instead, what survivors hear behind those words is “It’s not right for you to be sad over his death. You should be relieved and happy that he’s out of pain, and instead you’re focusing on yourself. How can you be so selfish?”
The reality is that survivors are indeed glad he’s no longer suffering. They are also relieved that they don’t have to suffer any more watching him die inch by inch. At the very same time, though, they miss him. They long for his presence, his smile, his hug. At times they focus on the relief, and at times they are overwhelmed by the void. Death is a “both-and” event, both happy AND sad, both relieved AND lost.
It is much better to acknowledge both sides of the equation. Instead of saying “At least he’s no longer suffering,” say “We’re all relieved that he’s no longer suffering. No one would want him to suffer. And yet, we’re really going to miss him.” Ideally, follow that up with an anecdote that illustrates the loss, i.e. “I’m especially going to miss his big bear hugs. No one could hug like that!”
If you can't offer an anecdote yourself (many advisors have not met the father of their clients), then after you remark that no one would want him to suffer, ask the client for a memory: “And yet, your family is really going to miss him. In fact, tell me something you will miss, or some story you hope people will remember about him.” Using techniques like this to authentically recognize the intensely mixed emotions of grief demonstrates profound understanding and offers genuine comfort. Your clients will not forget it….nor will they forget you.
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?
For future success, it is therefore crucial that financial professionals educate themselves so they understand the grief process and are equipped to communicate with and support widows. Use these five easy starting points to improve your service to widowed women:
These are just a few of the concepts to put into practice so you can serve the ever-growing numbers of widowed women who will cross your path.
Continue this pattern, always asking questions based on what the client is saying. You will notice the pitch of the voice lowering, longer pauses and slowed breathing as the anger gets spent and the client calms. Only then can you begin talking about what you can do together as you go forward. Ask what steps the client would like to take. Make appropriate suggestions for portfolio review, redistribution of assets, or simply keeping in contact every week or two.
At the end of the conversation, make sure you thank clients for being honest with you. Tell them your door is always open, and you will listen even when it is hard. Reassure them that although times are really tough right now, you can weather the storm together and come out on the other side.
If you can master these skills, your clients will come out of even angry conversations feeling heard, supported, and most of all, loyal to you.
If you find yourself at a loss for words, you are not alone. There has never been a financial advisor’s guide that explains what to say (or what not to say) and how to handle these potentially challenging and professionally awkward situations. When I became a 25-year-old widow with a 7-month-old baby boy, believe me, no one knew the right thing to do or say around me, including the financial professionals I needed to rely on. And I’ve heard the same stories countless times since then, from more than 2000 grieving people. Instead, what most professionals do is either ignore the painful reality and stick to business, or pick up what other people say and inadvertently perpetuate the mistakes.
You can do better than that. You can learn to do the right things and offer genuine comfort and support, no matter what your clients go through.
However, as I continue to get feedback from research and in my support groups, I find that many grieving people don’t appreciate it. They especially resent it when, as sometimes happens, the words are dripping with drama – “I can’t IMAGINE what this is like for you!” Yet even if you take care not to go over the top when you say it, you risk isolating people. They hear your implication that they are so crazy or outside the realm of normalcy that no one else can even imagine what it’s like. And since no one can imagine it, no one can be there and help. It builds a moat around your grieving client that can’t be crossed.
Besides, it ultimately is not true. We have very active emotional imaginations. Most of us can indeed imagine something of the pain and loss, the empty chair, the unanswered phone. In fact, imagining it is one key to building empathy, which is core to who we are as human beings and serves a crucial function in binding us together in mutually helpful ways.
So if you aren’t supposed to say “I know how you feel” or “I can’t imagine what you’re going through”, what do you say instead? Consider asking one of the following questions, modified for the situation if necessary:
Never assume you know what someone else is experiencing. Instead, ask open-ended questions and allow a grieving client to tell you, and then let your imagination take you as close as possible. That allows you to respond more effectively and serve your clients in ways others don’t know how to do.
When you know how to walk your clients through the toughest times of life, you build trust, loyalty, and referrals.
Imagine a usual day. You grab a coffee and settle in at your desk. You conduct two productive client meetings and go for lunch before the afternoon’s tasks. There’s nothing unusual; it’s just a typical day. Then you answer the phone, you hear the hospital chaplain’s voice …..and nothing is ever the same again.
Now imagine it’s the 5th anniversary. That fateful day is seared into your consciousness and it will never be just typical. Though others may expect you to be “over it” by now, you will never forget what happened or the person you so loved.
Perhaps we can learn something from our public memorials of tragic days. Everyone older than 50 remembers exactly where they were when JFK was assassinated, and can still hear Walter Kronkite’s somber voice. It has been 25 years since the Shuttle Challenger exploded, but we remember the name McAuliffe as we mark the day. Ten years after 9-11’s smoke, sirens, and crashing buildings, we pause on the anniversary to show videos, tell stories of heroes, wipe away a tear, and proclaim that we will never forget. Whenever we experience a major loss as a nation, we remember, celebrate, and honor that loss for years to come.
As these examples illustrate, when you are supporting grieving clients and friends, acknowledge that the goal of grief is not to forget or “put this behind us and get on with life”. Instead, we move on precisely because we remember, because we create an enduring memory to carry with us into a future that is different than anything we could have imagined before. We tell the stories and share appreciation for the privilege of having these people in our lives. We try to prevent this kind of tragedy from happening to someone else. We change in more ways than we thought possible. We live with grief and healing, allowing both to co-exist in the everlasting interplay between loss and gratitude, sorrow and joy.
In your practice, never assume your clients are “finished” with their grief at a particular point in time. Honor their need to remember and let them know you understand.
Two simple steps you can take: