Ideas. Lessons Learned, and Occasionally, Opinions
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.
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.
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.
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.
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.
For many in our society, closure means leaving grief behind, a milestone they usually expect within a matter of weeks or months. Closure means being “normal”, getting back to your old self, no longer crying or being affected by the death. It means “moving on with life” and leaving the past behind, even to the extent of forgetting it or ignoring it. Yet for those who have experienced death, this kind of closure is not only impossible but indeed undesirable.
Closure, if one even chooses to use the term, is more of a process than a defined moment. The initial part of closure is accepting the reality. At first, survivors keep hoping or wishing that it weren’t true. They expect their loved one to walk through the door. They wait for someone to tell them it was all a huge mistake. They just can’t accept that this person has died, that they will never physically see their loved one again or hear the voice, feel the hug, or get that valued input on a tough decision. Usually it takes weeks or even months for the reality to finally sink in. In time, they come to know, in both their heads and their hearts, that their loved one has died and is not coming back. They still don’t like it, but they accept it as true.
As your clients accept this reality, they can more actively make forward-looking choices that help them heal. They slowly begin to envision a life different from what they had planned before, a life in which they no longer expect their loved one to be there. They still feel the pain and loss, but except for short periods of time, they are not crippled by it.
For most of your clients, especially if it was a significant person who died, this healing phase is long and slow, and it involves a lot of back-and-forthing. They may alternate between tears and joy, fears and confidence, despair and hope. Sometimes they feel like they are taking three steps forward and two steps back.
It is important to give clients permission for whatever they are experiencing. Everyone else is telling them to put it behind them and get on with life. Set yourself apart by encouraging them to tell the stories and build memories that they will never “put behind them”. Reassure them that healing does not mean forgetting; it means taking the life, love, and lessons into the future with them.
Eventually your clients are able to let go of what can no longer be. Yet at the same time they realize they are taking the past, with all its pain and pleasure, into a new tomorrow. They become different and hopefully better, more compassionate, more appreciative, more tolerant people. They fully embrace life again, connecting, laughing, and loving with a full heart.
Still, there is no point of “final closure.” There is no point at which your clients can say, “Ah, now I have finally completed my grief.” Or “Yes, now I have healed.” There is no point at which they stop missing their loved one or wondering what life would be like if they were still alive. There is no point at which they will never cry again, although as time goes on the tears are bittersweet and less common. Because we never forget, we carry our loved ones with us forever.
“Closure”? No, or at least not in the way people usually use that term. Acceptance – yes. Peace – yes. A future enriched with love, joy, and hope – absolutely. But putting a period behind the final sentence, closing the door and locking it behind you? No, life and love are much too complex for that. This part of your client’s story does not end; instead it awaits the next chapter, which will undoubtedly build on all that came before.
Stand with your clients as they grieve. Let them know they do not have to forget or leave the past behind. Encourage them to create memories out of what can no longer be, and to live their lives as fully as possible enriched by those memories. Offer them the patience and understanding that few other advisors do. You will reap rewards both personally and professionally.
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.