Work With Clients on End-of-Life Issues

WASHINGTON -- The toughest conversations that advisors need to have with their clients have nothing to do with investment strategies.

Advisors who offer comprehensive planning services and seek long-term -- even multi-generational -- relationships with clients need to address the difficult questions associated with degenerative illness and death, said one speaker at Schwab Advisor Services' annual Impact conference.

Advisors may be well versed in issues like wills and life insurance, but Amy Florian -- CEO of Corgenius, a firm that works with advisors to help them support clients dealing with end-of-life issues and other tough transitions -- urged attendees to counsel their clients about everything from organ donation to the grim implications of do-not-resuscitate orders and dementia.

"There's a hundred thousand advisors in this country who have good products and good services," she said. "Clients of firms who feel like they're getting holistic advice -- things that go beyond just finances -- their perception of the value of that firm is 10 times higher than those who don't."

When the Internet brims with free advice on financial strategies, she argued, simply guiding an investment portfolio isn't the differentiator that it once was. "They have the information you have. Why do they need you? Because you can pull together all aspects of their life -- financial and nonfinancial -- and be a truly comprehensive advisor," Florian said.

Advisors, of course, are no substitute for doctors. But Florian emphasized the role that a trusted financial professional can play in helping educate aging clients and their relatives about the resources available to them -- helping find a local memory-loss facility, for instance -- and orchestrating the paperwork that can ease the process of end-of-life care, such as granting a relative durable power of attorney with the authority to make medical and financial decisions.

FOCUS ON DOCUMENTATION

Documentation is key. As a preliminary step, advisors should have their clients sign a "diminishing capacity" letter identifying individuals that the advisor can contact in the event that the client appears to be slipping. Florian suggested that advisors secure a notarized copy of the letter upon taking on a new client, and then update the contacts each year in an annual review.

"This eliminates so many problems," she said, "because you don't have to worry about compliance, you don't have to worry about privacy, you don't have to worry about what you can tell to who. Your client has given you permission to call these people if you notice any diminishment in their capacity."

Florian sees advisors playing the twin roles of educator and facilitator. Knowledgeable advisors can talk to clients about the options that would let them specify care in the event of a serious accident or debilitating illness. She recommended that they introduce clients to the Physician Orders for Life-Sustaining Treatment initiative, which allows seriously ill patients to create a medically binding document specifying what types of treatments they wish to undergo and which they do not.

"It has the weight of a doctor's standing order," Florian said. "This is a really monumental development, [but] it isn't available everywhere."

"If your state doesn't have one, tell them it's coming," she added.

Advisors can also counsel clients about living wills. Florian cited the Five Wishes template offered by the nonprofit group Aging With Dignity, which allows people to express their preferences for medical treatment and what they would like their friends and relatives to know.

SIGNS OF IMPAIRMENT

Florian urged advisors to watch for signs of confusion or memory loss in meetings with clients. She cautioned, however, that someone who asks the same question three times could be exhibiting either early signs of dementia or something far more benign -- like mild cognitive impairment or even a vitamin B12 deficiency, which can cause memory lapses.

In any case, Florian argued that it's not out of bounds for advisors to recommend that clients visit a doctor. The advisor may also deem it appropriate to notify the person who holds power of attorney for the client, or anyone else named in the diminishing capacity letter. "Don't make a diagnosis. That's above your pay grade. But tell them what you're observing," Florian said.

Advisors who take it upon themselves to talk to clients and their families about end-of-life decisions, daunting as it may be, are also helping their practices. After all, Florian noted, by helping guide a family through a difficult transition, advisors can engender a level of trust that is likely to translate into future clients with a strong loyalty to the practice.

"The other advantage here is you are involving the other generations," she pointed out. "You can't do this without involving the younger generation, who then see what comprehensive services you offer.

"If you walk people through the toughest times of their lives, you will have a client for life. And you'll have their family, and their friends and their associates," she said. "I facilitate support groups. They talk to each other; they trust each other. You do a good job for people in the toughest times in their lives and they won't keep you a secret."

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Client strategies Practice management Estate planning Financial planning
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