Client tragedy, a phone call and an advisor's tough job

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Managing investments is easy. Taking care of clients in their most acute time of need is hard. A recent tragedy concerning a client vividly brought home this reality.

The call came on a Wednesday morning. A client visiting her sister out of state had become acutely ill and uncommunicative. She was rushed to the emergency department by ambulance. Her partner, scrambling to get a flight to be with her, called us to let us know what happened.

By the evening our client was in the intensive care unit, still uncommunicative. Her condition quickly worsened. Her partner arrived and it was determined our client would need to be placed on a ventilator or she would die. At this point, the hospital asked for documentation showing that our client’s partner was indeed the health care surrogate.

All of our clients have an electronic vault containing their important documents. The problem? The client’s partner couldn’t remember how to get in the vault. She texted us and asked us to fax the living will and health care surrogate document to the hospital and we promptly obliged.

Our client, a delightful spitfire, had suffered serious health issues in the last three years. Although she was still enjoying life, she was losing her verve. In our last conversation about advance directives, she made it perfectly clear that if she had a serious health event that was going to kill her, she wanted to be kept comfortable and have as peaceful a death as possible. Her partner participated in these meetings and agreed to support her wishes. The client also shared her wishes with her entire family.

The doctors determined our client had pneumonia that had spread to her bloodstream. Pneumonia in people with chronic conditions can cause death very quickly. The next day, our client’s kidneys were failing. She would need dialysis, but even with dialysis her prognosis was grim.

Our client’s partner called. She knew what our client’s choice would have been — not to start dialysis and remove the ventilator. She was ready to carry out those wishes. One of the hardest decisions a person ever has to make is to discontinue life support for anyone, much less the love of your life. She was going to honor her partner but she was torn with pain and angst.

I gently reminded her of our advance directive conversations through the years. We talked about how mad our client would be at us both if she did not follow through and make the hard choice to end life support. Rehashing those conversations helped give the partner the peace of mind she needed to make the decision. Our client died peacefully with her family by her side.

Attorneys complete living wills and health care surrogate documents but they don’t make the time for education about how to actually prepare for a serious health event. Advisors can take this advance directive planning a step further by helping the client document their desired quality of life in the event they can no longer speak for themselves due to a health condition.

Advance directive planning involves much more than having a living will and health care surrogate. Most people consider four abilities essential to a life worth living: the ability to communicate, eat, groom themselves and have meaningful interaction with others. Memorializing these choices can be a godsend in the time of need. Documenting a desired quality of life is not a medical conversation so being a doctor or health care professional is not required. This conversation fits in perfectly with the estate planning discussion.

As my client’s story shows, people need someone to initiate the discussion, get the documents in place, codify the quality-of-life discussion, know where the documents are located and provide access when required. This is not something doctors or attorneys do.

Documenting a desired quality of life is not a medical conversation so being a doctor or health care professional is not required.

Should all these tasks be the client’s responsibility? They could be, but even the smartest and most organized person loses perspective and control when their loved one is dying in front of them. They need help and the best advisors step up in this time of need.

Thoughtful and well-documented advance directive conversations can alleviate the stress of painful decisions and situations when serious illness occurs. We were able to help ensure that our client had her wishes followed and did not end up debilitated and unable to care for herself. Her partner and family were cohesive in their decision-making and at peace with the choice to withdraw life support. Financial planners are in the perfect position to facilitate these types of outcomes. It is rewarding work.

The typical advisor provides a financial plan that covers investments and retirement projections. Some take it a step further by reviewing insurance, estate plans and tax issues. Too often, once this initial planning is complete, the advisor rarely revisits the plan in light of the changes in a client’s life.

This is where many advisors fall short and clients are tired of paying 1% AUM for nothing more than asset management. They want ongoing comprehensive planning. They want to know that the advisor will step up to solve financial problems, especially during serious life events.

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