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On Death Talk and Financial Planning

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A financial planning challenge

Rick Kahler MS CFP

By Rick Kahler MS CFP® http://www.KahlerFinancial.com

One of the challenges in financial planning is the strong taboo in our society against talking about money. Another powerful taboo is talking about death when someone has a serious illness.

When someone is diagnosed with cancer, for example, the focus is almost always on treatment and recovery. Rarely is there any discussion of what happens if the treatment doesn’t work. There seems to be an unspoken belief that if we don’t talk about it, it won’t happen.

Not talking about death isn’t limited to family and friends, according to Dr. Carol McClanahan, MD, CFP®

For example, in a recent presentation to financial advisors at the Insiders Forum in Phoenix, she pointed out that many doctors shy away from talking about dying until the very end.

Given this strong reluctance to talk about both money and dying, how can you work with a financial advisor to deal with the financial and emotional issues that go along with a family member’s serious illness?

Here are some suggestions based on Dr. McClanahan’s talk:

Don’t expect someone facing a serious illness to give you an accurate prognosis of their disease, as they are often in denial. McClanahan suggests turning to “Dr. Google” for accurate information. Specifically, she recommends the National Institutes of Health (www.nih.gov), which has statistics on every disease imaginable.

  1. Learn to interpret what doctors say. For example, when a cancer patient is told chemotherapy has a 25% chance of working, the average patient hears “working” as “being cured.” “Working” actually means there is a 25% chance of the tumor shrinking. Often the chances of being cured are far less than 25%, and the physical effects of chemotherapy can be devastating to one’s remaining quality of life. McClanahan says, “Most of what we do to people at the end of life is unnecessary torture.”
  2. Find out early about options for palliative care. This is multidisciplinary care focused on treating the symptoms of treatment, relieving suffering, and improving the quality of life. Because of denial and unwillingness to talk about what happens if they don’t get better, many patients never get into palliative care or get into it way too late. Similarly, most patients wait too long to get into hospice care. The average time in hospice care, according to McClanahan, is just 19 days.
  3. Share your money concerns with the advisor. McClanahan says that anxiety over having enough money to pay for their care and the resulting effect on the family finances are two of the top concerns patients have. Interestingly, most financial advisors focus instead on whether advance directives, estate documents, and funeral plans are in place.
  4. Call the advisor’s attention to signs that a person’s illness is advancing. These can include a shortened attention span, not remembering details of conversations, word-finding difficulties, inability to multitask, mental fuzziness, and depression. Ask advisors to deal with these symptoms: meet early in the day, address the most important issues first, keep meetings short, include family members as appropriate, and put action items in writing.
  5. Realize that sharing your emotions is part of financial planning. Serious illness affects people in many different ways, but the underlying concerns are always emotional. Discuss those concerns with the advisor, and work together to create a comprehensive plan addressing both death and recovery. Remember that, as McClanahan put it, “preparation for a negative outcome does not reduce the risk of cure.”

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The role of the financial planner

The role of a financial planner is to help clients prepare for the future, including the end of life. When that future becomes “now,” don’t hesitate to ask for the planner’s emotional support as well as financial advice. 

Conclusion

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2 Responses

  1. Medicare Reimbursement and Meaningful Conversations About End-Of-Life Care

    On October 30, the US Centers for Medicare & Medicaid Services announced that, starting January 1, 2016, CMS will reimburse physicians and other practitioners for talking with any Medicare recipient about their health care preferences … at the end of life – also known as advance care planning.

    Caught up in a political maelstrom several years ago, CMS has now caught up with a growing desire of patients and loved ones to express, and have health care respect, their wishes. Talking with a trusted provider, before one is faced with a terminal illness, can be an important part of the process.

    http://www.ihi.org/resources/Pages/AudioandVideo/WIHIMedicareReimbursements.aspx

    Jody

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  2. Of Plans and Goals

    Putting goals in writing is similar to eating a healthy diet or following a budget. We know from reams of research that the results are vitally important to well-being. We know that, done correctly, these actions work to produce results. We know our lives would be better if we did them.

    And despite all that knowledge, we don’t do them. Isn’t it interesting how our brains often work against us?

    Writing out goals helps our brains work for us instead. Once goals are down on paper, there is little need to do anything else with them. It’s uncanny how the unconscious portion of the brain can retain them and move us toward accomplishing them.

    One of the main reasons we don’t set goals is that the task of writing out or updating goals isn’t urgent. Our lives are filled with urgent tasks, like getting to places on time, providing meals, coping with household emergencies, and keeping up with our jobs. These, which some time management experts call “C” tasks, keep us so busy that we rarely set aside time to do the more important, non-urgent tasks. These are the “A” tasks like drawing a will, shopping for insurance, setting up a retirement account, and writing goals.

    Another reason some of us resist setting goals is having had an experience of “been there, done that, and it didn’t work.” Many of us have set goals that simply did not come to pass. One possible reason for this lack of success is that we were trying to achieve unmeasurable goals. For example: “I will become a great parent.” “I will become financially independent.” “I will be a great boss.” “I will get into shape.”

    These are not measurable. How do you know if you are a great parent? What is the measurement or the standard? The definition of a great parent is up to the subjective opinions of you and everyone else. There is no way to know if you are there. A goal like this, that doesn’t have a specific date for accomplishment and cannot be measured, is doomed to failure. No wonder so many of us have trouble keeping New Year’s resolutions; they often are unmeasurable goals.

    Wanting to be a great parent is an intention, not a goal. Goals are actions that support intentions. For example, what are some of the signs of great parenting? One might be having good communication with your children. This is still another intention. What does good communication look like? Maybe it means doing something with them weekly, acquiring exquisite listening skills, or connecting with them daily via text or email. All of those are actionable goals that can have a specific date for accomplishment and a measurable action.

    Some examples might be: “I will plan an activity to do with my child every Saturday afternoon, beginning February 1.” “I will have completed a Love and Logic workshop by May 1.” “By July 1, I will have formed a habit of texting my child once a day.”

    These goals are specific and measurable. They can easily be tracked by putting them into a calendar or a reminder program like Alarmed.com on your smart phone, tablet, or desktop.

    Creating measurable goals and writing them down is an effective tool. I know it works. For example, I once made a list of goals that included buying an SUV three years into the future, in January. I filed that goals sheet and forgot it until I came across it five years later. In my garage was a two-year-old SUV. Even without consciously remembering the goal, I had purchased it right on schedule.

    Rick Kahler MS CFP®

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