Dealing with a Client’s Terminal Diagnosis

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[From FPA Retreat 2010, our on-the-ground reporter highlights one of Saturday’s sessions.]

Among phobias, it’s at the top of the list after public speaking: facing death. And culturally speaking, it’s not just our own deaths we’re afraid of facing—we struggle to face death and grieving in almost anyone we know. But financial planners need to be prepared to help their clients face practical realities in the face of death, and Amy Florian, an expert on issues of grieving who frequently works with financial planners, helping to build their communication about these skills, described scenarios for how to work with clients who are facing a terminal diagnosis.

Florian covered a wealth of information in her session, from the four things every dying and/or grieving person needs to experience and express to move healthfully through the experience (appreciation, forgiveness, love and closure) through how to set the proper environment for the difficult meetings that follow a terminal diagnosis. But one of the things that seemed especially helpful was that she broke people into two categories: intuitives and instrumentals. In terms of how they process things, intuitives tend to speak the language of emotions, while instrumentals speak the language of action. One of the most important things to do is to determine your client’s style and your own, and to speak to them in the language with which they’re most comfortable. If you speak to an intuitive in the language of action, for example, by talking about estate and healthcare planning, they won’t feel heard or understand, and will leave the engagement frustrated, without having been able to concentrate on or process technical details while overwhelmed by feelings. Similarly, if you speak the language of feelings to an instrumental person, they feel pushed to discuss things they prefer not to discuss, and tend to shut down and want to deal with someone who can help them process the practical realities of their situations.

There are numerous ways to connect with both types of people, which is important, because each member of a couple can have contrasting styles and both of them need to feel heard. Florian made several practical suggestions:

  • Set aside plenty of time, especially for the first meeting after the diagnosis, and be ready to spend a majority of the time on nonfinancial issues, especially if you and/or your clients are intuitive.
  • Open the door (conversationally) and let the client decide whether to walk through it or not. Mention feelings, but if a client doesn’t want to discuss them, don’t push them. Similarly, if you mention some tactical matters related to financial planning in the wake of a diagnosis and a client isn’t ready to discuss practical realities, be patient and schedule follow up meetings. When they’re ready, they’ll remember that they can talk to you.
  • Make an environment conducive toward their needs. If you’re meeting with a couple, be sure that their chairs are side by side and close to one another. Couples tend to lean on each other in the wake of devastating news, and making it comfortable to be near one another is a way to make them immediately more comfortable. Make tissues easily accessible to them, have beverages and possibly even some comforting snacks (chocolate or pretzels were suggested) available in case clients need a moment. Clients may be distracted, so have materials available if you need them—pens, paper, copies of documents you’re planning to discuss.
  • Have distractions available. Instrumentals tend to want to do something with their hands when they’re overwhelmed. A Rubik’s cube, stress ball, or trinket they can fiddle with while they talk can help them to process what they’re thinking about. Similarly, have signs of life—pictures or plants can help ground clients in a time when they feel anything but grounded.
  • Avoid saying, “You look good.” It’s a surprisingly common, and not at all helpful, reaction that makes people who are already self conscious feel like their appearance is of significant importance. Florian recommends asking specific and open-ended questions, like “How was your morning?” or “How are things different for you?” In addition, she explored the power in saying “There’s a lot we can do to help you live as fully as possible until you take your last breath,” in situations where people are telling them there’s nothing to be done. Some other conversation suggestions:
    • Ask about their greatest concerns right now. They may share concerns that are not financial.
    • Ask, “How are people treating you & how do you wish they would treat you differently?”
    • If people begin griping, say “People are really human, aren’t they? They mean well, but they so don’t often do what we want.”
    • Ask “Who is most supportive, what are they doing that is supportive?”
    • Ask “What do you wish people knew about what you were going through?”
    • Ask “What would you most like me to do for you/with you before we proceed?”

Florian suggested a number of helpful resources: a book called Final Gifts; a Web site for ethical will resources, www.ethicalwill.com; and a Web site for a very helpful conversation tool called www.agingwithdignity.com. Look for her columns in the Journal of Financial Planning.

Mary Corbin
Managing Editor, FPA Press; Senior Editor, Journal of Financial Planning
Financial Planning Association

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