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Get This in Place with Clients Before Dementia or Illness Strikes

Everyone should have a Power of Attorney for Healthcare.

National Healthcare Decisions Day is April 16 (Tuesday), a day that calls attention to the incredibly important but often overlooked issue of advance care planning. This becomes critical as one ages, but serious accidents and illness can occur at any age. In fact, young people are involved in serious accidents more often than their elders. Therefore, everyone should have advance care planning in place. By broaching this conversation with your clients, you provide exceptional, holistic guidance that sets you apart, and you also reach into the next generation.

Start with one of the most important documents to ensure that every client completes before there is an issue: the Power of Attorney for Healthcare. This is a legal document that names a healthcare proxy (also known as a representative, surrogate or agent). This person is authorized to make health care decisions on behalf of the client if the client becomes unable to do so themselves.

It's normal for clients to have some resistance to talking about this. To counteract that, I recommend you introduce the document this way: “If you were in a car accident and unconscious in the ER, someone will be making your medical decisions for you. Do you want it to be the overworked ER doctor who never met you? Or the hospital ethics board? Do you want your family arguing, with ultimate decisions made by your most vocal and stubborn family member? Or do you want to maintain as much control as possible, even when you’re unconscious? Let’s make that happen for you. Then, let’s also see if we can get the document in place for your parents, siblings and adult kids. Remember, young people are often involved in accidents, and anyone can be in the recovery room after surgery, or for a number of reasons be unable to speak for themselves. I’d like to ensure you and your family are all protected. Can we get started on that?”

Proceed with basic education. For instance, “Many people have heard of a Power of Attorney for Healthcare, or even have one. But they don’t fully understand what it is or that simply naming someone is not sufficient to retain maximum control over medical treatment. It’s important to know that if you’re conscious and capable of making decisions, the POA doesn’t take effect. It only triggers if you are unable to make your own decisions for any reason. If that happens to be the case for you at any point, even if it’s only temporary, my goal is to help you be among those with the greatest chance that this document and your discussions with your chosen people accomplishes your goals and helps ensure you get treated the way you want.”

Guide clients to carefully choose one primary person and 1-2 alternates whom they trust to carry out their wishes. (Many couples will name each other, but if they’re in an accident together, then who has the authority? Alternates are important.) Then, emphasize that in addition to receiving the authority, those people must thoroughly understand what your client wants and why they want it, so each situation can be interpreted considering the client’s ultimate goals.

The operative question is: “What do you need to be able to do, feel, participate in or understand in order to make it worth it for you to have artificial interventions to prolong your body’s life? And at what point, if any, do you no longer want that?” Example: One woman in early-stage dementia stated that when 50% of the time she doesn’t recognize her own children, she no longer wants any artificial interventions—no feeding tube, ventilator, CPR or even antibiotics. Just keep her comfortable and if she dies of an illness or condition, so be it. If she recovers, so be it. Just let it happen naturally without interfering with artificial means.

What does your client want, physically and cognitively, to make it worth it for them to have interventions? How high must the chances be that the intervention will return them to “normal,” active living? At what point, if any, would they want to let nature take its course?

You may even consider facilitating this discussion. Volunteer to host a 20-minute online meeting for your client and their designated proxies. Encourage them to openly discuss your client’s wishes and let them ask questions. This not only informs the decision-makers but also gives your client evidence of whether those persons would feel comfortable making the desired decisions.

On the call, you can also encourage the primary and alternates to complete their own POA documents and have these conversations, as you would like to see all of them retain the greatest amount of control possible over their own lives and health.

When you do these things, you do the right thing for your client. At the same time, you meet people who are central to your client’s life and position yourself as a financial professional who cares about more than just finances. That’s better than any marketing you could do. As always, when you do the right thing for your client, it ends up being very good for your business, too. 


 Amy Florian is the CEO of Corgenius, combining neuroscience and psychology to train financial professions in how to build strong relationships with clients through all the losses and transitions of life. 

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