Financial Wellness - Part 1

While discussing financial wellness recently with Pam Campbell, Sales Director for Byron Park of Walnut Creek, my first thought about this concept was protection and preservation of wealth.  Considering the idea more fully over the past week, I see a rich depth to this concept that can be useful at any age or season of our lives.  It might actually come down to an idea heard recently at church  - - - “our job in this life is not so much about getting rich but more about being rich”.  

A business is considered sound financially when the inflow exceeds the outflow by an amount that can be expected to continue growing over time.  A Chief Financial Officer is often employed to help a business plan future income and control expenses in order to achieve a financially sound business.

 

An individual’s financial health is more often looked at in the negative.  We see areas that indicate imbalance or fear for future financial stability: a pending bankruptcy or losing wealth due to poor decisions or fraud. 

 

A recent study by the American Psychological Association found that “money” was named as the top stressor by 75% of the respondents. Not surprisingly, another poll by Associated Press/AOL found a high correlation between high debt levels and health problems such as heart attacks, headaches, ulcers, and depression.  So, while there is a pretty clear measure of financial un-wellness, there is less agreement about what constitutes financial wellness. 

 

By the way, the above study about stressors found similar result across all age groups EXCEPT those over 65, who reported lower levels of stress. Possibly this age group grasps the idea of financial wellness better than the rest of us.

What is Financial Wellness?  Is it the same as financial independence or fiscal capacity?  I would argue that financial wellness is not about the amount of wealth we have accumulated but more about knowing what we are capable of handling at each stage of life and having the wisdom to ask for help appropriate to our needs at each stage.

A good example of this in the business world is an entrepreneur who has the wisdom to bring in managers whose skills complement and supplement what the entrepreneur can offer.

Why do you think those surveyed over the age of 65 have less stress about money? Could it be they have learned to live within their means; or, they have learned the secret of a generous mindset; or, they have learned to appreciate and value what life offers over what money can buy – love, peace, joy and hope? These mental attitudes allow us to see a bigger picture of the value of human life which  can help us be rich at any level of monetary wealth.

 

If you are curious about this topic and would like information about the community event at Byron Park in Walnut Creek, please contact Pam Campbell for details. 
 

You can also receive an alert when the next installment of this blog on "Financial Wellness - Part 2" is posted by entering your email address above.  What do you think about Financial Wellness?  Be rich and share your thoughts.

 

Do Not Resuscitate (DNR)

How Do I Tell People What I Really Want?

This past week the story and controversy surrounding the death of an 87 year-old woman who did not make her end of life wishes known in writing was covered in the news.  The article by Lisa M. Krieger, "CPR Flap Could Have Been Avoided" in the Mercury News discusses an important form which many people do not know about or confuse with an Advanced Health Care Directive.

While a POLST does not insure a peaceful passing, it does help your health agent know what types of decisions you would want should you become unconscious and unable to choose not to accept certain medical procedures. Paramedics and doctors are not required to follow a DNR form in your wallet or language in the standard form used to name an agent for Health Power.

If you are terminally ill or frail elderly, there are three documents that will allow someone you choose to help you in your final hours. Otherwise, the hospital, doctors, paramedics and all other persons will follow standard medical protocol to keep your body functioning.

The Advanced Health Care Directive.

Many people think an Advanced Health Care Directive will be sufficient. The purpose of this document is to name a person who can make health decisions for you when you are unable to do so. This is why the hospital wants one on file when you are admitted. Doctors and medical personnel cannot make this decision for the patient. While important, since the Advanced Health Care Directive is prepared by an attorney not a doctor, paramedics and emergency personnel do not need to follow any particulars included on this form. In addition, in an emergency there is not time for them to read a legal manifesto.


The HIPPA Authorization Release.

As people age or when they are ill, it can become difficult to manage health care matters - from remembering and getting to doctor appointments to asking the doctor pertinent questions. If you have ongoing health issues, are terminally ill, or elderly, you should also consider signing a HIPPA release form to allow your health agent or another designated person to speak with your doctors about your health care needs. This can be given to more than one person and it is used even while you are competent and able to make your own decisions to allow someone else to speak with your doctors. In the event that you need assistance with health care issues, a HIPPA release form is the only way that someone else can discuss your health needs with the medical community.
The Physicians Order for Life Sustaining Treatment or "POLST".

The medical community developed a solution to help people discuss their end of life wishes in detail with their doctor. It is one page, printed on pink paper and signed by your treating physician. I tell my clients to post it on an entry wall or bedroom door so paramedics and others can see it. This allows the paramedics to not perform CPR, should that be your wish.

Otherwise, once CPR is started and a person receives oxygen, the heart can continue even when the brain is no longer working. Once emergency resuscitation is started, only a POLST or a decision by the named Health Care agent can stop normal ICU and emergency life sustaining treatments.

Below you’ll see links to samples of each form and a short word to remember their use. Review your health care directive to determine if the people you named many years ago are still able to serve you. If changes are needed, a simple amendment with your attorney will keep your written wishes up to date. Should you find, as some of my clients do, that those persons named earlier can no longer serve due to death or illness, you may want to consider naming a licensed, professional fiduciary.

URGENT! First Priority - Advanced Health Care Directive. Attorney Document.
Everyone over the age of 18 years of age should have one. This legal document names who will decide for you in case you can no longer make your own health decisions. Best if prepared by attorney with estate planning package, but the State of California offers this free form here. Second Priority - Assistance with Health Care Management
If you are diagnosed with a significant illness or find that you have trouble remembering what to ask your doctor, it may be time to ask a family member; your health agent; or a patient advocate to assist you in getting the medical care you need. Click here to see sample wording.
Third Priority - POLST. Doctor's Orders 
Make your specific medical wishes known by discussing the options with your doctor and putting it in writing. Then post nearby. Especially important if you have been diagnosed with a terminal illness or you are a frail elder. Click here to see a sample. 

Have You Been Cocooning Lately?

It’s been unusually cold this winter. Have you felt it deep inside your bones? Wrapped in a blanket, hunkered down. Under the weather. Sometimes we just want to cocoon for awhile, especially if our body is fighting off a cold. Occasionally, I just sit and soak up the sunshine or warmth and allow my natural body rhythms to help me back to health.

Sometimes, we cocoon when we need to slow down our life rhythm to accommodate new changes. Taking some time to take in recent experiences is a healthy way to manage stress in life. It usually gives us the refreshment we need to re-ignite the fire of our inner motivation.

Yet, there comes a point in a person’s life when this cocooning process is the dominant mode of life. Sometimes a terminal illness causes this. Or the inevitable frailty of old age causes us to cocoon. This process looks like shutting down to the outside. While a person cocoons, they hold on to only a few routines that must be done and let go of many activities that once gave them pleasure. Sometimes it is only for season, but sometimes it is a way of protecting themselves.

He Sings For The Fun Of It
When we watch those we love detach, sometimes all we see is the decline and not the inner joy. The decline scares us when we remember their earlier vitality. We wish for a return to what used to be. Sometimes they do too.

More often, people seem to sense when it is time to slow down and soak up the warmth or just enjoy simple pleasures. While we say things like "She is failing" or "He is declining", they seem to be thinking, "I am getting closer now!" For example, I know someone who has had to get his food through a stomach tube for a number of years since he had throat cancer. Even though he cannot swallow food, he sings little songs all through the day to cheer himself and his wife.

Not Failing, Cocooning
Rather than saying someone is "failing", let’s change the idea to "cocooning". Who wants to be seen as failing? We all want to be seen as capable, even if we need help in some areas of our life. I never wanted an "F" in school and I certainly don’t want it life either.

When we cocoon, we do so with hope that a re-invigorated butterfly will emerge. When in this state, whether because we are ill or frail, we need special care from those near by. This weekend my husband enthusiastically took on the job of making me soup. He helped me do a necessary task when I was not up for it. Maybe later, we’ll both need someone to cook healthy, tasty meals for us. Although, I am sure they won’t equal his.

It may take a village to raise a child, but as I have written elsewhere "it takes a stage crew for our final act". When we are older, we need to identify a trusted circle of care we can rely upon.  This will help us experience the kind of quality of life that protects us, leaving room for joy even as we prepare for "lift off".

TAP Into Your Circle of CareTM
As my mom likes to remind herself, "just because we have needs, does not mean we are needy". What keeps us from being "needy"? One way is to do an honest assessment of our needs and have conversations with others about our capabilities as we age. That way we are better able to seek and accept the type of help we’ll need at various stages of life. Even if your motto is "Need No Help", remember we all rely upon other people during our lifetime. The very fabric of our civilized lives is built upon mutual needs being fulfilled.

As we age, no matter our age, here’s the only question - what type of service can you offer and what service do you need now?

Who Shops For The Shoes?

This is a question I never considered until I became a professional fiduciary. Put yourself in these "shoes" for a moment.

Imagine you cannot drive; get a little disoriented; your feet hurt but you do not want new shoes because you like your routine; and, wearing sandals in freezing winter is easier than going shopping for shoes. Online doesn’t work because you don’t own a computer. Also, you don’t know your current size or what will feel right. Who will do this for you?

My client is a dream - she is wonderfully wise and witty - but she suffers from mild cognitive impairment. She also needs a walker to help her maneuver after a recent fall and broken bones. She wants very few personal trappings and demands nothing. To make sure she is getting the type of care she needs, I sometimes have to imagine what she needs and then try it out with her to see if she’ll like it.
　
Money Well-Spent
Scanning the selection, I picked out a variety including some that were larger than her "size" - her feet have swollen a bit since she last bought shoes. Seven pairs came back with me. I removed the size tags and we played a little game. I played the part of a Nordstrom shoe sales person, she the picky customer. That pair was not cute enough. Those were too small (her size). Ah, these were just right. Almost. She said they were "ugly as sin but comfortable". She accepted only one pair because she knew her doctor wanted her to have them. Remember, she does not like to spend money on anything frivolous. Except for cigarettes and cookies.

She now wears these shoes daily and it always makes me smile to see them on her feet. After some delicate negotiating to determine her desires; obtain her needs; and finally, to handle tasks she can no longer handle for herself or is not even aware she needs, she now has a new routine which provides her with warmth and comfort.

Even with this "dream client" - it took over 90 hours at the beginning of my work during a six week period to travel to her location (I do not charge for this time); chase down income checks lost in the mail after her move; secure the home; provide the necessary paperwork to various agencies so I could do my job as her Power of Attorney; work out a monthly budget; pay her bills timely; secure and check her mail with her - sorting her personal mail, from junk, from necessary.

Oh, and find her some new shoes.
　
Good Judgment is Valuable
What are those 90+ hours worth to the person who is being served? They can mean the difference between hearing and not hearing; or the difference of a less stressful life due to less worry about how to handle the overwhelming details. Or even more crucially, persistent follow-up and attention paid on behalf of an ill or elderly person insures a better standard of care from everyone involved. Not everyone has family who can do this for them.

What are the alternatives? If these tasks were to be handled by the family attorney or a CPA, the hourly charge for these services would be unpardonable at the normal going rate for these professionals. On the other hand, the multitude and variety of tasks required do not fit into the job description or malpractice insurance of a bookkeeper. Many times the most cost-effective and safest solution is a professional, licensed fiduciary.
　
Angels Among Us
A professional fiduciary uses his or her best judgement to find the most cost effective way to serve a client - kind of like the CEO of a small company. Even routine tasks like bill paying need someone to make sure they are being done properly. If there are changes in the situation (as there will be) or conflict between adult children or a lack of communication from health care providers these require the professional fiduciary to use good judgement, re-evaluate and find new solutions that will serve the client.

So, if you hear negative stories or comments about fiduciaries, consider the source - a disgruntled, disinherited adult child perhaps? And think about the shoes. Imagine having to go out in the blustery cold on a shuttle bus in your sandals while using your walker; without your hearing aid (lost back at the skilled nursing facility). You already know you’ll be tired before you even find the right store. Maybe a few fiduciaries have erred in judgment, but most of us are a necessary and even sometimes wonderful source of protection - like guardian angels we are unseen protectors. 

Merry Christmas to all and to all a good night!