Getting to the Heart of the Matter. (More on the nuances of working with an Elder client).

In my last posting, I ended with the postulate that somehow, many of us involved in the varying forms of elder practice have lost our way in dealing with older clients.

Even though such a conclusion might be a great ending point for a sermon or a call for repentance, I realized that in my own dealings with elder clients, I (like many) act upon specific marching orders with respect to the task to be done, not really focusing on anything else. The objective in these matters is usually clearly set before me, (i.e., save taxes, protect assets, minimize expenses).  Others also have parallel objectives. But somewhere along the way, I have found that many other well-intentioned efforts for a client fall into conflict, as his or her wishes, desires, and goals became more muddied with many life issues colliding.

All of this caused me one day to revisit “Bob”, my elderly client whom we met last week. With so many discussions and conversations around Bob and his consternation, I constructed this challenge for him: “Bob, you have many thoughts, concepts, ideas, and wishes in your head to the point where it’s beginning to make you nuts. What I’m most concerned about is, I would like you to hear from YOU. Not me, not the circumstances nor the conditions, nor your family, nor any other professional. Just YOU, and your heart and mind.

Here is what I would like to do. We’re going to take one calendar minute. Just one. In this minute, I’d like for you to write down the five things in your life that matter the most to you, in order. Your criteria should be judged by what would cause you the most pain if it were to be lost to be first, the second most painful thing second", (etc.)

I handed over a pen and a sheet of paper and said “go”.  Bob agreed to follow suit. Here is what came back:                                                                                                                                                                         

• (1) My life’s work and my independence, and not being a burden to my children.
• (2) Continuing to live in my home, and have a meaningful life in it.
• (3) Saving my estate from taxes and unnecessary expenses, so my children will have an inheritance from their parents.
• (4) A relationship with my family that is loving and respectful.
• (5) Friendship and companionship.

In reading Bob’s list, I had to say I was not at all shocked. Here’s a peek into the window of each point.

• (1) Not at all surprising; a large part of Bob’s personal worth is identified with what he has done in in his life, and in growing up with little. He is very much still proud of his hard work leading to his profession and standing. And he has consistently preached “independence” to his kids, thereby feeling that he needs to consistently lead by that example, as well.
• (2) Bob is not a sentimentalist when it comes to his home, but he’s seen it grow at every step, from the point where he was leaving work at night to work on its construction, to later additions and expansions. After many tough days downtown as younger man, returning there at night was a validation to him as to all he was working for. If the home were to be taken away from him, he mentioned that he would feel frail, lost, and without place, deep down.
• (3) Bob always lived well but not extravagantly, always being thrifty where he could. Over the years, he read many stories about estate battles and tax claims, and vowed that would never be him. He’s not a believer in tax evasion or disregard of rules (our standing joke is that he can’t do that with me!) but he’s entirely of the belief that government needs to live within its means. And he’s always wanted to provide for his children.
• (4) At first, you (like me) might be surprised that the “family values” piece of the exercise did not make the top three of Bob's list. But this in my experience is the fundamental difference between men and women, and what they value in priority. In Bob’s world, seeing the kids do well and check in once in a while is just fine, even though he loves them and worries for them constantly.
• (5) In reading this point, I was somber knowing how many people Bob has lost over the past few years. But I also chuckled at the “companionship” point, where he mentioned the desire for a female friend to go to the theatre and to events with. (I said “really?”. He said, “Sure….what ever made you think I don’t like women?”) We both laughed, and I was surprised that Bob really had no “been there, done that” attitude on this particular point.

Although the above exercise might be dismissed by some as nothing more than a meaningless mind-game, notice what it did do. The exercise identified the things that were most important to Bob, in order. The exercise also instructs all of us that not all people necessarily value the same things in the same priority, and we must respect that priority from person to person.  Moreover, knowing what these priorities are for an elder individual goes a long way in streamlining approaches and saving precious financial resources to make a much better world for that elder client, parent, or friend.

We will visit again with Bob in the days to come, and also, I’ll be sharing more about the concepts of Total Trust Care ?, as we move forward.