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What Has The Pandemic Taught Us About The Importance Of End-Of-Life Planning?

Talking to your loved ones about their end-of-life wishes can be scary for you and them! Irv Rothenberg shares why these awkward conversations can be essential starting points for ensuring a long lasting-legacy.

Transcript

Tim Maurer
Hello, Tim Maurer, back with another episode of Ask Buckingham, a new video podcast designed to bring clarity in the midst of confusion by connecting your great personal finance questions with straightforward answers from industry thought leaders. Today’s question will be answered by Irv Rothenberg, a long time Buckingham wealth advisor, who has found a new cause in his retirement that we think you need to hear about. Irv, your retirement from a long and gratifying career as an advisor really has to be put in air quotes, because you’ve taken on an active role in encouraging people to address a topic that most of us choose to ignore, the end of our life. What inspired you to start inviting people to have these difficult conversations?

Irv Rothenberg
Well, it’s a great question, Tim, I think a lot of things. First of all, as I’ve aged, my experience with loss, of course, increases as the circle of people that I know come to ends of their lives, particular, God rest her soul, my wife had major open heart surgery late in her life. That gave us the opportunity to do some planning, and yet still found that at the very tail end, the ending was controlled by the medical profession, instead of exactly the way we would like to have seen it done. And then I’ve had friends, who I’ve ended up seeing in ICU with tubes and without their family, or a family in disagreement, I’ve had clients that have spent their final months searching for cures instead of with their loved ones celebrating their life.

Irv Rothenberg
And I think, in general, what I’ve learned Tim, is that the medical profession is wonderful, but they’re focused on cures, they’re not focused on quality of life. It’s not what that was designed for. And so the lack of knowledge about choices, palliative care. And then finally, I think the rise of dementia in our society, which steals from some, the ability to do planning later in life, when they thought they might have had time to do it.

Tim Maurer
Sure. Irv, if I’ve got to ask, what is it that gave you the confidence then as you saw this need and experienced it personally, what gave you the confidence to actually step in to that place of having this conversation yourself, and then inviting other people to have it?

Irv Rothenberg
I just think that the pain that I personally experienced or saw people experiencing, and what I realized is that one advantage of aging and having no hair is that people will pay some attention to you, and you can have those conversations without upsetting them. So, that’s part of it.

Tim Maurer
You could get away with it. I’m curious, as you do this work in so many interesting ways, are you seeing an increase in people’s interest to have these type of discussions as our own mortality has been more of a daily headline in the midst of this COVID-19 crisis?

Irv Rothenberg
Yes, definitely, I think that. First of all, obviously, we all know that 100% of us will die, whether we want to face that or not. And what COVID-19 has done is stolen time away from us. It’s taken away the time to plan or to communicate. In a normal circumstance, and you might find as much as 10% of the population might die without warning. The other 90% would have some opportunity to know that there’s an illness or to do some planning. Well, with COVID-19, that statistic has gone out the window, the anxiety is much higher and it’s more likely to 20% or 30% of the people might find themselves suddenly in bad shape without the ability.

Irv Rothenberg
And most of us, obviously, would prefer to die at home in our own bed, surrounded by people that we love. But about a fifth of all Americans, normally, would pass away in an ICU. So that figure again, has been bent way out of shape by COVID-19 and all our stories that we’ve all heard and seen about people trying to talk to each other through windows and with signs and without the ability to plan. So I think, yes, it’s had a big effect on people’s willingness to talk about this subject.

Tim Maurer
One of the ironic, almost positive turns that people’s consciousness is more raised to these matters at a time like this. So what are some general do’s and don’ts that you would recommend for making decisions and having conversations about end of life?

Irv Rothenberg
Well, a great question. I think, first of all, the whole issue about why people don’t have conversations about it is fear. I mean, we know that death is going to have the last laugh, and so it makes it very difficult for us to talk about this circumstance. But I think some of the things you can do is, take a little bit of time you wrap your head around an illness. If you find out that you’ve got one of these diseases or something that you didn’t know, give it a little time. And another big thing would be to designate a family advocate to help you with quality of life issues. You’re going to lose your perspective and your ability to deal, and if you can name a family advocate, they can help you with things.

Irv Rothenberg
Another thing is, in California, in particular, we have what’s called a polst, P-O-L-S-T, which is a physician’s order for life sustaining treatment. So, in addition to any kind of advanced directive, this is a one-page document between you and your doctor, that more or less assures the kind of treatment that you to have, a life sustaining or non-life sustaining treatment. And it’s a one-page document that relieves the medical profession of liability and makes it clear that what you want to get done.

Irv Rothenberg
And then another thing, I think, would be, each state has now begun to develop an end of life act, an actual law, which says what the circumstances in your state may be for the kinds of medical treatment you may want to have or choices you may want to have. So you would want to learn about that.

Irv Rothenberg
And then finally, I think in general, you want to leave some hints for your family and friends about what your funeral and perhaps burial desires might be, so that they’re not left completely in the dark guessing. So those would be some of the things you can do. The don’ts would be those typical things that we would tend to advise clients when major circumstances happen, don’t get a divorce, go out and buy a Porsche, perhaps post everything about yourself on Facebook tomorrow. You want to give a little bit of time to sink in and think about what your response may be.

Tim Maurer
Sure. So one of the reasons we talked about this at the beginning that we tend not to have these conversations is that we don’t really want to talk about the eventuality of our own imminent demise, right?

Irv Rothenberg
That’s right.

Tim Maurer
So it doesn’t feel imminent. So I’m curious, what are four practical things that you might suggest that we could do, that anybody could do, to take wise next steps in this direction?

Irv Rothenberg
Well, one, have a conversation, that’s the most important thing. That’s such a gift to your family, to your friends, to yourself. So, having a conversation so that people know what’s in your heart and your mind, I think is the biggest single gift you can give those around you at the end. Then, from a practical point of view, to answer your question, get your affairs in order. I mean, there may be some paperwork involved, tell your story. With today’s cell phone, or zoom, or whatever, it’s easy to dictate a little bit about how you saw life, and for you to take that last selfie, if you will. Say goodbye, visits, by virtually, if you have to, phones, letters, and legacy, I think that’s a really big thing you want to leave your mark.

Irv Rothenberg
What that means for each person may be very individual. For some, it may be something philanthropic, for another it might be an ethical will that basically talks about what your thoughts about life were, not what you’re doing with your property, but what were your philosophies, what did you believe in, what message did you think you left behind? And then, as I said earlier, from some practical point of view, obviously, some funeral arrangements, giving some hints about whether you want to be buried, or cremated, or use one of the new green type of burial situations, or your funeral service. There may be religious considerations that you want, or the music, or who should talk, even writing your own obituary.

Irv Rothenberg
I mean, that’s become more popular and it gives you the last word, if you will, rather than perhaps someone who didn’t know you all that well. And then, of course, from a very practical point of view, passwords. In today’s world, I’ve seen poor families scrambling because they don’t know how to get into the computers and find some of those things. So I think those are the practical things that you can do just by talking.

Tim Maurer
Thank you, Irv. And I want to let you know, if you’re watching this and you’re wondering whether or not this conversation applies to you, you may notice that Irv is a little bit more, say, experienced in life than I am from the video that you see before you. And I just want you to understand that I believe this is something that is just as, if not even more important for folks who are in my situation, with a wife and two kids who are teenagers, these decisions to me, have an impact on whatever legacy I might have regardless of when that ultimate end might come. So regardless of your age, I believe that there are steps that you can, and should take that Irv is recommending from the time you become an adult, and are no longer a minor on your parents’ care, all the way through to the very end. Irv, any final words of wisdom that you might leave with us today?

Irv Rothenberg
There are a couple of thoughts. I think, first, it’s very hard, but I try not to judge how somebody else might get prepared for the end of life. Some people might prefer to do it by eating pizza or watching a ball game, sitting on a couch, it’s not my desire, but that may very well be. So, you need to have compassion for others. And that doesn’t mean doing anything, that means simply understanding that having that feeling of compassion in your heart. There’s a loving kindness meditation that I came across years ago, it’s a Buddhist meditation that I tried, I have pinned up on my desk, and I think about it and I use it all the time in thinking about myself or others. And it goes, “May you be peaceful, may you be free from suffering, may you be happy, may you be at ease.” And you can substitute the word, may I be, all those things, and be kind to yourself. So, that’s my final thought about a way to kind of get focused.

Tim Maurer
May you be indeed, Irv. Thank you so much for joining us, and thank you for tuning into this episode of Ask Buckingham. If you have a question that you’d like to see us address, you can do so by navigating to the website, ask buckingham.com, or by emailing your question to question@askbuckingham.com, or just click in the upper corner of the screen, it’ll take you directly to the website. Remember that there are no dumb questions, but unfortunately there are plenty of poor answers out there. Our hope is that in giving you straight answers to your questions, it will bring a sense of calm and allow you to apply what you’ve learned in pursuit of good decision making. So please follow us, and by all means, Ask Buckingham.

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Meet your guests.

Tom Bodin
Tom Bodin
Practice Integration Officer

As a Practice Integration Officer at Buckingham, Tom Bodin provides fractional CFO services to align wealth creation strategies for owners of legal, dental, and medical offices including tax, pension and retirement planning.

Vince Crivello
Vince Crivello
Head of the Practice Management Group

As head of the Practice Management Group at Buckingham, Vince helps lead client experience design initiatives, oversee consulting and training programs, and provide key industry insights to advisors.

Aaron Grey
Aaron Grey
Director of Planning Integration

As the director of planning integration at Buckingham, Aaron helps advisors develop, implement, monitor and update wealth management strategies in pursuit of their clients’ financial goals.

Kevin Grogan
Kevin Grogan
Managing Director, Investment Strategy

Guided by academic research, Kevin Grogan, Director of Investment Strategy, oversees our overall strategy and helps clients and advisors alike distill complex investing topics. 

Jared Hoffman
Jared Hoffman
Managing Director, Relationship Management

As Managing Director at Buckingham, Jared provides education on best practices around cybersecurity. He is a member of Infraguard, a partnership between the FBI and public sector created to share information on cybercrime.

blerina_hysi
Blerina Hysi
Fixed Income Trading Manager

As fixed income trading manager, Blerina helps construct and maintain customized bond portfolios, all with an eye toward finding the best way to implement the client’s comprehensive financial plan.

Mike Kenneally
Vice President & Co-Founder at ECD Lacrosse

Mike Kenneally is vice-president and co-founder of East Coast Dyes Lacrosse, a small lacrosse equipment manufacturing company in Maryland.

Jared Kizer, CFA
Chief Investment Officer

As Chief Investment Officer and chair of the firm’s Investment Policy Committee, Jared evaluates findings from academic research and applies that learning to architect the firm’s investment strategy.

Jeffrey Levine
Jeffrey Levine
Director of Advanced Planning

As Director of Advanced Planning, Jeffrey serves as a technical resource for advisors and the firm’s primary thought leader regarding evidence-based planning concepts and strategies.

michael_oneal
Michael O'Neal
Executive Director at OneWorld Health

Michael is the executive director of the global nonprofit One World Health, which partners with communities in developing countries to bring permanent, sustainable healthcare to the chronically underserved.

Irv Rothenberg
Irv Rothenberg
Wealth Advisor

A wealth advisor with more than 40 years’ experience, Irv’s passion is helping advisors and their clients create meaningful conversations around important end of life issues.

Jonathan Scheid
Jonathan Scheid, CFA, AIF
Managing Director, Solutions

With over 20 years of experience working with advisors and their clients, Jonathan enjoys sharing interesting perspectives on a wide range of investment and economic topics.

Meir Statman
Meir Statman, PhD
Research Advisor

Meir Statman is the Glenn Klimek Professor of Finance at the Leavey School of Business, Santa Clara University. His research focuses on how investors and money managers make financial decisions and how these decisions are reflected in financial markets.

Susan Strasbaugh
Susan Strasbaugh
Wealth Advisor

As part of a firm of fiduciary, fee-only wealth advisors, Susan takes a total-care approach to identifying, organizing, planning, implementing and coordinating clients’ most important financial goals.

Larry Swedroe
Larry Swedroe
Chief Research Officer

As Chief Research Officer, Larry Swedroe has authored or co-authored 16 financial books and devotes all of his time to research and education in the areas of investing, financial planning and behavioral finance.