A lot of financial planning puzzles would be much easier to solve if we knew our clients’ date of death. That idea of knowing when the inevitable will happen often elicits a chuckle from people because it is so clearly not something we know. But some clients have a dramatically heightened sense of when their lives will end. A diagnosis for a terminal illness is no laughing matter and presents a myriad of financial planning issues to address.

At a recent study group meeting, we had the privilege of spending some time with Carolyn McClanahan, an M.D. and CFP.  McClanahan is known in the financial planning profession for her ability to educate financial planners in a non-political way about the biggest issues facing our health-care systems.  She has been the go-to source for many on the good, the bad and the ugly of the Affordable Care Act. She is also leading the charge to equip and empower planners to better serve clients near the end of their lives.

Like many of us, McClanahan has an extensive list of financial items to address. I will get to some of those in a bit. She was quick to point out that diving into such a list as soon as one hears their client is ill is often not the best approach. She advocates listening, really listening, before assembling a to-do list. 

When a client shares the news with you, it is best to simply say, “Tell me more.” Often, they will have a to-do list in mind, but they may raise issues that are far from financial. Whatever they tell you is likely what is weighing on them the most.

She is also a big fan of the question, “What do you understand about your prognosis?”  This can give you some insight into how they view the situation. Some will be in denial. Others will be ready to fight. Some may say they know their odds are slim, but they want to try anything and everything in the hopes it may help someone someday. Many are accepting of the situation and do not want to put their body through the rigors of treatments that are unlikely to work.

Their spouses, other family and friends will all have reactions and opinions. It is important to remember who the client is and therefore whose wishes should get the most weight. That sounds straightforward, but sometimes the terminally ill want to hit that bucket list so hard that the surviving spouse’s long-term security could be less stable.