Working with Those at the End: Tips from a Former Hospice Consultant

As a former Hospice Consultant, I know what it’s like to work with people who are in the final and most difficult stage of their life yet. Dying is the only for sure thing that will happen to all of us some day. It’s arguably one of the most painful experiences we go through, for those we love and leave behind. In the estate planning business, it’s not uncommon to have clients that may be in the final stage of their life or know someone who is. Here are some tips I’ve learned about working with those who are facing the end of life.

DO:

• Use your best active listening skills – I know. It sounds childish and cliché. But it’s so important. Everyone wants to feel like they’re being listened to, no matter what stage of life they’re in. Can you imagine how much more someone who is dying wants that? Most times, people at the end of their lives are in constant contact with doctors, nurses, caregivers, friends, and family (some that are not so great). Many have gone from being independent and functional to losing their identities, roles, careers, and life as they knew it. Almost all have lost their own voice, and some have been stripped or willingly given up their right to make their own healthcare and financial decisions. Your ability to listen and then provide great service to them might be the ONLY or LAST chance they will have to fulfill their remaining desires. Really pay attention to family dynamics. Let YOUR CLIENT lead the conversation on who they want to care for to the best of your ability and don’t pry for information that may be irrelevant as it could trigger unnecessary pain and distress

• Be culturally and socially conscious – What we consider as “social norms” do not always reflect our clients’ views. For example, a client might not shake your hand, hug, or look at you directly in the eyes. Your first inclination might be that they are being rude, but in some cultures, those actions are signs of disrespect and for those fighting or dying of a particular illness, contact with others could place you or them at further risk. The bottom line is, it’s best to be kind, respectful and open to hearing what your client wants and take your social cues from them.

• Give support to the family member(s) that is with them – It’s so easy to forget about the client’s caregiver or person handling their affairs. That person has to carry the weight of their own grief in addition to making their loved one feel supported and cared for in every way. This person is sometimes the main one that needs to feel safe to cry, express their anger and frustration, and ask lots of questions. Just remember, if the family member, guardian or friend is in your office with your client, please know that this appointment might be harder for them than it is for your client. They’re the ones who have typically not made peace with what is happening.

• Help them overcome information overload in the moment – Be prepared to provide booklets, books, and reports to give them additional information to take home and read if they get too overwhelmed in the moment. It’s also very common for questions to be asked more than one time. Be patient as they process the information.

• Be aware of your body language – Maintain a professional, yet open posture with your arms and legs uncrossed – it may make your client feel more at ease. Please don’t be afraid to smile, even if it is a sad occasion. Trust me, more often than not, your pleasant demeanor will make a much more positive impact.

• Be aware of PHYSICAL impairments and make it easier for your client to communicate with you –Impairments can include pain (sometimes extreme), confusion, deafness, blindness, emotional distress, or learning disabilities (i.e caused by dementia, tumor, etc…). Think of using hearing devices, or white boards to accommodate your clients with special needs.

Be encouraged that any small act, though simple, might make all the difference in your client’s experience.
DON’T:

• Over-do It (but always have compassion) – It goes without saying that you have to have compassion and empathy for your client. However, sometimes with good intentions, if you try too hard or use a script to communicate with your client, it can come off as inauthentic and rehearsed. Always “take the temperature of the room” and pay attention to your client’s reactions. Trust that they will guide you on the best way to communicate with them.
• Take ANYTHING personally – This is a VERY difficult time for your client and their loved ones. If they seem irritated, angry, or impatient, know that it is NOT you. As a matter of fact, you might be a refreshing change to their routine. You might have to take a few hits, but it’s worth them feeling like they’re in a safe place with someone they trust.
• Beat around the bush – Definitely avoid phrases like: “You are going to a better place”, “Don’t worry about your family”, or “I understand what you are going through” (a lot of people say this). You might have gone through something similar, and it is great to try to find common ground with your client, but you can’t know how another person is processing his/her own feelings. Every situation is different and the way everyone copes is also different. More importantly, this phrase almost always leads to the professional telling their own life story, which inadvertently takes the attention and support away from the client. It’s always ok just to say, “I’m sorry for what you’re going through”, or “I can only imagine how you must feel”.

My MOST Important tip: Remember, YOU ARE HUMAN! I can guarantee you that the one thing you told yourself a hundred times not to say, is the ONE thing you’ll say. Your client knows why they came to you, and while the dying process is difficult to cope with, most have found peace knowing that their family will be taken care of.

The fact that you are reading this, or seeking tips on how to communicate means that you have already expressed a genuine concern for how your client is treated. So, please do not be too hard on yourself. You do not have to overperform or change to accommodate what you “think” will be the best communication method for your client. As long as you treat them like they’re still here, you’ll be great.

Jenn Belgarde

Member Services Coordinator
American Academy of Estate Planning Attorneys, Inc.
9444 Balboa Avenue, Suite 300
San Diego, California 92123
Phone: (858) 453-2128
www.aaepa.com