How do you have end-of-life discussions?

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Transcript:

[Michael:] Hello. My name is Michael Liersch. I’m the head of Advice and Planning for Wealth & Investment Management at Wells Fargo. I’m here with Dr. Pawlecki, our chief health officer at Wells Fargo. Did you know we had one? He is an amazing human being. And he’s joined the About Money podcast for Wells Fargo, where he talks about how we think about life, but also how we think about the end of life, and also when we are the ones left behind after someone passes, or when we’re the one who passes and leave others behind.

So we’re going to be having those challenging conversations with Dr. Pawlecki. Thank you for joining me. I really appreciate it. And we’re going to really explore how you can navigate those conversations and make them more empowering rather than divisive and disempowering. And a lot of people, Dr. Pawlecki, find these discussions challenging.

But before we go there, I want to ask you, what on earth is a chief health officer?

[Dr. Pawlecki:] So, for Wells Fargo, they recognized that there was a real need to make sure that our employees were healthy, engaged, and productive, to help people as individuals, but also help on the health benefits, help with different projects that are going on, and really kind of take the perspective of the employee and their health and well-being in order to make certain that people are at their best.

[Michael:] I think what’s interesting about your role is you talk about benefits, which is a translation sometimes for when I’m sick or not well, or when a family member is sick or not well, what do I do? How do I navigate that? And there’s all the technical details. But I think what most people find challenging are the conversations and the emotional details behind that.

We are having conversations as employees actually in preparation for this, and we started talking a lot about, you know, our own experiences. I talked about in my own life, you know, my mother-in-law, you know, my wife’s stepmother asking me for help a month before my wife’s father died.

And I didn’t probably lean into that conversation. Actually, I know I didn’t lean into that conversation as much as I should have. And he died a month later. And it took two to three years to unwind everything because there wasn’t a lot of preparation, and I could have helped. You know, these are the kinds of things that we’re all navigating.

And I’m a professional on this.

[Dr. Pawlecki:] So many people think that, oh, that’s something I can put off for later on, but they don’t realize that they’re already dealing with a lot of these different issues already.

And so when I entered into the workplace, I realized that end-of-life issues are actually a workplace issue, and they’re a workplace issue because of the fact that many of our people are caregivers. They’re caregivers to their family members, people who are having significant health issues, and they’re having to address that person’s health needs over time and the distractions that come along with that.

Even normal passages of people, you’re losing someone in their life. There’s grief that happens, and that grief is something that is normal and we should be addressing that. But for those who have to not only deal with the grief but also have to then be executor on a will, that can be a yearslong process of trying to deal with that and the distractions that come with that.
So, there’s many reasons why people of all ages need to be thinking about this, and this issue — and not only thinking about it but talking about it and saying, OK, what’s important to me?

So there, my parents are 80 and pretty good health, but, you know, they’re 80. And so I often ask them what would they want, and they don’t want to talk about this issue for themselves. So, I was able to get this kit, which is called the Conversation Starter Kit.

[Michael:] OK.

[Dr. Pawlecki:] And there’s several of them. One of them’s called Five Wishes.

So I printed out one for each of my parents. And as I read through them, my dad’s was not surprising. He said, You know, in the event that something happens to me, I would want this, I wouldn’t want that. And if it’s not working, then go ahead and unhook me and let me pass. My mom’s most important thing to her was: I want to be warm.

And I was like, oh my gosh, she’s always cold. And they moved to Florida, and at 60 degrees, she’s wearing a parka, like she’s always cold. And so from that moment on, after I had that aha moment, I will always keep my mother warm no matter what happens. That’s her most important thing. And I will make certain that she has that.

And those are the kind of things that are so important that we might think we know what somebody wants, but we might not actually. And there’s a huge problem that frequently happens among family members, where people think that mom or dad or someone in the family wants one thing and in fact they may want something very different or it might be counter to what they want.

It sets up dynamics in the family, which can be very divisive, and it can lead to lifelong problems among the surviving family members if things don’t go the way that that one of them thinks they should. So hearing directly from the source, that becomes a very valuable healing process for someone having to deal with it and gets rid of some of the guilt that goes along with some of the decisions and regret that can sometimes happen at the end of someone’s life.

[Michael:] So let’s practice, if that’s OK, in front of all our listeners.

[Dr. Pawlecki:] Yep.

[Michael:] So, and Rachel, I know we actually haven’t talked about this, whoops, OK, so that’s my wife. So, for me, I want to live a productive life where my brain works and I can show up for my family in every way.

So that would be what I would want. And now that you’re saying that, it really takes a lot of things off the table in terms of what you’re talking about, and that helps guide Rachel in terms of helping make decisions on my behalf if I couldn’t make them. How about you? You tell us, what are your values?

[Dr. Pawlecki:] Mine would be very similar. I want to make certain that I’m able to enjoy and be present. And it’s not about the length of time for me. It’s really about what’s the experience that’s there and the ability to contribute and to enjoy those that I love around me.

[Michael:] That was kind of intense.

[Dr. Pawlecki:] Yeah.

[Michael:] So, I guess, again, part of this is if you do this with your spouse or your partner or your in-laws or your mom or dad or your children, it can really create a deep connection pretty quickly with somebody.

[Dr. Pawlecki:] Well, that’s absolutely true. In these times when we don’t have those connections, this is an opportunity to really dig into what’s important.

[Michael:] Oh, wait, let me get my phone. Just kidding. OK, I gotcha, I gotcha. You are so right. So true. Thank you.

So, my question for you along these lines is how do you, you used a certain choice to start that conversation with your parents, what would you suggest they do to kick off this conversation with their loved ones at any age? What would be your thought?

[Dr. Pawlecki:] You look for those convenient moments when it’s OK to start to introduce the conversation. You had mentioned something about the fact that your mother’s friend was ill and passing away and that was the appropriate time to start to bring something up. Other types are when you start to have those conversations, it can be, there’s some efforts around the Thanksgiving table that say you start to have the conversation with the whole family that’s there and say, what would you want in this case?

And it can be fun and it can be a little depressing. But you look for those opportunities to introduce the concept because not knowing becomes so much more difficult.

[Michael:] So it’s interesting you say that because as I’ve been researching this conversation, and I even went back to my own advice a decade, two decades ago. And I used to start off with, you know, introduce the conversation very gently to how can we be of service to each other as family members, help each other, think through it.

I’ve really, the pendulum has swung for me, Dr. Pawlecki, and I think sometimes we just have to be very direct, to your point, and just say this is an important conversation, it’s an urgent conversation. We can choose those moments, to your point. Ideally, though, we wouldn’t wait for those moments to have this conversation. That’s the whole point of this is, you know, waiting until after the fact, you know, when you’re in that situation — and I know a lot of our listeners have been in — where you have to help someone make those end-of-life decisions in that moment when someone’s passed and all the documents are scattered everywhere, like with my father-in-law, taking multiple years to resolve it all. And he was an estate planning attorney, Dr. Pawlecki.

[Dr. Pawlecki:] Yeah.

[Michael:] You know, we didn’t know which documents were the accurate ones. I mean, these are not the moments to do this. And so now I’ve come to a different conclusion that I want to share with the listeners, which is sometimes it’s important to be honest and direct about the importance and the urgency of the conversation because we don’t know when these things are going to happen.

We all have experiences, or we have others that we’re close to who have had these experiences. So my recommendation or my suggestion to the listeners would be do this as soon as possible. Before you do it, though, find a trusted group of people that you know, maybe they’re your friends, maybe they are family that you feel really comfortable with, who would be open-minded. Be authentic, share your fears, share your concerns. Share the experiences that you’ve heard others have, what’s worked, what hasn’t worked. And that will be a way if you’re, let’s say, an adult child wanting to talk to a parent who wants to be silent about these things of how you might approach it in a very direct but authentic and loving way and empathetic way. If you’re a parent wanting to talk to your kids about this, how you might do the same.

I love this idea of also seeking out, you know, when you’re at your annual physical, or you know whomever the medical professional is that you trust, talking to them about it, is what I hear you saying, too.

So with that in mind, you know, let’s get to really tangible actions people can take. So we talked a lot about the discussion. So it sounds like getting professional feedback from someone you trust or just having very open, authentic conversations with people you trust can be a great way to then approach a dialogue with people that you need to have this with.

The second step: I really have a strong belief that there are at least two things that every human should really consider doing because it solves a lot of the kind of conversational points that we’ve talked about very technically, you know, whether it’s health directives or a power of attorney or a trustee, which is two documents: your will and a revocable or revocable — you say tomato, I say tomato, right? — your revocable trust. So a will and a revocable trust can really help set the stage for partners and spouses or an individual, especially if you have children, family members, that you want to really outline some of these ideas around. A professional, or even if you go online, there are a lot of default documents and can give or set the stage for not only having these conversations but executing them very formally. And then ultimately going back to all your accounts, all the money that you have, and making sure that your beneficiary designations are aligned with that will and that trust because ultimately those beneficiary designations, Dr. Pawlecki, which a lot of people don’t know, override the will and the trust. So some people have, you know, assigned a beneficiary as their, you know, a three-year-old child. Not a good idea for a variety of different reasons. And if you don’t know that as a listener, go look it up. Not a good idea, you know, all the way to, you know, forgetting that you’ve left an ex-spouse on there or an ex-partner, or you’ve left your mom or dad on there when now you have a spouse or a partner that you’d rather have benefit. I mean, all these things are realities that happen each and every day.

[Dr. Pawlecki:] I would add the fact that a lot of people may think that they don’t even have much at all, so why would they have a will? And …

[Michael:] You mean in terms of money or a home?

[Dr. Pawlecki:] Exactly.

[Michael:] It’s not worth anything so they can deal with it when I die kind of idea.

[Dr. Pawlecki:] But what happens if you have a cat or a dog or something? What do you want done with the dog or the cat? Like who do you want to take care of them? There are some very practical things to think through is what’s important to you. And then what would you want and who would you want to take care of that if you’re not able to do that.

[Michael:] Well, and to your point on not having a lot, I’ll never forget when my grandmother passed, she was very deliberate about all these things. She’s very, very sophisticated, intelligent, like procedural woman, and she laid everything out. And even though, to your point, it wasn’t a lot of money or a lot of things, she really aligned it to each of her, I think it was six children, you know, what she’d want her grandchildren. And then every small dollar, every small item had extraordinary meaning in that process, which ended up being a beautiful thing.

[Dr. Pawlecki:] What a gift.

[Michael:] And her memory lives on, which is a bit of what you’re saying.

[Dr. Pawlecki:] What a gift that she was able to pass on to her loved ones.

[Michael:] Yes.

[Dr. Pawlecki:] She was able to make that happen. And people knew what was important to her. And she was thinking this all out. And then people weren’t fighting over that ring or that other thing because she’s laid out what’s happening there. And people recognize that that’s my gift from that person.

[Michael:] There was a ring, people wanted to fight over, but the grandchildren figured it out. So it’s funny you said that because you didn’t even know that. But, so two quick things that we want to end this episode on is first, thank you so much, Dr. Pawlecki, for sharing with us all your thoughts and insights. So glad to have you here at Wells Fargo as our chief health officer, and hopefully everyone understands the value of it now because, you know, employees are human beings. They have spouses, partners, families. To your point on employee benefits, all these kinds of things, it’s not just about the insurance or the health insurance or disability insurance. It’s about your life and how you want to live it and what happens after you pass away, a family member passes away. How can an organization help support that? But if you’re not a part of the organization, how can you help empower yourself and your family?

So thank you so much. The second thing I want to mention is, and I love that you said this, that the conversation, authentically speaking, it’s challenging. You and I both have challenges around it. You know, sometimes I haven’t had it when it needed to happen. So that’s just real. So it’s a tough conversation to have; even professionals find it difficult. But if you have it, it’s a gift. It’s a gift to yourself. It’s a gift to your family. And sometimes the best gifts are the ones that present challenges out of the gate, but at the end, provide a lot of reward and benefit to everybody involved.

So thank you for sharing that with us and hope to have you back again.

[Dr. Pawlecki:] Thank you, Michael.

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