Death is scary (but we need to get over it)
By Paul Wilson
Passing through nature to eternity.
— Hamlet Act I, Scene 2
Selling insurance can be tough. Really tough. In addition to the hurdles faced by anyone who sells for a living — prospecting, marketing, referrals, rejection, competition — there's also the fact that selling insurance involves talking about scary things. No one likes to think about Alzheimer's, chronic illness, cancer or especially, death. And yet, that's just what advisors who sell products like long-term care insurance and life insurance ask their clients to do with every conversation: Face their own mortality.
Avoidance of this uncomfortable line of thinking is one of the largest factors preventing clients from taking the necessary steps to protect themselves and their families. In survey after survey and countless conversations with advisors every day, people cite their discomfort with discussing illness and death as a major factor in their lack of coverage.
When men are unprepared and look not for it.
— Richard III Act III, Scene 2
A recent poll by the AP-NORC Center for Public Affairs Research found that two-thirds of people over age 40 have done little or no long-term care planning. One-third admitted that they'd rather not think about getting older at all.
But whether or not they think about it doesn't change the fact that it's happening, or diminish the unpleasant results facing those who don't prepare. Government figures show that nearly 70 percent of Americans will need an average of three years of long-term care at some point after they turn 65.
In the UK, Aviva found that one-fifth of the population says they are worried about the possibility that they or a loved one will contract a serious illness during the next six months. Yet, just as in the U.S., a huge disconnect remains between people's concerns and their level of insurance coverage.
In her article, "Why We Need to Talk About Death and Dying," Judith Johnson cites the following statistics:
- 80 percent of Americans do not put their personal affairs in order before they die.
- Approximately 20 percent of Americans spend their last days in an ICU.
- The average funeral in the U.S., including a cemetery plot and grave, costs between $10,000 and $12,000. Only about 5 percent of Americans preplan their end of life rituals.
According to the National Centre for Social Research (NatCen), 45 percent of people feel death is a long way off.
In our fear, we substitute what we wish to be true for what we know to be true.
— Sigmund Freud, "Reflections On War and Death"
For years, advisors and others in the financial services industry have done their best to share the vast quantity of data out there with their clients in an effort to break the spell and jumpstart planning – to snap them out of their delusions. You can't argue with the facts, right? So, why isn't it working?
"Statistics, facts and figures tend not to resonate anymore," says Stephen Forman, senior vice president of Long Term Care Associates. "The Alzheimer's Association recently came out with a bunch of new statistics: 1 in 3 people dies with Alzheimer's. It's incurable. Very scary stuff, right? But if you tell people 1 in 3 will die from it, most people tend to live in denial and say, 'That's very scary for them. I will be one of the 2 in 3 that won't die from it.' People tend to reverse those statistics, so you can't win that argument."
Among other things, this mindset is a result of human psychology and ongoing social trends. The topics of illness and death have become taboo in modern times, increasingly ignored or pushed to the boundaries of society and the back of people's minds.
In his essay, "Reflections On War and Death," Sigmund Freud wrote:
Our attitude had not been a sincere one. To listen to us we were, of course, prepared to maintain that death is the necessary termination of life, that everyone of us owes nature his death and must be prepared to pay his debt, in short, that death was natural, undeniable, and inevitable. In practice we were accustomed to act as if matters were quite different. We have shown an unmistakable tendency to put death aside, to eliminate it from life. We attempted to hush it up … We cannot, indeed, imagine our own death; whenever we try to do so we find that we survive ourselves as spectators. The school of psychoanalysis could thus assert that at bottom no one believes in his own death, which amounts to saying: in the unconscious every one of us is convinced of his immortality.
- I don’t expect to die anytime soon. But it could happen this moment, while I am writing. I was talking the other day with Jim Toback, a friend of 35 years, and the conversation turned to our deaths, as it always does. "Ask someone how they feel about death," he said, "and they’ll tell you everyone’s gonna die. Ask them, In the next 30 seconds? No, no, no, that’s not gonna happen. How about this afternoon? No. What you’re really asking them to admit is, Oh my God, I don’t really exist. I might be gone at any given second."
She cites the $55 billion Medicare paid in medical bills in 2009 solely for the last two months of patients' lives, one-quarter to one-third of which is estimated to have had no meaningful impact.
Another costly by-product of our fear of death, she says, is the tendency for medical professionals and organizations to continue to try to cure terminally ill patients with rounds of costly and unnecessary tests and procedures, rather than offering palliative care and respecting the patients' rights to die in a dignified, peaceful manner.
Beyond the dollars and cents, there is also, of course, the toll taken on the patients and their families.
"Unless we can start conversations about dying, we end up with people receiving unwanted medical attention or leaving behind an emotional mess for their families who feel they weren't able to fully support the dying person," says Hilary Fisher, director of Dying Matters, an umbrella group of the National Council for Palliative Care that promotes public awareness of dying, death and bereavement.
If given a choice (and forced to think about it), most of us want to die at home, in our sleep and without warning. But, of course, that's not the way it usually happens. Only 1 in 10 will get to die at home, according to research by public policy organization Demos. Instead, approximately two-thirds will die in hospital, even though only 7 percent of people say they would choose to die there, while one-fifth will die in a care home. "Unless we can devise ways to get people to talk about how they want to live while they are dying, our efforts to improve services will be like groping in the dark," write the study's authors.
Clearly, changing the conversation is a huge undertaking that will require a concerted and ongoing effort from a number of directions. And advisors are on the front lines, wielding enormous influence and shouldering a great responsibility. What steps can they take to help their clients confront and address their biggest fears?
See also: Six ways to help fearful clients
Rather than bombarding clients with scary statistics in the hopes of initiating a fear-based conversion, Stephen Forman suggests a different strategy. "We need to move to a consequences-based presentation," he says. "Basically, throw the statistics out the window and say, 'It probably won't happen, but you have people in your life who you love that are very close to you. You've made commitments to them.' It changes the whole conversation. "Never underestimate the ability of people to pay for something they want, to pay for something that's important to them," Forman continues. "There's never urgency in people's lives for something they believe will never happen to them. That's where we've been in the past. But never underestimate the ability of people to come up with money from nowhere to pay for something that's important to them."
Approaching clients at the right time is also key, according to Dr. Anne Brennan Malec, a clinical psychologist and financial therapist in Chicago.
In an article published in the Wall Street Journal last year, she noted that while it's tempting to avoid the topic of death when dealing with middle-aged clients, this is actually the time when people are often most receptive to the subject. Talking about death with older clients could hit too close to home, while younger clients often see it as a nebulous event sometime in the distant future, rather than something that must be addressed immediately.
To bring up the subject in a delicate manner, Malec suggests discussing the idea of preserving a client's legacy. If advisors say they would like to set up the estate "to honor [client's] beliefs," it can "provide a framework for tackling touchy subjects like powers of attorney and funeral arrangements, and getting to the details of providing for loved ones during and after a protracted illness."
In the same article, Kristine Porcaro, co-founder of Lexington Wealth Management, points out that while subtlety works well in many cases, it isn't always enough.
"If you tried to get at the topic of death by talking about legacies, some of our clients would say, 'What are you talking about?'" Porcaro says. "In some cases we have a history together of talking very plainly. So you always have to be aware of the person you're with."
Advisors are a seasoned bunch who are accustomed to tough conversations with their clients. But it looks like it's time to make them even tougher. After all, so much is at stake, and things simply aren't improving.
— Louisa May Alcott, "Little Women"
At the end of the day, yes, death is scary. But guess what? So is life. And it becomes even harder when someone you love leaves you with crippling debt or full-time caregiving responsibilities. No one wants to grow old; this has been true for as long as humans have had the ability to conceive of their own mortality. Fear of death doesn't make us special or inculpable, it just makes us human. And this fear can no longer be seen as an acceptable excuse for an entire nation of adults who continue to look the other way at the expense of their financial futures and those of their children and grandchildren. No one's suggesting that advisors call their clients names or browbeat them into submission, but we're all responsible for our actions, for those we love and care for. And being uncomfortable or scared doesn’t change that.