Make it accessible

Accessibility is a term generally associated with seeing-eye dogs, hearing aids and wheelchairs. But as the population of Canada (and the world) continues to get older, the term is being applied more and more in discussions about aging.

Aging workforces and the increasing longevity of workers has and will continue to prompt businesses, families and governments to adjust their thinking about how to deliver service.

The City of Toronto, for example, turned its attention to the need for change half a decade ago when the city’s Diversity Management and Community Engagement office revealed Accessibility Design Guidelines. The 2004 guidelines, a response to “the varying needs of the disability community,” include recommendations for everything from outside facilities, signage, exterior and interior routes, to waiting areas, textures and everything in between.

Age was not the only factor driving the initiative, but the city did acknowledge the impact aging residents have on disability statistics, pointing out that the disability rate for persons aged 65 and over is more than 40%. For persons 75 and over, the number is more than 50%. “The demographic implications are obvious and will drive the need for change,” say the policy authors. “In the upcoming decades, the proportion of the population 65 and over will increase dramatically.”

Despite the wealth of confirmed information that the aging process will affect clients and their advisors in a myriad of ways, most advisors have not responded to the needs of their clients.

Betty-Ann Howard, MSW and CFP at Independent Planning Group Inc. in Kingston, Ont., says the trend needs to change.

While Howard is diligent about talking to her current clients about factors that may affect them as they age, she is keenly aware of the need to establish the same level of frank, intimate trust in new client relationships.

“In long-term client relationships, I have already talked to them about the concerns and issues they may face with aging,” explains Howard. “I have also already met their kids, talked to them about their plans and the importance of communicating that plan with loved ones.”

However, like many advisors, Howard continues to start relationships with clients who are in their pre- and post-retirement years. “I approach the topic delicately and respectfully, and I concentrate on normalizing the process,” she says. “Rather than starting a conversation with the assumption that a client is having difficulty, I start the conversation by relating how I, too, have difficulties.”

For example, when talking about a complicated product, she’ll say, “I’ve had 10 years of experience and all kinds of training, and I still can find it complicated. Can you relate?”

Asking a question, prefaced with her own humanity, tends to prompt honest communication from her clients. “In counselling, it’s called normalization,” says Howard, who spent nearly three decades in the field of social work and nursing, at times helping to develop federal initiatives in these areas. “It can elicit the answers you are looking for.”

Two experts in the field of aging agree that a communicative, open-minded approach is essential when developing a more accessible environment for aging clients.

“There is a great variation in terms of how older persons manage their aging experience,” explains Suzanna Waters Castillo, expert on aging and long-term care at the University of Wisconsin-Madison. “Older people are not simply adrift in a sea of anomie but continue to grow, find meaning and participate [in life and their affairs].”

She explains that in aging studies, activity theory suggests actively engaged older persons have greater life satisfaction. “The major change is a slowing of the cognitive process — problem solving, for example,” says Castillo. “This is due to age-related changes in the central nervous system and the sensory system.” As a result, she says, “older adults need more time to complete physical and mental tasks.” Accommodating this requires communication and foresight on the part of the advisor.

Pam Holliday, research associate at the Toronto Rehabilitation Institute, agrees. She says some sensitively phrased questions along the way will go a long way in accommodating aging clients.

“Don’t assume a person needs help,” she says. “Ask them. They will tell you what they need and when it is appropriate to help.”

Even before an advisor meets with a client (established or new), assessments and decisions can be made to make the experience more appealing and more accessible.

Physical challenges and solutions

Holliday suggests you start by examining the physical components of your business.

“Mobility and dexterity are issues for many older people, as is arthritis and hip, knee and hand pain,” she explains. “With this in mind, examine how a client experiences entering and exiting your office and the building your office is located in.”

Holliday suggests you start by examining the physical components of your business.

“Mobility and dexterity are issues for many older people, as is arthritis and hip, knee and hand pain,” she explains. “With this in mind, examine how a client experiences entering and exiting your office and the building your office is located in.”

This examination should include both interior and exterior areas:

Exterior:

Parking: “Where do your clients park?” asks Holliday. “Is there a long distance between where they park and your front door?”

Stairs: Is there an alternative to stairs, both outside and inside the building?

Rest areas: Holliday suggests examining the distance from bus stops and parking spaces to the front door of your building and the front door of your office. “Clients with mobility issues, and even those that don’t [have them], often need rest areas, benches, where they can take short breaks when walking longer-than-comfortable distances.”

Doors: Doors that are heavy to open, or difficult to open when holding on to a walker, cane or bag pose significant problems to older people, explains Holliday. Automatic doors should be made available for these clients whenever possible.

Interior:

Chairs: Holliday suggests purchasing chairs with armrests that provide support when they move from a sitting to standing position, and vice versa. She also suggests chairs with high backs and firm seat cushions, which provide more support and require less work to vacate.

Flooring: Thick, plush carpets are a hazard for people with mobility issues, says Holliday. Also, advisors should get rid of all tripping hazards — scatter rugs or flooring with turned-up edges. Cords should also be kept off the floor and away from foot and wheelchair access points.

Grab bars: Holliday suggests installing grab bars in any area where an older client may need support — particularly if they need to perform a function, such as opening a door or pressing a button while holding on to their personal belongings. “The grab bars enable a person to hold on to something stable or to rest personal belongings while performing the other task. That’s essential for balance as well as peace of mind.”

Cognitive challenges and solutions

Although aging is not an automatic precursor to mental difficulties, Holliday suggests looking at other areas of the business to ensure there are no impediments to those who may have cognitive impairments as well.

“[Advisors] are not dealing with people who are stupid or dumb or any less intelligent,” she explains, “but when you put a lot of things on their plate, they can become confused. [As such] you have to be organized and present material clearly, in plain language, as you would for anyone else.”

Consider the following:

Printed documents: According to the Canadian National Institute for the Blind (CNIB), more than 836,000 Canadians live with significant vision loss. That number is expected to rise dramatically in the decades ahead, along with Canada’s aging population. The standard recommended by the CNIB for all printed matter (or website content) is 14-point Garamond.

Noise: The Canadian Hearing Society (CHS) documents point out that hearing loss can range from mild to profound cases and that “hard of hearing people relate to the world visually to a larger degree than hearing people.” With this in mind, CHS suggests using visuals wherever possible. Since not all hearing devices operate in the same fashion, reduce ambient noise by developing offices or meeting rooms that are isolated and free from noise distractions, Holliday says.

Peter Merrick, author and founder of merrickwealth.com, realized the importance of aging and health for his clients, and dedicated an entire section to the impact of these factors in his recently released book, The Essential Individual Pension Plan Handbook.

“You need to talk about it,” he says in a matter-of-fact tone when asked how he approaches clients about the impact of aging. “Tough questions need to be asked. As an advisor, who is objective, we are in a good position to ask these questions.” Merrick suggests asking clients a simple question: If you can’t take care of yourself, how would you like to be taken care of?

By asking this (and other) questions, Merrick prompts his clients to examine their desires and wishes, and communicate these goals to him. It’s then his responsibility to ensure the plan and the money are in place to achieve the client’s objectives.

For advisors dealing with actual or potential cognitive impairments, Merrick suggests ensuring the client has an “iron-clad” power of attorney (POA) on file.

A power of attorney grants a designated person the authority to carry out financial or health affairs on a grantor’s behalf, in the event that a person cannot do it him/herself.

To create an “iron-clad” POA, both clients and agents need to be informed about the different POAs available, explains Barry Fish, a wills and estates lawyer with Fish & Associates.

For finances, clients can make use of a bank power of attorney or a continuing power of attorney for property. The bank POA is limited to bank transactions, says Fish, and will terminate when the client becomes incapable. At that point, the government becomes involved in your financial affairs.

The continuing power of attorney for property gives a designated person authority in all of the grantor’s financial matters, including real estate. (This type of POA may be called enduring power of attorney in other provinces). Unlike a bank power of attorney, it survives incapacity and takes effect immediately upon signing and receipt of the document, explains Fish.

Clients who are uneasy about when a POA document takes effect can suspend the POA or stipulate that it is not to be used until they are actually proven incapable. Fish says grantors can also create a POA but hold on to the document, or keep it with a lawyer, and not hand it over to the designated person right away. A personal care power of attorney gives the appointee powers to make health decisions for the grantor.

Merrick suggests looking at POAs to ensure that multiple documents do not nullify each other or remain in force simultaneously. Howard also suggests that clients be prepared to assign an alternate appointee in the POAs in case the appointed person becomes incapacitated, predeceases the client or is otherwise unavailable.

While POAs may be a good backup plan for real or perceived mental deterioration in aging clients, Castillo warns that normal cognitive changes are not the equivalent of cognitive impairment.

“Major changes in intellectual functioning occur only late in life and usually not before age 60,” she explains. As such, “crystallized memory stays in place and supports intellectual function, [enabling] lifelong abilities to stay in place. Changes only occur for those abilities that are not at the core of a person’s life skills.”

Since financial planning is, typically, not a primary skill set of most clients, Castillo suggests advisors allow more time for clients to complete physical and mental tasks, rather than assume a person is losing his or her mental faculties.

This is the approach Howard takes with all of her clients, building extra time into her scheduled appointments to accommodate post-retirement clients. She believes that by planning in this way, advisors can create better, more communicative, more accessible environments.

“We need to take the time with people,” she says, particularly as they age.

Originally published onAdvisor.ca on July 8, 2008