Below are the economic and market highlights for the week:
- Nonfarm payrolls surged in September, posting 254K new hires. That blew past analyst estimates of 150K, and was better than August’s and July’s payrolls, which were revised up to 159K and 144K, respectively. Job gains helped push the unemployment rate to 4.10%, down 0.1 percentage points from the month prior. A separate survey of household employment painted an even stronger jobs picture, with a gain of 430K. While the non-farm payroll report samples businesses and jobs added or lost, the household survey samples individuals and includes self-employed and agricultural workers, giving a more comprehensive view of the employment situation. The payroll report also showed wage growth continued to heat up with average hourly wages rising 0.40% on the month, which was higher by 4% from a year ago. Cumulatively, the last three months of labor data suggest a healthy jobs market, strengthening the soft-landing narrative.
- It was full speed ahead for the services sector in September. The ISM Services Index rose to 54.9, up from August’s 51.5. This was the index’s highest reading since February 2023. Numbers above 50 indicate expansion while those below signal contraction. Drilling through the report, business activity surged to 59.9, up from 53.3 in August. New orders jumped to 59.4, up from the previous month’s 53. Oddly, employment slipped 2.1 points to 48.1. However, businesses attributed the drop to employees leaving and the delay with finding suitable replacements. Healthy demand for services kept the heat on prices with the pricing gauge rising 2.1 points to 59.4. With the services sector accounting for 79% of U.S. output, the report is bullish for the economy. Meanwhile, manufacturers continued their struggles in September. The ISM Manufacturing Index was unchanged month to month at 47.2. New orders, production, and employment all remained in contraction territory. The minor positive in the manufacturing report was that the prices gauge fell to 48.3 from 54.
October: Spooky Tricks or Sweet Treats for Investors
Labor and geopolitical strife weighed on markets this week, threatening to break a potential fourth week of gains for the Dow Jones Industrial Average. Billions of dollars in goods transport came to a screeching halt on Tuesday after the International Longshoremen’s Association went on strike, shuttering ports from Maine to Texas. The strike had risked disrupting trade during the critical pre-holiday inventory stocking period, but it was back to work on Friday with the union and the United States Maritime Alliance, representing ocean carriers and port operators, striking a tentative agreement to a 62% wage increase over six years and a decision to extend their existing contract until January 15, 2025 in order to give more time to iron out job security concerns over automation. Also on Tuesday, Iran unleashed a missile barrage on Israel prompting anxiety over a widening Middle East conflict. Israel vowed to respond, but it remains unclear whether the retaliation will target Iran’s oil or nuclear facilities. The escalation caused oil prices to spike on Thursday, rising 5%. Friday’s strong payrolls and the temporary resolution of the dockworker’s strike helped lift markets on Friday and helped the Dow Jones Industrial Average close at a record high on its way to its fourth straight winning week.
Despite some of the spooky omens that have started to manifest in early October, markets are coming off a strong Q3. The Dow Jones Industrial Average finished the quarter up 8.1% while the S&P 500 notched a 5.53% gain, propelled by the Fed’s September rate cut. Oddly, it was the softening in the labor market in July and August that spurred the Fed to lead with a 50 bps cut rather than a smaller 25 bps reduction, but the strength in September’s reading is likely to mean the Fed will take a more measured approach going forward. In many respects, the recent data has been idyllic with inflation moving towards the Fed’s goal while the employment picture still remains intact. The services industry, which accounts for the bulk of economic output, along with the uptick in wage growth should support continued spending for the remainder of the year. If anything, the data is starting to shift from a “soft landing” to a “no landing” scenario, where the economy could grow 2.5-3%. Bond markets in particular have adopted the no landing case, pushing the 10-year U.S. treasury yield to 3.971% on Friday. Next week’s CPI and PPI reports will be instructive on what we might expect from the Fed for its final two meetings of the year, but the uptick on the jobs and services fronts has all but extinguished the market’s fright over spiraling deceleration.
The Week Ahead
Wall Street will pour over the latest inflation data as well big bank earnings as they kick off the Q3 2024 earnings season.
Finding Peace: Insights on End-of-Life Planning and Hospice Care
Earlier this week, America’s oldest living president in history celebrated his 100th birthday. Former president Jimmy Carter reached this milestone on Tuesday, October 1. No other U.S. president has lived to 100, and the next closest in age is George H.W. Bush who passed away six years ago at the age of 94. Carter and his wife, Rosalynn, both entered home hospice care in February 2023 after the former president experienced a series of hospital stays and health issues, including a battle with cancer that began in 2015, and following Rosalyn’s diagnosis of dementia. Rosalynn passed away in November 2023. Experts in the field of end-of-life care have commended the Carters and their family for publicly discussing their choice of hospice since it is widely misunderstood.
Hospice is intended to provide health care to someone who no longer seeks a cure for a terminal condition. The focus of medical care shifts from life-saving to improving the quality of life for as long as it lasts. The goal is for a patient to be able to pass away with dignity in a manner they choose and to live the end of their life as fully as possible. Hospice care is usually provided at home, but it may also be provided in a hospital, nursing home, or dedicated hospice facility.
Below are some additional aspects of hospice care that can help individuals and their families discuss and plan for the kind of care that a patient with a life-limiting illness wishes to have.
Hospice is different than palliative care
Both hospice and palliative care focus on what can be done to support an individual with a serious health condition that can’t be cured completely, however, palliative care patients continue to seek treatment for their illness to prolong their life and keep symptoms at bay. In contrast, hospice is comfort care when life-prolonging care is no longer beneficial or desired.
Hospice does not mean that an individual will soon pass away
A common misperception is that hospice care hastens death and the dying process. Hospice is not intended to shorten one’s life, but rather it is intended to support to a patient and their loved ones as the end of life draws near through:
- Symptom management
- Pain management
- Stress management and other mental health support
- Family support
Some patients may enter hospice and their condition improves such that they may be discharged from hospice. They are able to return to hospice at a later time if or when it becomes necessary. Most people find the choice of hospice care to be a source of solace, knowing that an empathetic, compassionate, and experienced medical team is there to help any time of the day or night to give a patient the best opportunity to live the end of their life on their terms. The 2023 National Hospice and Palliative Care Organization Facts and Figures report states that the average lifetime length of stay in hospice is 92.1 days. The median lifetime length of stay was 17 days. Former President Jimmy Carter has been under hospice care for 19 months, although experts note that is uncommon. Advocates for hospice share that patients generally do not pursue hospice as an option early enough due to misconceptions, but the experience can be highly beneficial to the patient and their caregivers. Starting hospice early may be able to provide months of meaningful care and quality time with loved ones. Patients and families who have chosen hospice often wish they had experienced hospice care earlier in the illness.
Hospice includes a wide range of services
A hospice provider will assess a patient’s declining health and life expectancy and assist the patient and their family with medical decision-making to enhance the end-of-life experience. Hospice agencies can arrange for pain medications to be delivered to a home along with hospital beds, oxygen tanks, wheelchairs, walkers, bandages, catheters, and other medical equipment and supplies that may be needed. Some may think hospice provides round-the-clock care, but this is rarely the case. While hospice provides a lot of needed support, most of the care of a person dying is provided by family, friends, spouses, grown children, neighbors, or additional paid helpers. However, hospice provides regular visits by professional caregivers, including doctors, nurses, social workers, home health aides, and trained volunteers. A patient’s hospice care team is available by phone 24/7.
Hospice agencies can provide guidance about medications to optimize the patient’s wellbeing, such as pain relievers, anti-nausea medications, anti-anxiety medicines for reducing anxiety or restlessness, antidepressants for managing depression or mood changes, steroids for symptom management, and others. Hospice may provide short-term “respite care” to give family members a short break from caring for their loved one, and hospice can also offer emotional and spiritual counseling.
Medicare includes a hospice benefit
Most Medicaid, Medicare, and private insurance providers will cover some or most of the services provided by hospice. Older adults enrolled in Medicare can receive hospice care if they have six months or less to live. In most cases, patients will need to sign a statement choosing hospice care instead of other Medicare-covered treatments for their illness. There may be a copayment of up to $5 for each prescription for outpatient drugs for pain and symptom management. A patient can still receive services that are not part of a patient’s terminal illness and related conditions, such as dental and vision benefits. An explanation of Medicare’s hospice benefit is available here.
Planning ahead is important
Engaging in early end-of-life planning is more than a practical step; it can ease the burden on loved ones and enable individuals to make informed decisions without the pressure of time constraints.
An end-of-life plan documents an individual’s wishes for the final days, including the type of medical care they would like to receive and designates a person to help make medical and financial decisions if a person becomes unable to make them. Our advisors understand that this type of planning can be overwhelming, and our team of estate and financial planning experts can help make the process as smooth as possible.