Most people don’t like to discuss their wishes for what will happen at the end stages of their life or directly after death. But there are many important decisions, including what types of health care are wanted toward the end of life, or what will happen to one’s assets when one dies. Here, we introduce some of the most important plans for you to help your loved one make, including plans for advanced care, hospice, financial plans, and estate plans.

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Advance Care Planning

Part of helping someone live well with a serious illness involves accommodating his or her needs as the illness progresses. Although you may be dealing with adjustments to daily living, it is important that you and your loved one talk in advance about his or her beliefs, values, and wishes for end-of-life care. If you wait until your loved one is badly debilitated before getting these affairs in order, it may be too late for him or her to express requests, make rational decisions, and sign important documents.

Advance care planning (for yourself as well as your loved one) includes:

• Learning what life-sustaining treatments are available (artificial nutrition and hydration, extended mechanical ventilators, resuscitation, etc.)
• Deciding what medical treatments your loved one would want if his or her cancer becomes life-threatening
• Communicating with your loved one about his or her personal values and spiritual beliefs about death and dying
• Deciding who your loved one would want to speak for him or her and make decisions about his or her care if unable to do so for him or herself
• Preparing legal documentation of your loved one’s end-of-life preferences (Advance Directives- Living Will, determining Health Proxy) and giving copies to health care providers

Personal Business
In addition to the difficult decisions involving physical, emotional and spiritual care at the end of life, most people have personal business that will require management by someone who can be trusted. Naming someone to take charge of financial affairs is called durable power of attorney for finances. This is separate from the advance directive described above, but a patient may choose the same person.

Some financial institutions may only recognize the persons named on an account to make decisions about it, so it’s important to not wait until the patient is too ill to make changes or add a secondary name on an account. The same goes for other financial assets and legally binding documents such as investments, properties, and car titles. Adjusting the information on important documents before the patient becomes too ill may prevent years of legal battles and financial burdens.  Familiarize yourself with this important list of documents and topics regarding personal finance business. If you need to learn more about these you can meet with an associate at your bank, seek advice from a legal service, call your hospital to speak with Patient Relations or a Social Worker, or search the Internet.

•  Bank Accounts - Pay-On-Death beneficiary designations; Do you need to add co-signers?
•  Safe Deposit Boxes – where are the keys? Who are the co-signers?
•  Life Insurance Policies – who are the beneficiaries? Do they need amending?
•  Health Insurance Policies – where are membership cards? What are the ID numbers?
•  Durable Power of Attorney for Health Care – has this been signed? where is original? Do health care providers have copies? •  Durable Power of Attorney for Finance – who has been designated? What is their contact information?
•  Will and/or Living Trust – Where are they? What attorney drafted them?
•  Deeds/Property Titles - Who has ownership of the property? Does “tenancy” need to be designated?
•  Stocks/Bonds – Who are the beneficiaries? Do they need to be amended?
•  Birth Certificate – Know where your loved one was born in case you need to order one.
•  Military Papers – if applicable, where are the discharge papers?
•  Social Security Papers – Where are these documents?
•  Benefits Forms – Have copies of all forms (SSI, SSDI, GA, MediCal, Food Stamps, etc.)
•  Loan Papers – Keep payment contracts and credit card statements organized.
•  Vehicle Registrations – Who is listed as the owner and where is the certificate?
•  Income Tax Returns –Keep returns for the last five years and the accountant’s contact information.
•  Funeral Instructions – Is there a contract with a funeral home? Are wishes written down?

If your loved one does not specify who is to inherit his or her belongings, each state has a formula that will disperse property out to your next of kin after a lengthy and costly process. If a person dies intestate (without a formal will) the state takes control of the property, determines the legal nearest blood relatives and disburses the estate to them.  Many times property is sold, all the expenses are paid and what is left goes to the heirs.

There are many issues involved in estate planning that you should be aware of. The best way to become educated on these topics is to seek legal advice or refer to a social worker at the hospital for references. The Internet can be very helpful because it will lead you to many resources and references, but make sure that the information has been written by a legitimate source such as a government or nationally known organization. Also, guarantee that the information you read is current and relevant to the state you live in.