End-of-life planning is not an event that we look forward to, it is inevitable, but nonetheless, necessary and should be embraced with the utmost compassion, respect, and grace. This is a delicate time for the individual and the family. There are many facets during this time that should be addressed, some seemingly simple and some seem difficult but preparation can always ease into the various transitions that will occur. Maybe these are discussions and preparations that have been discussed years in advance or maybe this is a new possibility that needs addressing. There are various avenues and arrangements to consider to ensure the most graceful and peaceful death for a loved one.
This is a never easy topic to address, but the National Institute of Aging generalizes, “people who are dying need care in four areas—physical comfort, mental and emotional needs, spiritual issues, and practical tasks. Their families need support as well” (nia.nih.gov). The National Institute of Health describes the end of life as the term used to describe the medical and support given to the families and individuals during the time surrounding the death; including before, during, and after (nia.nih.gov).
First on the agenda, ensuring your loved ones are comfortable. Many discomforts can be minimized or relieved in varying ways. It can be difficult to know the end is coming, and even worse knowing that suffering can ensue causing death to be more painful. NIH asserts, “Experts believe that care for someone who is dying should focus on relieving pain without worrying about possible long-term problems of drug dependence or abuse” (nia.nih.gov). There is no reason to allow your loved one to struggle with pain, get ahead of the pain and prevent it, rather than relieve it. If it seems harder to manage the pain then Palliative care or Hospice care may be needed.
Palliative care is a resource offered to patients that are living with a serious illness that helps to improve life and help with symptoms, the National Institute of Aging suggests that it’s best to seek palliative care soon after diagnosis to help provide the family with medical choices to move forward in treatment or cure. Consult your insurance provider to specify what kind of coverage exists for palliative care. Once palliative care and treatments are deemed not beneficial treatments, and death could be determined within 6 months, Hospice care becomes an option. The NIH warns, “It’s important for a patient to discuss hospice care options with their doctor. Sometimes, people don’t begin hospice care soon enough to take full advantage of the help it offers. Starting hospice early may be able to provide months of meaningful care and quality time with loved ones” (nia.nih.gov). Hospice is the point where death is eminent, it is a resource designed to provide quality remaining life with the understanding that treatments aimed at a cure are no longer a medical option and stopping treatment would be more beneficial and opting more for medical care that relies on comfort.
Hospice provides substantial support, but if the patient is choosing to die at home with hospice, care ultimately lies on the family. Private care can be purchased to help with around-the-clock care, having a nurse in the home to assist with everyday tasks that is not obligatory of hospice treatment and plans.
Both palliative and hospice care offer mental, emotional, and spiritual support to the family and the individual, in addition to the medical necessities that come with end-of-life arrangements, ensure your loved one has their legal matters in order. A medical proxy needs to be decided in case your loved one is unable to make a decision, someone that is designated by the patient can make medical decisions on their behalf. Appoint a power of attorney to make medical and legal decisions for you, they do not need to be one and the same. Whoever is appointed power of attorney only holds that duty while the benefactor is still alive. Once deceased, the power of attorney is relinquished of their duties. Assign an executor of the estate for, after death, this person manages the deceased estate as outlined by a last will and testament, if an attorney has not already been appointed for this task. These people will consist of the end-of-life team along with doctors, care providers, family, friends, and spiritual leaders.
Discussion should be had to get the basics down and then a Last Will and Testament should be drawn up to outline any and all wishes they would like endorsed upon their death. This should include the division of any money and assets, burial decrees, and any other last wishes that need to be executed. If a Will was drafted years before, consider whether it needs to be amended? Burial plans and expenses should also be outlined, as well as, any insurance policies that will be paying out and those specified beneficiaries that were named.
After all the foot work of making sure business is handled and care is in action, consider making sure to address any mental needs that become evident during the end. The National Institute of Health asserts, “It is important to treat emotional pain and suffering. Encouraging conversations about feelings might help. If the depression or anxiety is severe, medicine may help” (nia.nih.gov). Having familiar family and friends present can offer comfort and solace, a warm touch can be soothing, and soft sounds and music can be relaxing; offering feelings of connection and reminiscent of memories past.
In addition to mental health care, spiritual care is beneficial for coming to terms with the end. Maybe the person dying has lost faith and seems to find it in the end, making for a more peaceful transition into the afterlife. NIH explains that those about to die may have a sense of guilt or need to make amends, these conversations are still important regardless if the person is not actively conscious. NIH says, “Sharing memories of good times is another way some people find peace near death. This can be comforting for everyone. Some doctors think it is possible that even if a patient is unconscious, he or she might still be able to hear. It is probably never too late to say how you feel or to talk about fond memories” (nia.nih.gov). Bring spiritual leaders by regularly to offer spiritual strength to the person dying if that is within their requests. Keeping a spiritual text near the bed, may also provide comfort, its symbolism offers a closer proximity to a spiritual outlet.
Managing the end of life plan can be exhausting but covering all the bases can help make the transitions less stressful with a well thought out plan and options to ensure quality, comfortable care during the end. Be well informed, speak to an attorney when drafting a Will or assigning family to make decisions. Talk to the insurance provider for plan clarifications and coverages. Contact and consult with burial services for seamless transition and transportation. Keep a journal as the care giver to help keep other team members of the end of life team in the loop. If the loved one is cognizant, encourage them to keep a journal too, just to write down thoughts and feelings to assist in feeling alive and alert.
Do You Have a Plan For End of Life?
When a loved one is dying, there are a plethora of things that have to happen. There are some things your loved ones can and should do before they pass away. Probably the most important is to have your final wishes legally memorialized in a will to remove the burden of having family members, friends, and loved ones wonder what your final wishes are. We are going to go over planning for services and wishes for your final days from your family, friends, loved ones, and healthcare team.
When you are in the hospital, the last thing you want is for your family burdened with decisions that may affect the length of time you have left. To help with these decisions, each person should have an advance directive, or a living will on file at the hospital or with their doctor. The advance directive/living will let everyone involved in your healthcare know what you want to do or not done to prolong your life. Organ donation is also covered in an advance directive. A key component to planning is to nominate a trusted individual as the power of attorney or a healthcare proxy. They will be your voice when you can no longer use yours. If you don’t have an advance medical care directive, you can visit CaringInfo.org and print out advance directive paperwork templates for the state you live in. The forms are an outline of your end-of-life stage to your family, friends, and loved ones. You can state detailed things you want in the final stages such as a certain artist playing softly in the background in your hospital room or request a massage to help relieve certain symptoms. You can simply write or type out your wishes and have them witnessed and notarized. That way no one can question the validity of your words.
A will is another important part of your planning that needs to be in order before you pass away. You can prepare your will online using LegacyWriter or LegalZoom. These sites are good for those that don’t have very many assets and who only need a simple will. However, if you have a more complicated situation, you should use an estate planning attorney. They can help you with setting up a trust fund for your grandchildren or planning for multi-generation funds. You want to make sure that all of your finances are in order and make sure your estate is accessible to your loved ones that you have designated as your heir. You don’t want to leave a mess behind for your family to sort through. It is best to start making these plans and arrangements when you are younger or when a major life-changing event happens. Such events could include new life, a death, marriage, divorce or you yourself inherit a large sum of money. You want to be aware of all of your assets in your estate. It is best to go over your estate at least once a year. You don’t want to suddenly get diagnosed with dementia or any other cognitive impairment illness because you have to be coherent when you designate a healthcare proxy. Your family can’t sign your name for you. You have to do it yourself so set a date yearly and go over your plans with your loved ones.
Communicate, communicate, communicate! It is very important that you communicate your wishes to those that are closest to you and on your healthcare team. If no one knows your wishes, then they won’t know what to do for you when you can’t make the decisions anymore for yourself. Don’t make your family and healthcare team guess what you want. When you go to the doctor’s office, update them on what you want when you are in your final days. Have a family dinner and have all of your close family members over. Let them know about your wishes and make sure your power of attorney is still on board. Make changes as needed. No one to know exactly what you will be leaving behind. Although helpful in certain situations, there is no need to share that information with anyone if you are not comfortable doing so. If your children or heirs ask, reassure them that they will find out when the time is right. This will be less stressful for everyone involved because no one can fight over your estate.
Some other things to consider are online accounts you may have. If you have social media accounts, what do you want to be done with them? Do you pay your bills online? Do you do your banking online? There is a place that can help you store that information and allow a designated loved one access to it when the time is right. You can use Everplans. They will store that information for you and your heirs when the time comes.
Did you know you can preplan your own funeral? If you do this, you are making sure it goes smoothly and the way you want it to. You can choose the funeral home, burial or cremation, flower arrangements, music, photo collages, or home movies. This is often done directly with the funeral home. They will ensure that your wishes are honored, no matter what they are. Preplanning eliminates much of the stress of organizing a funeral for your family after you pass. The funeral home will explain everything to your family. If your family has questions, all they have to do is ask. To further alleviate stress from your family members, assign each of them a specific job. If you have a child that is a healthcare professional, maybe they should be your power of attorney. If you have a child that is a banker then they might be the best choice for handling your estate.
Do you want the future generations in your family to know who you are? Make sure you take pictures everywhere you go, especially on vacations. Label them with names and dates so they can see how things were at a specific time. You can even designate certain pictures to certain family members so they can remember the special times you had together. They can always make copies to share with others if it’s necessary. There are even websites that can make your pictures into beautiful albums! The possibilities are endless.
There are four important phrases you and your loved ones can say to each other before they pass on. Fights, grudges, resentments, and regrets have no place at the end of life. If there are, you can start to make things right by simply saying: I forgive you, please forgive me, thank you and I love you. You might have been saying these simple phrases all of your life but they are most important in the end. These phrases are very freeing to everyone. You will all be at peace and you won’t have regrets. Be a role model for the younger family members and the older ones as well.
It is important for you to be at peace with all of your decisions before you pass away. If your need to, see a religious officiant and confess your sins. Spend time with your family and resolve all issues. You want to feel free, calm and at peace with all of your decisions and choices. Reassure your family that you love them and that it is ok to let you go in the end. Tell them to honor your wishes because they are your wishes.