End-of-life planning refers to the steps a person takes to get their affairs in order and determine how they want to spend their last days.
People may also refer to end-of-life planning as advance care planning. It typically involves a person completing a living will, a healthcare proxy, and a last will and testament.
Whether a person is well or facing a terminal illness, end-of-life planning helps ensure that those who care for them can carry out their last wishes. While it may be a difficult subject to consider and discuss, it is important for a person to have their affairs in order to help facilitate a smooth process after their passing.
In this article, we will discuss what people can expect with end-of-life planning.
This type of planning
Individuals do not need a lawyer for an advance directive, living will, or healthcare proxy. But a person may need legal help for special circumstances and power of attorney. The National Institute on Aging has an easy-to-follow
End-of-life planning involves forethought to ensure that a person receives healthcare treatment consistent with their wishes and preferences, should they be unable to make their own decisions or speak for themselves. It can require people to answer specific and difficult questions about death and dying. Questions a person may want to consider include:
- Do I need or have a will?
- Does my family know where I keep my important papers?
- Do I have life insurance or money set aside for burial, cremation, or funeral expenses?
- How and where do I wish to die if I have a choice?
- Do I want
lifesaving measuresif or when they become necessary?
- Is palliative care right for me?
- How do I want my body handled after my death?
- Do I have social media accounts that need closure?
- Do I want to donate my organs or my body?
- Do I want a death announcement or an obituary? What do I want in it?
- What sort of memorial do I want, if any?
A person’s end of life
- Home: An individual may receive end-of-life care in their own home. The individual’s doctor can help plan for home care help.
- Hospice care: This involves end-of-life care for people who decide to stop treatment, or when there is no available treatment or cure for their medical condition. A person can receive hospice care in their home or at a medical facility.
- Skilled nursing facility or nursing home: Individuals who require higher levels of support may choose around-the-clock supervision and nursing care from a skilled facility or nursing home.
- Hospital: Individuals who want life-sustaining treatment may choose a hospital setting for their end-of-life care.
According to the American Academy of Family Physicians, a person with Medicare has no out-of-pocket costs when advance care planning takes place during their annual wellness visit. Most people are eligible for Medicare, which can cover aspects of hospice care and services. In most states, Medicaid offers similar coverage.
End-of-life care at a hospital or skilled nursing facility depends upon a person’s insurance policy coverage. There are various ways a person can pay for end-of-life care services that Medicare does not cover, including life insurance, reverse mortgages, and long-term care insurance.
While it may seem daunting, planning ahead can help make advance care easier. This may include:
Documentation people may want to complete can include:
According to the Hospice Foundation of America, advance directives are documents known as a living will and a healthcare proxy.
A living will describes the type of medical care a person would want in specific circumstances. A healthcare proxy appoints someone of an individual’s choosing to have the authority to make decisions on their behalf if they cannot do so.
A person signs an advance directive in the presence of two witnesses. Some states also require notarization of the advance directive. Individuals can go over and change their advance directives as many times as necessary. People can find an example of an advance directive form here.
POLST: Portable medical orders
POLST are medical orders that travel with a person who is seriously ill or has advanced frailty. Healthcare professionals use these orders when a person requires medical care and cannot communicate their desires.
Last will and testament
A last will and testament, also known as a will, is a legal document where the decedent (person who dies) gives instructions to a named executor on how to distribute their finances and possessions.
Power of attorney
Power of attorney is a legal document that allows a person to appoint an agent to act on their behalf, should they become incapacitated or unable to function as usual. A person may become unable to make decisions due to dementia or Alzheimer’s disease, an accidental brain injury, or a stroke.
Organ and tissue donor designation
A person can choose to donate organs, tissues, or both upon their death. People can learn more about organ donation from the Health Resources & Services Administration.
Choosing how to die
Everyone has different thoughts, values, and beliefs on how they want to die. Some examples may include:
A person may decide to refuse life-sustaining treatment if it does not help or prolongs suffering from their underlying medical condition. Examples of life-sustaining treatment may include:
- mechanical ventilation
- renal dialysis
- medications to restart the heart
- artificial nutrition and hydration (tube feedings)
Assisted suicide or euthanasia
Euthanasia and physician-assisted suicide are when a mentally competent, terminally ill adult makes the choice to end their life with prescribed medication. The laws on assisted suicide vary according to country.
A person allows a disease to take its natural course until they experience a natural death. The person still receives supportive care measures from caregivers and often a hospice.
- traditional in-ground or mausoleum burial
- natural, or green, burial
- body donation for medical education or scientific research
Having a conversation about an end-of-life plan with loved ones may not seem necessary when a person is well. But as a person’s health can change in a moment’s time, it is important to discuss and document a person’s wishes while they are of sound mind and body.
The Hospice Foundation of America has suggestions on starting an end-of-life conversation. Additionally, Compassion & Choices Plan Your Care Resource Center has a free downloadable toolkit that can help guide a person in having end-of-life conversations with healthcare professionals and others a person may want involved in their end-of-life care.
End-of-life planning refers to the steps a person takes to plan their end-of-life care wishes. These steps typically include discussions with loved ones and healthcare professionals, along with completing documents such as advance directives and powers of attorney.
Thinking about the end-of-life of care may not be easy, but making these decisions ahead of time can offer peace of mind to both the person and those responsible for carrying out their wishes.