If it is established that your loved one has no chance of recovering from his or her illness, there are certain things you can do to make the last weeks or months go as smoothly as possible.
In many cases, your planning opportunities will be limited if your loved one is too sick to sign documents or talk to you. Having certain legal documents in place, such as powers of attorney, helps prevent legal, financial and treatment complications at this stage of life.
At the death of a loved one, there is always the need for a family member or other close person to step in and make important decisions regarding financial, and post-death arrangements. This time is never easy, but armed with the right information, your role as decision maker will be much simpler.
Reviewing the Letter of Instruction Your Loved One Has Prepared
A Letter of Instruction is not an actual legal document, but simply a list of commands and instructions that is prepared for people to follow when your loved one is ill or has died.
A Letter of Instruction includes, but is not limited to, the following:
1) A list of legal documents and their location so someone could locate them.
2) The location and instructions to computer programs (financial software) and file names when this information may be stored.
3) The names and phone numbers of close family members to contact.
4) Description of prepaid funeral arrangements. If not, a preference for one funeral home over another.
5) A description of the type of desired funeral and whether burial, cremation, or body donation is preferred.
6) The location of a pre-purchased burial plot or preference.
7) A preference for charities to receive donations in your memory.
8) Preferences for certain hospitals.
9) A relatively current list of assets and debts.
10) A list of insurance policies including life, medical, disability, long-term care, and property insurance.
11) The location of all investment account statements.
12) The location of all deeds to property.
13) The location of copies of tax returns.
14) The name, address and telephone number of the following people:
The Letter of Instruction must be in a location where you will be able to find it, such as the top drawer of a desk. The Letter of Instruction should be dated so it will be possible to determine which version is the most current (if several different versions are found). The Letter should be updated when situations change (a change of doctors, a purchase of a burial plot, or a shift in money from one account to another). The letter does not have to be written, it can be taped (video or audio) or put on a computer file.
If already prepared, you should locate and review this important document while he or she is still alive. It is also important to make sure that doctors and hospital administrators have copies of living wills and Medical Durable Power of Attorney forms on file. You should also have original copies of any Durable Power of Attorney documents where you are the agent.
The Letter of Instruction should list your loved one's important advisors. In particular, contact the lawyer, accountant and stockbroker. Each will be able to give you important information you'll need for the days and weeks ahead.
Stay on Top of Your Loved One's Financial Affairs
Even though your loved one is dying, make sure that his or her financial affairs are in order. If your loved one has appointed you the agent on a Durable Power of Attorney (or you share a joint account), then you can act quickly. If not, you may have trouble accessing assets to pay bills. Once your loved one has died, then you will be able to act on these assets if you are the executor of the estate.
Consider Hospice Care to Help Your Loved One Die with Dignity
You should discuss his or her feelings regarding Hospice care. Hospices do not try to heal their patients through medicine or surgery, but try to help the patient cope with the emotional and physical pain through support, therapy, and pain-killing drugs. They try to keep the patient as alert as possible and allow "death with dignity." Hospice care can be administered at home, in a hospital, in a nursing home, or in a separate facility devoted exclusively to hospice care.
To be eligible for Hospice care, your loved one will need to:
The traditional Medicare fee-for-service plan will cover the cost of hospice care. Your loved one will have to give up conventional hospital coverage under Part A. This decision is reversible if your loved one changes his or her mind.
Consider Issuing a Do Not Resuscitate (DNR) Order
Every adult has a right to refuse medical treatment, even if it causes death. There may come a time when it is appropriate to prevent any attempts to revive your loved one (doctors call this resuscitation), since it would simply prolong suffering and postpone the inevitable. If you have a Medical Durable Power of Attorney, you can issue a Do Not Resuscitate order, preventing hospital staff and doctors from giving CPR or trying to restore breathing or heart function. Discuss this matter with the doctors, social workers at the hospital, and other family members.
If this option is used, make sure that the medical chart at the hospital or skilled nursing facility states DNR clearly.
Start to Make Funeral Arrangements Before Your Loved One Dies
It is common for people to make funeral arrangements immediately after a loved one dies. The time between death and burial is very short (for religious and legal reasons) and fraught with emotion. Anything you can do in advance will make those days immediately following the death of your loved one much easier for you.
Prices vary greatly from funeral home to funeral home. Shop carefully and ask a lot of questions. Also understand that the director may steer you towards more expensive options. Ask for an itemized estimate that you can review against the bill after the funeral is over.Check if your loved one left a Letter of Instruction or if instructions are in the will. These documents may help you avoid guessing what kind of funeral your loved one would have wanted and may even tell you that these arrangements have already been taken care of or prepaid.