End-of-Life Planning Facilitating Difficult Conversations and Decisions

elderly man and young woman staring at laptop

The subject of end-of-life care is a difficult one to discuss with your loved ones. And if you’re reading this article, we realize that you’re probably concerned about the right way to approach it at this very moment. First, please know that we at B’zoe Care sympathize with you and want to reassure you that you are far from alone in seeking support and advice on this topic.

How you approach the conversions can make all the difference not only to your loved ones’ reception to it, but to your own well-being. End-of-life planning is necessary to ensure that their wishes are conducted properly, while they are still in control. In addition, the more your loved one has planned, the less stress your family will undergo

End-of-life plan should begin by having discussions with three invaluable professionals, in no particular order:

  1.     An attorney will set up estate plan documents according to your instructions.
  2.     The Primary Care Physician, with whom your loved one should discuss preferred treatment options in the event a medical condition no longer permits such decisions. A healthcare proxy allows the person designated to control medical treatment when the patient no longer can. We recommend including a backup to the first choice, just in case.
  3.     A financial planner, who can arrange for the most tax-advantageous plans for heirs and beneficiaries. The attorney can recommend such a planner.

When having end-of-life conversations with your family, understand how difficult and emotional this will be for everyone. It is critical for family to listen to each other’s concerns. Different individuals may have other ideas and points of view. However, keep in mind that your ill loved one is in control here. It may be the end-of-life, but it is still their life.

Consider the following:

How to approach end-of-life conversations

No one wants to have this talk, but it helps everyone make the best choices for the future. Choose a relaxed time of day, which is usually mornings, and a family brunch meeting is ideal. Be honest and encourage everyone to ask questions. It is important to evaluate the different care options. Will your loved one be able to remain at home, or will they require a hospice? Listen to your loved ones while allowing them to maintain control. Everyone will have their concerns, and it is important to express them.

 

What do end-of-life decisions include?

End-of-life planning, also known as advance care planning, helps seniors maintain control over their final days as they document their end-of-life decisions.

While the distribution of property is a strictly personal matter, heirs will appreciate knowing a few details and perhaps express an opinion. After all, this involves everyone. An attorney can draw a living trust naming a Trustee who will distribute any property in the trust following the demise of your loved one. The advantage of a trust is that all property that is included will not be probated, which greatly eases the burden on all survivors. Any property, such as real estate, personal items, automobiles, insurance, and more can be placed into the trust. This should avoid petty post-death arguments such as, “But Mom wanted ME to have the bracelet.” 

 

What are the needs for end-of-life care?

 People nearing the end of life need to include the following in their advanced planning care:

  1.     Physical comfort is crucial, as is pain management and personal care. Consider your loved ones emotional needs and take advantage of counseling if needed. Ensure that your family is aware of any needs they may have.
  2.     Palliative care (end-of-life for terminal care) usually involves the last few months of their life. The critical professionals looking out for your loved ones well-being are your doctors, nurses, social services, and physical and mental therapists. 
  3.     If their final days are at home, the visiting healthcare provider (most likely a trained nurse) will be a central person in their life, along with friends and family.
  4.     A doctor can tell you how to approach palliative care in your area.

 

What questions are most appropriate in end-of-life discussions?

You may want to delay these questions or avoid them altogether; however, these are questions that should be asked as early in the end-of-life stage as possible. The longer you delay talking about death, the greater the chances you will not get the answers you hope for. Be calm and straightforward. 

  1.  What is the exact health situation?

Your loved ones’ health will change. There will be good days and bad days. Be sure to check in regularly with the healthcare provider to get an accurate status. And be sure to share this status with family. 

While most seniors are happier remaining within the familiar surroundings of their home, hospice care may be a more practical solution when the terminally ill patient is within six months of end-of-life, his or her health is declining despite the care being provided, he or she becomes mentally confused, and pain becomes uncontrolled.

  1.  What should I be doing as things get worse?

How much medical treatment does your loved one want to manage their symptoms before the side effects become worse than the illness? Only they and their doctor can decide.

  1.  Discuss the worst fears.

This is a difficult time. Interestingly, it is also a time they can speak most freely – who will stop or blame them? Their fears can include pain, leaving behind loved ones, worrying about how family members will survive without their presence, and more. Talk about what is going on inside of them. Make sure they know you are there for them.

  1.  Can they have a great day as they approach end-of-life?

They are fighting illness, age, perhaps pain and loneliness. Does a great day even figure into the equation? Absolutely. This should be a time for utter selfishness on their part. If they cannot get to a beauty shop, have a beautician and/or manicurist come to them. Will hiring a personal chef to prepare the meal of a lifetime cheer them up? Do it. Unless they are in a situation where they are struggling financially, now is the time for a silly splurge or two.  

  1.  What is your loved one’s last wish?

Do they have some kind of hope or wish niggling at the back of their mind? Perhaps it is seeing an old high school friend. Consider this the time to make wishes come true.

 

What documents are part of an end-of-life care plan?

Try to have their personal information, such as social security number, birth certificate, necessary contacts and their numbers, and debt documents conveniently in one place for your family to find. You can ask about necessary keys to lock boxes, etc. 

Legal documents should include a living will, trust documents, power of attorney, and health care directive, also known as a living will. 

The Last Will and Testament specifies how your loved one would like personal possessions/assets to be distributed following their death. They can name an executor who will carry out their wishes. Discuss with your loved one who the most logical choice might be. Most likely their Last Will and Testament will have to be filed with the Probate Clerk and go through probate. There are only a few exceptions, such as for very small estates or when the belongings are held jointly.

Anything they own can be placed in a Living Trust, same as they might place it in their Will, but a Trust does not have to be filed with the probate court. The trustee will distribute the designated assets to the appropriate heirs and beneficiaries without the added expense of probate.

Your loved one can create a letter of intent to emphasize their final wishes regarding the funeral, what to do with pets, and necessary information regarding online accounts. This is not a legal document but can ease the end-of-life process. Make a list of needed online passwords.

A financial power of attorney can give whoever they trust to manage their post-funeral finances, both assets and debts.

 

Conclusion:

Planning for end-of-life guarantees that your loved ones desires and wishes are carried out by their designated representatives when they are no longer able to do so. In addition, a heavy burden will be lifted from all family members as they know the deceased’s last wishes are being honored and respected.