Strategic End-of-Life Planning: A Guide to Ensure Your Wishes are Honoured

Rethinking Advance Care Planning

Most people don't think about death all that often. End of life care can feel like a headache for old age, and none of us like to think about the prospect of serious illness.

Sadly, sometimes it takes the death of a loved one or the onset of a serious illness to remind us that life limiting illness and palliative care decisions can hit us when we least expect it- forcing us to confront their own mortality.

These situations act as triggers for planning ahead on health care- forcing people to think about what wishes they want seen through before they die, and to discuss how certain treatments might fit into these decisions.

Since you're reading this, maybe you're in that same position. Instead of putting the responsibility on your family and friends to organise your affairs when you die, doing it yourself can help to alleviate some of the pain and suffering so your loved ones have space to grieve.

What is end of life planning?

End-of-life planning involves setting out detailed instructions to tell your family and friends how you want your final moments to look.

Rather than Estate planning - which focuses on allocating assets - an end of life plan is centred around personal choices like lifestyle, wellbeing and preferences around medical care and burial arrangements. This can be relevant for how to manage physical symptoms of a terminal illness, or the palliative care team you want with you in the end.

Advance care planning should be more than just a conversation but a series of formal legal documents which provide guidance and authority to your loved ones. As a dying person, you may enter a stage where you lack capacity to make these decisions for yourself.

With this in mind, it's important to leave instructions so that your daily living and future care reflects what you want.

What Does An End-of-Life Plan Include?

A comprehensive end-of-life plan will include instructions for all aspects of your life when you become ill or otherwise incapacitated. It should detail any preferences for living arrangements, healthcare, financial decisions, and any logistics surrounding your death.

This could include an Estate plan, decisions surrounding funerals, burial arrangements or organ donation. For some, it even involves appointing a medical treatment decision maker as a medical power of attorney or in an advance care directive. Assuming this person has knowledge of your medical condition, medical treatment, and end-of-life care wishes, they can act on your behalf if you lose capacity to make your own decisions.

How to Create an End-of-Life Plan: Step by Step

Since there are so many different elements which make up an end of life care plan it is worth breaking the process down into smaller steps to make it easier to get started. If you haven't already done the hard work the first step is to create an create an Estate Plan.

1. Protect your assets

2. Decide what medical care you want

3. Plan your future living arrangements

4. Decide on funeral and burial arrangements

5. Write an obituary or death notice

6. Manage your digital legacy

1. Protect your assets

To begin, create an inventory of all your assets and debts, then decide how you want these to be distributed. Create a will or a trust to make sure your assets will be protected.

Identify your Beneficiaries and name an Executor to carry out your wishes when you die. This represents an important part of efforts to plan ahead.

2. Decide what medical care you want

Consider creating a medical or financial Power of Attorney or Advanced Care Directive. A Power of Attorney will authorise certain people to make decisions for you about medical care or finances if you become incapacitated.

You can include specific instructions around medical decisions, for example, if you oppose the use of assisted ventilation in the situation you stop breathing on your own. You can also include preferences for holistic health or natural medicines, covering specific medical treatment decisions and nursing home preferences.

3. Plan your future living arrangements

Talk to your family and friends about your housing situation in the event you become incapacitated and can no longer care for yourself. Do you want to hire a support worker and remain in your own home, or would a family member be able to provide support for you? Is a retirement home or assisted living a better option to reduce any burden on your family.

Thinking about what services you might require in line with a health diagnosis and associated future medical care, as well as any personal preferences you can integrate in whilst planning ahead. This can be an integral part of end of life care planning; with detailed instructions ensuring your family isn't left guessing when the time comes.

4. Decide on funeral and burial arrangements

You can choose to organise all your burial arrangements and memorial service up front either through a prepaid funeral or a funeral bond. The latter sets money aside in an account which can be used to pay the costs of a funeral or memorial service after your death. As well as ensuring your wishes are carried through, planning ahead in this way provides financial support to your family at this time.

You can leave instructions to loved ones about any preferences for your burial, if you would like to be buried in a plot alongside other family members or if you want to be cremated, and whether or not you want your ashes to be scattered. Alternatively, you can choose to register for tissue and organ donor or may wish to donate your body for scientific research.

5. Write an obituary or death notice

This is most commonly done after someone's death by a family member of a close friend. But you can choose to write your own obituary or death notice ahead of time to relieve the pressure on your loved ones.

It should include a full name, maiden name and any details you want remembered about your life. Your family can add the date and place of death as well as details for the funeral service when you pass away.

6. Manage your digital legacy

Most people have some form of social media these days, but they don't automatically deactivate upon your death.

Whether it's Facebook, Instagram, Linkedin or Twitter, each platform has a different process for how they manage profiles for users who have died. Some allow you to set up a memorial page so people can continue to leave messages and share photos after you die.

You can also authorise these providers to shut down accounts or deactivate them. It is worth creating a document with a list of all your social media accounts and their passwords with instructions detailing what your preferences are. This way someone you trust can carry out your wishes after you are gone.

Getting the Paperwork Ready - Advance Care Documents

The final step for end of life planning is to get all the advance care planning paperwork neatly organised and store it in a safe place. This can grant authority which locks in specific palliative care or medical treatment preferences.

On top of this, it's important to communicate the location of these major documents with a trusted family member or solicitor. This ensures they can act quickly when the time comes.

Your paperwork should be made up of:

• Birth, marriage, divorce or citizenship certificates;

• Passports;

• Medicare and Centrelink details;

• Financial documents including bank account statements, credit cards and investments;

• Details and keys for safe deposit boxes or storage units;

• Property titles or deeds;

• Car registration and ownership papers;

• Bank loan documents;

• Superannuation and life insurance information;

• Will, codicils and Trust details;

• Power of Attorney documents or Advanced care directives;

• Organ/Tissue Donor Registrations;

• And funeral and burial arrangements.

Summary

End of life planning is a vital part of a comprehensive Estate Plan. It sets out a clear roadmap for your family and friends to follow when you reach the final stage of your life.

Whether that's nursing home decisions, preferences of health professionals or palliative care specifics- advance care planning is an important way to guarantee you will have the best quality of life when you start to lose your faculties.

Organising your affairs up front doesn't just mean simply creating a Will and forgetting about it. It should involve thinking about medical and housing decisions in the event you fall ill, and appointing someone to oversee those decisions when you can't do it yourself.

It can also be helpful to arrange your own funeral and burial decisions yourself. If you put in the hard work early on, it can reduce some of the burdens on yourself and your loved ones when the time comes.

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