End of Life Planning Guide

When a loved one’s passing is near, the last months and weeks can take a huge emotional toll on relatives and caregivers who feel powerless to change the current circumstances. While no one has control over the forces of life and death, we do still have to make difficult decisions in the final days and cope with our own feelings of grief, stress and pain. That feeling of loss may be overwhelming even before our loved one has died.

In this challenging time, what can often help family members most (besides a willing and sympathetic ear) is the sense that they are doing everything possible to prepare for the inevitable. That’s why it’s very important to plan to get the help you need so that confusion and panic don’t cloud what is already a very difficult situation.

Affordable Burials and Cremations has put together a basic end of life planning guide to help you make sure you are taking the right steps and doing the right things to prepare for end of life. Whether you read this information for yourself, for a friend or for a family member, it is our hope that this material will help you know what to do long before it is actually needed. It will help you understand what others are experiencing near end of life, and help you make good choices when the time comes.

The Final Months: What Kind of Help Does Your Loved One Need?

As a spouse, friend or family member, of course you want to be able to offer support to the person who is facing death. The fact is that most of aren’t trained in how to provide emotional, spiritual and practical help to the dying. It is a part of our culture in the West to avoid even discussing these types of things, yet the need hasn’t gone away. To fill the void, we have professionalized these services to some degree in the form of hospice care. In a nutshell, hospice care:

•        Is delivered either at home, in the hospital, or in special settings
•        Provides help with physical, practical concerns from bathing and dressing to household chores and meal preparation
•        Assists the patient in daily functioning such as movement (physiotherapy, occupational therapy) and speech
•        Offers spiritual and emotional help such as counselling and religious support
•        Is designed to keep pain to a minimum with medication and other methods, rather than provide cures or treatments
•        Is recommended for patients who are likely to pass away within a period of six months or less
•        Also helps caregivers and loved ones by providing respite care and bereavement support

You may decide upon hospice care for a loved one in the final few months of their illness if they are no longer receiving any benefit from medical treatment and would prefer to live their last months in comfort and with dignity. Often, hospice care is a logical and relatively inexpensive answer for people who have expressed the wish to die peacefully at home, without medical interventions. Hospice care may be covered by OHIP or by other insurance providers.

Depending on your loved one’s situation, palliative care rather than hospice care may be indicated. This preference varies from person to person, but both may come into play for the same individual at different stages of his or her illness. While similar to, and often confused with, hospice care, palliative care has some key differences. Sometimes, hospital-based palliative care has an interdisciplinary team that offers services to the patient that are similar to hospice care in that they take into account all aspects of the person’s physical and emotional well-being. Choosing between hospice and palliative care can be difficult, but by consulting with your loved one’s medical team and respecting their wishes and the needs of the family, you will be able to make the choice that best supports your loved one.

Palliative care factors include:

•        Need for a hospital based setting (i.e. the patient is still benefitting from therapeutic, rehabilitative measures)
•        A coordinated health care program that works across various settings (i.e. upon discharge, the patient continues a monitored medication regime at home)
•        Pain management and other services provided at any stage of illness, no terminal diagnosis required
•        Professional, rather than volunteer, services

No matter which service is indicated at any point in a loved one’s illness, you should always receive competent, compassionate and respectful care from your hospice or palliative care team. This will help your loved one but also you, as you know your spouse or relative will be receiving the very best care and comfort possible in addition to the support you provide.

Planning for the Future: Estate Planning Basics

It may seem cold to be thinking in terms of assets and debts when the person you love is diagnosed with a terminal illness or is nearing the end of their natural life. However, managing property and acting in accordance with other end-of-life wishes are essential. Dealing with such issues before death can alleviate much anxiety, worry and guilt in the future, whereas leaving such tasks unexplored can lead to confusion, despair, and very real legal and financial troubles later on. Making arrangements now will provide protection from disputes, seizure, and tax burdens that may fall to children and other relatives in the future.

Good estate planning should include:

•        Detailed specifications on how money and other property should be managed and distributed, both during life and after death
•        Specific directives on the medical and health care measures the individual wants to receive, especially if they become unable to communicate their wishes clearly later on
•        Name(s) of those designated to act as guardians or trustees for any dependent children
•        Information on final arrangements, such as whether burial or cremation is preferred
•        Name(s) of personal executives, representatives and powers of attorney to act on your behalf should you become unable to make decisions regarding your affairs
•        Comprehensive instructions on how to conclude matters of business that may currently be suspended, such as how to dissolve a partnership

The purpose of putting such documents into place before death is to give legal force to someone’s wishes. If no such documents are finalized, then the individual may not have control over what happens to his or her property, money, or even their person, during an illness and after death. Estate planning is important for everyone, even those who don’t think they have enough assets to make it worthwhile. Everyone owns some form of property, whether it’s real estate or clothing or bank accounts or pets. And many surviving individuals will be potentially entitled to additional funds, such as pensions and insurance proceeds. That’s why it’s important to set wishes on paper, to prevent key decisions from being made based on the whims of surviving relatives or on the provincial intestate succession laws that govern property distribution when a person dies without a will.

A basic will may be sufficient for some people to address these issues, however, if more complex issues are present – for example, if the individual has a dependent child with special needs, or has children from previous marriages and wants to designate assets to them on an ongoing basis, a trust may be necessary. Trusts can be administered in virtually unlimited ways and therefore can become quite complex. To find out more about wills, estates and trusts, click here or speak to a lawyer who has experience in Ontario estate law.

Respecting Final Wishes: Planning for a Burial or Cremation

With our cultural aversion to talking about such matters, it’s no wonder that final arrangements often come as a shock to loved ones, who don’t know how to proceed when someone has died and are also stunned by the costs of typical funeral services. For the person in the position of making final arrangements, dealing with his or her own grief and sense of loss, plus the added possible complication of unsupportive or self-interested family members, can make knowing what to do very confusing and stressful, especially if there are no written instructions from the deceased. Planning for final arrangements in advance is the key both to ensuring that final wishes are properly respected, and that loved ones can proceed with these wishes confidently and without undue stress.

Here are some steps to take when planning for a burial or cremation.

 

•      Talk to the person you’re caring for. Ideally, these plans should be made while your loved one is still alive – and that includes picking out a casket or an urn, deciding who will say what at the service, and choosing the headstone or decorative tree that will memorialize your loved one after death. While it may seem anathema to discuss death with a vulnerable sick person, the truth is that most people actually do know what they want to happen to them after death, and even the person who says ‘I won’t be alive, so I don’t care’, when probed, often has preferences in mind.
•      Get wishes in writing. If your loved one is quite clear about what they want to happen after their deaths, they may be willing to put such instructions in writing. Unless notarized, these instructions won’t have the force of law, but in such a situation most family members will want to respect these written wishes. To make the wishes legally binding, you may want to use these instructions to make pre-arrangements for burial or cremation. By putting a contract in place, these final wishes will now be legally binding.
•      Speak to a funeral home. Funeral homes and mortuaries are experienced in dealing with death; that is their only business. No matter what the anticipated circumstances may be, they will have the necessary experience to advise you about all aspects of death, from getting the right paperwork in order to collect and transporting the body, to embalming, burial or cremation. By contacting a reputable Ontario funeral home in advance of death, you will be able to have all your questions answered in advance, and you will also have the time to get a second (or third, fourth, or fifth) opinion to find a funeral home that matches your needs and budget.

 

Final Steps: What to do When Someone has Died

No matter how careful your preparations have been, it’s still a shock when someone dies. You may feel completely numb, paralyzed with grief, overwhelmed at the tasks that lie ahead, or a combination of all three. It’s important to get help and support with the things that must be done. Even if you are in charge of the arrangements by design, you can still enlist the help of friends, family members and professionals to help you through the things that need to be done:

•        Notify people: If your loved one passes away in hospital, the attending doctor will be informed automatically; otherwise, you will want to notify the patient’s health care team. If death is accidental, or in some other circumstances, the police must be informed. You will also need to inform family members, relatives and friends. This can seem like a monumental task and you may fear leaving out important people. This is where other people, as well as public tools such as an obituary, email notice or social media invitation, can come into play to make sure the news gets to the right people.
•        Choose a funeral home. Even if you have not yet decided on the particulars of a service or memorial, it’s essential to choose a funeral home so that a professional can deal with the storage, transport and care of remains and register the death.
•        Follow the written instructions left to you by the deceased. These instructions will help you make immediate decisions on such issues as organ donation and disposing of the remains.
•        Request the death certificate and copies. These will be necessary for a variety of reasons, from obtaining life insurance to closing bank accounts.
•        Secure the deceased’s property. While you don’t have to dispose of an entire estate in the first days and weeks following death, it is important to ensure that such property is secure for the time being, and of course, that any dependent children, pets, etc. are properly cared for.
•        Secure burial and funeral benefits from the deceased’s insurance, pension plan, or other associations such as Veterans’ Associations.
•        Find out if you are eligible to receive survivor benefits from the government.
•        Arrange for an appropriate casket or urn, and a cemetery marker or headstone.
•        Plan the memorial service
•        Notify the businesses, agencies and other organizations that were involved with the deceased, of their death, so that mail, subscriptions and other communications can be forwarded or concluded. You will also need to cancel the person’s pensions and benefits, personal identification and credit cards, SIN number, phone numbers, and more.

Affordable Burials and Cremations would be honoured to help you through this difficult time and make sure that the choices you make are the best ones for you and your family. Call today to discuss final planning with one of our experienced, respectful representatives.