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HomeEnd of Life Planning

End of Life Planning


Aging in place, and aging in general, require planning for end-of-life issues.

Estate planning, end-of-life medical care, medical advance directives and other issues can be overwhelming, but with some plans in place it will be easier to face these issues as they arise.

Below are several topics that may help in thinking ahead for this unpleasant eventuality.

Click each title to expand/contract the text to read each article.

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Information for Your Survivors
Information for Your Survivors


Consider what personal information may be needed by those who are assisting you. Consider how to collect and store that information in a SECURE place so that it is easy to access by those you trust (caretakers/estate executor/heirs), and yet protected from identity thieves and others who may wish to do you harm. In the wrong hands, this information could become very dangerous, however it is also important to properly prepare yourselves, your loved ones, and your estate for the future. There are some books that have been published (“Peace of Mind Planner”) to assist with the collection of this information, but purchase of this type of book is not necessary to pull this information together. 


Here are some pieces of information you may want to consider putting together. You will also want to determine an approach for making this information accessible to those who may need it: 


  • If I am temporarily unable to do these things, please take care of: (mail, pets, plants, etc.)
  • If I die, please contact: (family members, close friends, employers, etc.) 
  • Where is my SS card located? Where are my military service records? Where is my birth certificate? Where is my marriage license and/or divorce decrees?
  • Where was I born? What are the names of my parents (and their birthplaces), my siblings, my spouse, my ex-spouses, my children, my grandchildren?
  • Where is my living will, my power of attorney document, my DNR order, my organ donor form, my driver’s license, my health insurance card, my passport?
  • What is my blood type? Where are my medical and health insurance records? Who is my primary care doctor? What is my preferred pharmacy? What medical specialists do I use? What are my medical conditions? What are my allergies?
  • What religious organizations do I belong to (if any)? Who is the person there to notify in the event of a serious medical issue?
  • Do I have a P.O. Box? Where is the key? Do I have a safety deposit box? Where are the keys? Do I have a storage unit? What is the password/lock combination/where are the keys?
  • Contact information for: estate executory, attorney, accountant, tax preparer, financial advisor, insurance agents, health care providers (including vision and dental), clergy persons, funeral home, funeral insurance, and any dependents (including aging parents)
  • Computer access information: What important things are on my computer and any external storage devices? Where are they? What are the usernames and passwords to access them? (Are any devices accessed with fingerprint or facial recognition? Is there an alternate way to access them?)
  • Financial account information: account numbers, usernames/passwords for bank accounts, investment accounts, retirement/pension accounts, credit cards. Also, where is my ATM card and what is the PIN?
  • Other sorts of financial information: frequent flyer accounts, safe deposit boxes, tax records, debt records (mortgages, car loans, etc.), life insurance, social security benefits, veteran’s benefits, etc.
  • Property records: where are the documents relating to property and where is the property? real estate, commercial/retail property, vehicles, heirloom property, firearms, hidden valuables, safe/vault, anything that is valuable that might not look it to the casual observer (artwork, antiques, etc.)
  • Insurance accounts: life, homeowner/renter, flood, rental/storage, health, Medicare/Medicaid, dental/vision, vehicle, other
  • Pet information: What veterinarian do I use? Do my pets have any medical conditions/take any medications? Special diets? Who will take care of them in my absence? Any special care instructions?
  • What accounts will need to be canceled if I can no longer use them: any autopay accounts, subscriptions (print/online/streaming/delivery), memberships, retail accounts, phone, utilities, cable/internet, charities, library card
  • Social media/email/website/blog: What are the usernames and passwords? What do I want done with them? (Canceled, put into memorial status, turned over to someone else?)
  • Any wishes, last words, special instructions for my heirs or caretakers? 
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Living Will/ Advance Health Care Directives
Living Will/ Advance Health Care Directives

It is important to let others know of your plans and preferences for aging in place, and it is useful to designate a surrogate to make decisions for you in the event you are temporarily unable to make your wishes known.


Beginning to plan for the end of life requires careful consideration and lot of coordination and documentation. Advance care planning involves learning about the types of decisions that might need to be made, considering those decisions ahead of time, and then letting others know—both your family and your health care providers—about your preferences. These preferences are often put into an advance directive, a legal document that goes into effect only if you are incapacitated and unable to speak for yourself. This could be the result of disease or severe injury—no matter how old you are. It helps others know what type of medical care you want. An advance directive also allows you to express your values and desires related to end of life care.


As part of your advanced planning, you will want to consider your wishes around different types of medical interventions in different emergency medical situations, should you be incapacitated. This may include your thoughts about being put on a ventilator, getting Cardio-Pulmonary Resuscitation (CPR), artificial hydration and nutrition, as well as your thoughts about comfort care. You may or may not want to execute a Do Not Resuscitate Form, depending on your wishes. Identifying what you consider to be Comfortable, who you would like to have near you, are also important things to think about when developing your Advanced Directives. 


As part of the development of your Advanced Directives, you will need to identify a Health Care Surrogate who can facilitate your medical care and make decisions on your behalf should you become incapacitated or unable to speak for yourself. 


For more information on Advance Directives, see the National Institute on Aging Resources and the additional links on our website under How to Age In Place. 

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Wills and Probate
Wills and Probate

In Florida, all the assets of a deceased person (their “estate”) must go through probate, a court proceeding that allocates these assets to creditors and heirs. If the deceased person left a will, the court will determine the validity of the will and (if the will is found to be valid) will distribute the estate according to the provisions of the will. Thus, to assure that your wishes will be carried out, it is important to create a valid will and make sure that your heirs know where to find it.

For a will to be considered valid in Florida, it must be signed by the person writing the will and two witnesses; it is best to have these signatures notarized.


There are many websites that will let you generate a will for free; there are also several estate planning guides available at the public library. These resources are a good place to start, as they will help you identify what sorts of assets you need to account for. Such guides are especially useful for making an inventory of your estate, including both assets and debts. Make sure to identify any especially valuable items such as collectibles or jewelry that might escape the notice of a casual observer. (You don’t want that small Rembrandt to wind up in a garage sale!) It is also important to note the location of documents such as deeds, titles, or insurance papers that would be necessary for your heirs to access.


If your estate is complex, it is probably best to use a lawyer specializing in family law or elder law to help you draw up your will. 

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Long Term Care/ Hospice
Long Term Care/ Hospice

According to an article by Charlotte Grinberg sometimes it is simply not realistically possible for people to receive the care they need at home. This may be due to financial issues, the need for professional medical care, or the need for supervision and assistance with the daily activities of living.


According to a study published by The Center for Retirement Research, “about one-third of retirees do not have the resources for even minimal care and only one-fifth can afford severe care.” This is at least in part due to “Medicare’s insufficient funding for in-home caregiving support for those receiving hospice [which] makes dying at home unaffordable and impossible for far too many.”


Eventually, one might need to consider a long-term care facility and/or hospice. How do you know when to make that transition? AARP offers many resources for people trying to think and plan ahead for long term care, and the federal government runs LongTermCare.gov to help people make well informed decisions. More information is available at FloridaHealthFinder.gov. (Much of the information here is taken from that site.)


Hospice provides a coordinated program of professional and volunteer services for patients with a terminal illness. Staff members are specially trained to assist you and your loved ones in dealing with end-of-life issues. They offer palliative care, which provides comfort and relieves pain and other symptoms when there is no cure available. Hospice allows you to die with dignity, respecting your values and encouraging you and your loved ones to be involved in the decision making process all along the way. The goal is to provide a good quality of life while preparing for the end of life. 



Tallahassee is home to a number of great hospice organizations with positive reputations in the community and flexible approaches. In Tallahassee, most hospice organizations exclusively offer services wherever the patients call home, with one Hospice Inpatient Facility, (The Dozier House, Big Bend Hospice).


To be eligible for hospice services a patient must have a prognosis of living six months or less and no longer want curative care. If a patient lives beyond six months after admission they can continue to receive services as long as the doctor continues to document the patient’s eligibility. Hospice services are often not fully used because most people turn to hospice only during the last two to six weeks of the patient’s life, though they could have the services for much longer.


Services can include nursing and physician care; social work; pastoral services; nutritional counseling; grief counseling for patients and their families; physical, occupational, speech, and massage therapy; music and art therapy; home health aide and homemaker services; home medical supplies and equipment; and respite services for caregivers. Grief counseling and support continue to be available to loved ones after the patient dies. 


You can find a list of Florida hospice providers, home health agencies, and nurse registries on Facility Locator at FloridaHealthFinder.gov. After you have an agency or a list of agencies click on a name to find the address, phone number, driving directions, the administrator and owner, emergency actions (where applicable), and a link to inspection reports. 

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Legal Help
Legal Help

How much of this stuff can you handle on your own? How much of it requires involving your medical professionals? How do you make sure your survivors and heirs will be protected? When do you need a lawyer? How do you pick the right one? All these questions can be overwhelming.

 

According to their website (www.nolo.com), the Nolo Network “is one of the web's largest libraries of consumer-friendly legal information – all available for free.”


They offer many do-it-yourself guides as well as information about how to select a legal professional when necessary. They offer a lot of advice about wills, trusts, estate planning and probate. https://www.nolo.com/legal-encyclopedia/wills-trusts-estates

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Funeral Arrangements
Funeral Arrangements

What do you want to have happen to your remains after your death? Do you want a funeral or a memorial service? Would you prefer a solemn ceremony or something else? Do you prefer burial or cremation or something else? Do you want a specific location as your resting place or not? 


Making arrangements yourself will make the process much easier for your family when the time comes, and can help avoid possible disagreements down the road. Many financial options are available (AARP has an article here) and it may be best to consult with a professional to help you make these decisions. Whatever you choose, be sure to make those decisions known to your family and/or caregivers.

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Digital Legacy
Digital Legacy

What will happen to your online accounts after you can no longer access them? Many of them you will probably want to have deleted (shopping accounts, bank accounts, mailing lists, store rewards accounts, etc.) but some social media accounts may be put into “memorial” status so that others can still access the information. 


Ideally, you would create a list of the various services and accounts that exist in your name so that they can be deactivated when you no longer need to use them. You might also want to record the usernames and passwords for these accounts, but be very careful with such a document if you do - such information would be useful to your heirs, but also to potential identity thieves. 

More information is available at the website of the Digital Legacy Association.

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