Don’t Wait to Start End-of-Life Planning: Here’s What to Do

No one wants to think about planning for the end of life. It can be hard to put yourself in the mindset of preparing for death, and the logistics can feel overwhelming. But planning ahead will make the process easier for both you and your loved ones whenever that time comes. And it can bring you peace of mind to know you are prepared. 

End-of-life planning is the best way to be sure that your personal wishes for your medical care and finances will be respected. There are steps, questions, and people that can help you know where to start.

End-of-life checklist

There are a lot of things to think about when planning for death. And each step takes time, thought, and documentation. 

Some of these items can be done many years before your death. Others may seem more relevant to someone who anticipates their death in the weeks or months ahead. No matter where you are on that timeline, it’s never too early to start the process. The following checklist can guide you through it.

1. Prepare a living will 

A living will is a type of advance directive. Advance directives are legal documents that specify your preferences for your end of life. They only go into effect if you are no longer able to express your wishes due to injury or illness. 

A living will specifies which medical treatments you want — and don’t want — for end-of-life care. It goes into effect in the event you need life-sustaining treatment and cannot communicate your wishes. This can include things like:

• Restarting your heart with CPR or defibrillation

• A mechanical ventilator (breathing machine)

• Feeding tubes 

• Emergency surgery

• Medicines and blood products

• Your preferences for organ donation

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You can also choose to designate a medical power of attorney (also called a medical proxy). This is a person assigned by you who can legally make decisions for you if you no longer can. This can include decisions outside of life-sustaining treatment. They should be familiar with your wishes and preferences so they can be sure that they are upheld.

Each state has its own paperwork that you can fill out on your own. Some people choose to hire an attorney to help with the process.

Advance directives can also include your plan for your assets after you die.

2. Make a list of your assets 

Assets are anything that you own that has value. This list will vary from person to person. Common items on this list include:

• A house or estate

• Bank accounts

• Investments and stocks

• Certificate of deposits (CDs)

• Retirement funds

• Life insurance policies

• Personal possessions like cars, artwork, furniture, and jewelry

A written list will help you take inventory of your finances and decide who you want to inherit them. It will also be a big help for your loved ones after you die, so that they can be sure all your assets are accounted for.

3. Make a plan for your assets

Once you have an inventory of your assets, it is important to formally document who will inherit them. There are different documents that can do this depending on how you want your assets to be handled in the future. The two most common ones are:

• A will: This documents how your assets will be distributed after your death. It can also include who will care for living adult dependents, pets, and children under the age of 18. A will takes effect only after a person has died.

• A trust: This names the person (trustee) who is responsible for managing and distributing your assets once you are no longer able to. A trust goes into effect as soon as it is created. So, if a person becomes seriously ill or unable to manage their finances, the trust will take effect then.

Without a will or trust, a person’s assets will be distributed according to the laws in their state. 

Similar to your medical care preferences, you can also assign a durable power of attorney to make financial decisions for you when you are no longer able to.

A will can also document your funeral and burial arrangements if you have made them in advance. 

4. Write down your funeral and burial preferences 

There are a lot of decisions involved when it comes to funeral and burial arrangements. And if your loved ones do not know your preferences, these can make for stressful decisions. Some of the main decisions include:

• Body disposition: Most people prefer to decide what happens to their body after they die. The most common choices are burial or cremation. But there are other options, too, like donating your body to medical research. 

• The type of ceremony: There are many different types of end-of-life ceremonies. These include celebration-of-life services, wakes, viewings and visitations, funerals, and burials. And they can be held in different places, such as outdoors, funeral homes, or a place of worship.

• Spiritual traditions: For many people, a lot of these decisions are guided by religious and spiritual beliefs. Write down any specific traditions that you want carried out during your services. This can include specific readings or songs.

• Interment: If you choose burial or cremation, it is important for your loved ones to know where you want your body or ashes to go. This usually includes considerations of religious beliefs, location availability, and desire to be near family members and friends. This can also include choosing specific coffins or urns, or items you want buried with you.

5. Create an obituary or death notice 

Many people choose to write their obituary while they are still alive. This can help ensure that it captures the details of your life that are important to you. It can also alleviate some burden on your loved ones in the immediate aftermath of your death.

You can write the obituary in its entirety, jot down a few bullet points, or talk to a loved one about what information you’d like it to include. 

6. Write a letter to your loved ones 

It may seem like a daunting task to write letters to your loved ones and close friends before you die. But this may be one of the more fulfilling, meaningful tasks you can do to prepare for death. 

Many people who are nearing the end of life feel burdened by the unexpressed gratitude and feelings they have for the people who matter most to them. So, taking the time to reflect and communicate these thoughts can be both positive and liberating. Heartfelt letters can also help provide a sense of closure to friends and family after you have died.

People who can help you with end-of-life plans

End-of-life planning can be a lot of work. But it isn’t something that you need to do alone. There are many people who can help you with the process:

• Attorneys can help you with any advance directive documentation — including wills, trusts, power of attorneys, and executors.

• Doctors can help you understand your medical care options and set up an advance directive regarding your medical care.

• Healthcare providers who specialize in end-of-life care can also be a helpful resource to guide you through the decisions and tasks involved. These include hospice and palliative care nurses and case managers, as well as death doulas.

• Financial planners can help you decide how to distribute your financial assets.

• Estate planners can help you decide how to distribute your estate. They can also help you create a living will or trust.

• Family members or friends are perhaps the most important resource of all. Especially important are those who listen to your wishes and provide emotional support as you work through the planning process.

Questions to think about for end-of-life planning

As you embark on your end-of-life planning journey, there are questions to consider to help you make decisions about your preferences. 

Medical treatment questions to consider:

• Do I want all life-saving treatments if I am near death?

• Do I want a provider to try to restart my heart if it stops beating?

• Do I want to be put on life support if I can’t breathe on my own?

• If I can no longer eat, do I want a feeding tube?

• Would I prefer to die in a hospital or at home?

• Do I want to donate my organs?

Funeral and burial questions to consider:

• How do I want my body to be handled after I die?

• Where do I want my remains to be laid to rest?

• Do I want a viewing of my body?

• Do I want a traditional funeral? Or a memorial service?

• Do I have life insurance that can help pay for my burial or funeral arrangements?

• How do I want to be remembered? How can this be reflected in my death announcement or service?

Family and estate planning questions to consider:

• Is anyone in my family dependent on me? Who will care for them when I am gone?

• Who will care for my pets?

• Do I want a will or trust?

• Is my family familiar with my assets and financial accounts? 

• Is someone familiar with my monthly bills and how I pay them?

• Does my family have the access and passwords they need for financial and billing accounts?

• Is there a designated person who knows how to access my phone and computer?

• Are there any subscription services or social media accounts that I need to close or give someone access to?

When should you start making end-of-life plans?

It is never too early to start making end-of-life plans. And it’s better to make them when you are healthy and at home, rather than sick or in the hospital. Many people may choose to wait until they are older. However, it can be helpful to start making these plans earlier for several reasons:

• It is better to have plans in place if circumstances should change without warning.

• It can give you peace of mind knowing your wishes will be followed — and your family will be cared for — no matter what happens.

• These decisions require time and reflection. It is probably best not to feel pressured or rushed during the process.

• Since planning takes time and energy, this is likely easier when you are healthy. It can be hard to be in the right mindset for these decisions when you are sick or not feeling like your usual self.

• Thinking ahead may help you reprioritize or reorganize financial accounts and goals. 

• Research suggests that thinking about death can actually improve your sense of purpose and meaning, and make it easier to cope with death.

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Written by:

Cherilyn Davis, MD

Cherilyn Davis, MD, is a board-certified pediatrician in New York City. She has held local and national roles at the American Medical Women’s Association including board member of the physician division and physician chair of social media.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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