I have never thought of dying before, but now that I have been diagnosed with bladder cancer, I find myself wondering, are there things that I should do to prepare for death?
None of us likes to think about the end of life, particularly while we still feel young and healthy. Many of us are poorly prepared to think about dying. As a result, many people have not made appropriate preparations with their families, physicians, lawyers, and so forth. End-of-life decisions, such as living wills, healthcare proxies, and advanced directives should be addressed directly long before you become ill and potentially unable to communicate your wishes.
If you have never had a serious discussion with your family about your views on the end of life, now is the time. For many American families, this can be a difficult discussion, but it is important to persist. By the end of the discussion, your family should be able to verbalize your feelings on several issues.
First, if you were to stop breathing on your own, would you want to be placed on a ventilator if there were a good chance that you could eventually come off the ventilator and breathe on your own? What if there was not a good chance of coming off the ventilator? Second, if your heart were to stop beating, would you want to have CPR and/or defibrillation (shocking with “the paddles”)?
Third, if you were unable to eat on your own, would you want to be fed through a tube in your stomach? Fourth, if you are unable to communicate with your doctors, who should be your voice to make decisions about your health care? You should choose a single family member or close friend if no family member is able or willing to act on your behalf.
It is important that everyone in your family be aware of your choice and is accepting of it. Legally, your spouse is first in line to make decisions followed by adult children, although most states will allow you to choose if you fill out and sign the appropriate forms.
Once your family understands your feelings and directives about end-of-life care, you should think about how those who depend on you would get along if you were not there. If you are in charge of the finances, you need to show someone where all your records are kept and counsel that person as to how to manage the finances in your absence. Similarly, any other chore or duty that is exclusively yours needs to be addressed.
For most of us, it can be helpful to consult an estate-planning attorney to guide us through the legal process associated with these decisions. The American Cancer Society has a brochure that discusses the common issues that should be addressed, including questions regarding business, taxes, and loans. You will want to make sure that the following are in order: life insurance, retirement plans, titles to assets, property, bank accounts, safe deposit boxes, stocks, bonds, car deeds, and your will.
It is important that beneficiaries are clearly designated and that account numbers, addresses, telephone numbers, and contact information are recorded. All of this information needs to be kept somewhere that is easily accessible to your family, and your family should know that you have taken care of these things for them.