End-of-Life Planning: Legal, Financial, and Other Considerations

Avoiding planning for the future can negatively impact both the patient, in regard to comfort during treatment, and the patient's survivors, in regard to taking care of the patient’s affairs and ensuring that his or her wishes are followed with respect to children, investments, assets, etc. Facing the prospect of a fast-moving disease, caregivers can help by ensuring that the following subjects are considered and, where necessary, completed as early as possible, with the patient’s wishes reflected.

It is worth noting, of course, that ALL of us, whether battling a disease or not, should make these arrangements and keep them updated. A Washington Post article provides excellent guidance for updating and maintaining your records and annually communicating them to those who will need to manage your affairs in the event of your death. You need not be afraid to raise these issues with your loved one—taking care of these details has absolutely nothing to do with cancer, lung cancer, or any other disease. Rather, it is about being prepared for what is inevitable for all of us and can strike even the healthiest at any time. Set an example by doing this yourself as well!

The following documents should be drafted with the assistance of a legal professional:

  • Health care proxy/living will: This document gives authorization to a designated person to make health care decisions on the patient’s behalf in the event that she or he cannot do so.
  • Do Not Resuscitate (DNR) order (if desired): Patients may choose an advanced directive to forgo CPR or other resuscitative efforts should the heart stop beating or breathing stop. A DNR may be written by a doctor after discussing the issue with the patient or his/her health care proxy and/or family.
  • Power of attorney: This authorizes a person to act as another’s agent or attorney in general, for a definite time, or a specific act. If expiration of the terms of the POA are not specified, is usually expires when the person granting it dies.
  • Will: This is a legal document that disposes of the deceased’s property/possessions.
  • Organ and tissue donation: Even people with cancer can donate certain organs to others or for medical research. Simply expressing that one intends to be a donor may not be sufficient. Caregivers can assist the patient by ensuring that the appropriate measures are taken to express this wish (eg, advanced directives, organ donor cards, driver’s license).
  • Letter of instructions: Although not technically a legal document, a letter can provide survivors with critical information for carrying out the patient’s wishes and for locating critical information and documents. The caregiver should help the patient make a comprehensive list of:
    • Wishes and instructions with respect to property, children, pets, etc.
    • Names and phone numbers of family, friends, associates, and representatives to be contacted (including attorneys, work managers, insurance agents, accountants, financial advisors)
    • Location of important papers and records (again, refer to the Washington Post article for additional guidance), including the documents listed above, and all relevant account numbers and passwords, such as for:
      • Bank and investment accounts
      • Utility bills
      • Mortgage
      • Internet services
      • Bills, credit cards, loans
      • Property title
      • Social Security
      • Medicare
      • Pension
      • Insurance (auto, health, life)

The American Cancer Society provides some excellent detail and guidance around many of the common end-of-life documents

The Cancer Legal Resource Center offers free legal advice for people with cancer .  You can visit their website for help with legal issues.

TIP:  As early as possible, confirm the location and details of each of the above, and any processes that may be required to properly dispose of and/or transfer them in advance of, or upon, the patient’s death.