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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

Nearing End Of Life

Summary

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For information about each of the following subjects, see the other sections of this document.

While it may be painful to think about, it is inevitable that at some point we all die. As wonderful as modern medicine is at prolonging life, it has not yet been able to overcome death. Please do not take this to mean that we suggest you give up hope. No matter how certain things seem, you can still have joy in your life. There is always reason to hope. 

Your choice

Just as you have control over how you live, you also have the ability to control the last period of your life.

As a practical matter, it is your choice whether to keep trying to eliminate your disease, to let go and seek the fullest life available in your circumstances, or to choose an in-between path. It is also your choice how much of your personal and financial resources you are willing to spend and for how long. 

It is even your choice how to make the decision: whether on your own, in consultation with family and friends, your clergyman, and/or in consultation with your medical team. Ultimately, we are talking about your life. The final decision is yours.

Think about what care you want or do not want

Even at an end stage, you are entitled to good medical care and attention from your health care team.  

Part of your decision is what medical care you do or do not want. Think about your values and what is important to you. For instance:

  • Is quality of life more important then length of life? 
  • Is it important that you keep your head clear?  
  • What are the important relationships, activities or other things that are important to you?
  • Do you want to die at home instead of in a hospital?
  • Think about the costs, even if you have health insurance. According to a study from Mt. Sinai School of Medicine in 2012, 43% of Medicare patients spend more than their total assets out-of-pocketon end of life care.

The way to assure your desires will be satisfied is to execute the legal documents generally known as Advance Directives. Advance Directives allow you to keep control of your medical care even if you become unable to communicate.  (To learn about Advance Directives, click here.

It is also important to have a discussion with your family. There are all the obvious reasons for speaking about your desires with the people closest to you. In addition, if you become unable to speak for yourself, they could legally try to force additional medical care that you may not want. For information about how to talk with your family about end of life, click here.

Thinking about what could happen is not giving up. Writing legal documents about events that could happen is not going to make them happen. The documents and discussions that accompany them just make it more likely that you will get the care you want and that you won't receive the treatments you don't want. Merely executing the documents can bring peace of mind.

Whatever you decide, you can change your mind as often as you desire. 

NOTE: The sooner you tell your doctor(s) about your priorities, the better.

Continuing medical care

If you want continuing medical care, in addition to providing treatment, your doctor can help control both physical and emotional symptoms. If your doctor isn't aggressive about reducing or eliminating pain, bring in a doctor who will provide such care. Do not be afraid of becoming addicted to pain medication. It is not common in this situation. To learn how to get the medical care you need, see Managing Your Medical Care.

Hospice care

If you decide comfort is your goal rather than to continue to fight the disease, hospice care is available. Hospice care provides physical and emotional comfort to you and your family in a variety of settings, including in your home. Hospice care is generally available for free if necessary. There are doctors who are known as Palliative Care specialists who specialize in end of life care.

Your enviornment

Think about how the space in which you spend these days looks, sounds and smells. This is an opportunity to create the space you've dreamed of.

Leaving early

If you want to leave the planet before nature takes its course, speak with your doctor. Most deaths in this country are negotiated between patients and their doctor. As an alternative, while we do not recommend it, there is also the possibility of assisted suicide and ending your own life.

Planning Ahead

If you haven't already, it is wise to get your affairs in order now. (To learn the basics of estate planning, click here).  At the least, everyone should have a Will. (To learn about wills, including how to make one challenge proof, click here.) If you have made plans, review them to be sure they reflect your current wishes and financial situation.

If you want to save your heirs unnecessary expense and stress, consider pre-planning your funeral. Pre-planning is different than pre-paying. For information about funeral planning, click here.

Ethical Will And Messages


Consider putting together a document known as an Ethical Will. It passes on to your heirs information they should know such as your family history, what you learned in your lifetime, and whatever else is important to you. You can create this legacy in whatever way is easiest for you - for instance, by writing a letter, or by putting together a scrap book with annotations.  (To learn about Ethical Wills, click here.)

Thanks to the internet, you can also leave messages, in video or print format, for loved ones, and even have messages mailed at pre-arranged times. For example, click here.

Visitation from a Partner

If you are part of an unmarried couple (heterosexual or homosexual), hospitals can no longer discriminate against them visiting. Still, you can assure your partner will be able to visit if you end up in a healthcare facility by naming him or her as your health care Proxy in your Health Care Power of Attorney. Unless you take such steps, although he or she may be barred from visiting you as "non-fmaily" even though such restrictions are now prohibited. 

To Learn More


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