Wishes

I know no one likes to think about this, as if thinking about it might cause it to happen, but your physical existence is going to end one day. More often than not, it’s a total surprise when it happens and no one, including the deceased, is prepared for all that comes next.

Earlier cultures and religions have prescribed rituals that are carried out by the family and community, but in many cases today, no one knows what to do. In the midst of dealing with the pain of loss, those left behind have to deal with funeral and burial arrangements, trying their best to do what they think their loved one would have wanted.

This is because no one wants to talk about it beforehand and is often the cause of family arguments at the funeral. These circumstances are not only upsetting to the grievers, but also to the deceased, who is stuck in a confused state, unable to move forward on the journey of a lifetime.

Once you’ve taken care of the details, your family, in spite of their earlier protests that you will never die, will breathe easier and you can live your life to the fullest knowing everything is in order.

The following is a list of the documents you may need to convey your last wishes.

Personal Fact Sheet
This is not a formal document. It is a worksheet to document personal data and to organize your financial information. Optional sections include a summary of assets and liabilities, a summary of insurance policies, and a free-form paragraph (for additional information). The final document should be stored in a location where the person who may become responsible for your affairs would expect to find such information.

In addition to the organization of your financial matters, this document may be useful to your spouse or other family members if you become incapacitated or upon your death. It contains the type of information needed if another person is required to manage your financial affairs, such as a Conservator appointed by a court, or your Agent as designated under a Power of Attorney. Also, this document contains the type of information that a lawyer or an executor would need for the administration of an estate.

Simple Will
A document under which a Will maker states his or her intentions regarding the persons or entities (“beneficiaries”) who will receive the Will maker’s property, and the person or entity (“Executor”) who will carry out the Will maker’s wishes.

Living Trust/Joint Living Trust
A trust created by a person (known as the “Grantor”) for use during that person’s lifetime. Typically, the Living Trust includes provisions that provide distributions of the trust income to the Grantor during the Grantor’s lifetime. After the death of the Grantor, the Living Trust has provisions that designate beneficiaries who will receive the Grantor’s property, similar to a Simple Will. The Grantor generally manages the trust during the Grantor’s lifetime, as the “Trustee;” after the death of the Grantor, a Successor Trustee carries out the remaining terms of the Living Trust, much in the same manner as an Executor.

Pour Over Will
A specialized will that is used as a supplementary document to the Living Trust. Its primary function is to “pour over” the Will maker’s remaining assets (at the Will maker’s death) in the Will maker’s’ Living Trust. The Pour Over Will should only be used if a Living Trust has been prepared.

Advance Health Care Directive
CAUTION: The states of California, Oregon, Rhode Island and Wisconsin require the use of their respective state specific forms (see Living Will and Health Care Power of Attorney). In addition, the states of Nevada, New Hampshire, Ohio, South Carolina, Tennessee, Texas and Vermont have unique statutory requirements regarding the form of medical directives. The North Dakota statute provides that the form provided in its statute is the “preferred” form. Kentucky, Oklahoma, Oregon and Virginia have adopted specific advance directive forms.

This document combines the best features of the Living Will and Health Care Power of Attorney. When signed by a competent adult (a “Declarant”) in advance of serious illness or accident, it provides directions regarding health care that should (or should not) be provided to the Declarant if the Declarant is unable to communicate his or her wishes.

Declarant may state: whether life-sustaining procedures should be withdrawn or withheld so that you can die naturally if you have a “terminal condition” or are in a “permanent coma;” whether “artificial nutrition/hydration” should be provided to you if you have a “terminal condition” or are in a “permanent coma;” what procedures (e.g., chemotherapy, kidney dialysis, cardiopulmonary resuscitation, use of respirator) you do or do not wish to receive; whether you have made arrangements to make “anatomical gifts; what effect shall be given if you are pregnant; and other provisions that limit or expand the document (e.g., regarding access to medical records, authority to perform an autopsy, the location of your health care [hospital, nursing home]). The Declarant retains the right to make his or her own health care decisions as long as able to do so. The document only becomes effective when you do not have the capacity to give, withdraw or withhold informed consent regarding your health care.

Living Will
CAUTION: The Living Will may not be valid in your state of residence (see Advanced Health Care Directive). An attorney should be consulted if there is any uncertainty regarding which state’s document to use.

A document under which a competent adult, prior to becoming unconscious or incompetent, declares his or her intention that life-sustaining procedures should be withheld or withdrawn under specified circumstances. The Living Will should not be confused with the Simple Will or the Living Trust. The Living Will is related to the Health Care (Durable) Power of Attorney document.

Health Care (Durable) Power of Attorney
CAUTION: The Health Care Power of Attorney may not be valid in your state of residence (see Advanced Health Care Directive). An attorney should be consulted if there is any uncertainty regarding which state’s document to use.

A document which allows an individual (“Principal”) to designate another individual (“Agent”) to make health care decisions for the Principal if the Principal is unconscious, incompetent or otherwise unable to make such decisions. The document may also contain wishes and desires to guide the Agent in making health care decisions for the Principal. “Durable” means the document is only effective during any period of time that the Declarant is not competent.

Power of Attorney
A document under which a person (a “Grantor”) authorizes another person or entity (an “Attorney-in-Fact” or “Agent”) to act on his or her behalf. The Agent will be able to handle the Grantor’s affairs during a period of time when the Grantor is unavailable or unable to do so. A General Power of Attorney authorizes the Agent to act in a variety of situations. In contrast, a Special Power of Attorney authorizes an Agent to act on his or her behalf in specific situations only (i.e., Health Care Power of Attorney).

Organ Donation/Anatomical Gifts
Making a gift of your body can be done by several methods: a bequest of particular organs for transplantation, donation of all organs and tissues. or the donation of the entire body to a medical school. Alternative disposition preferences should also be made if the donation cannot be completed for any reason.

Wallet-size donor cards are available from local agencies, such as hospitals, the local office of the National Kidney Foundation, or a community eye bank. Some states provide organ donation check-off on driver’s licenses. Also inform family members or close friends to assure fulfillment of your desires. To donate the whole body, the school or hospital to which such donation will be made should be contacted (ahead of time). The institution will advise of their particular procedures and can provide the necessary forms.

The dissection of human bodies is an invaluable part of medical school training and scientific research. A donor form may indicate whether the Declarant prefers his/her body be used for anatomy classes or for scientific research. Bodies generally are rejected if they are decomposed, obese, emaciated, amputated, infectious, mutilated, have been recently operated on, autopsied, or are otherwise unfit. With the exception of corneas, organ donations cannot be made if the body is to be donated to science.

The cost of donating a body to medical science may include a minimal fee for transportation of the body. Some schools will pick up the body. Donation of a body to science is the most economical disposition of a body. A special embalming process is required. The body is kept from six months to two years. Upon completion of the medical studies, the remains are generally cremated. Some schools will return the body or cremains, sometimes charging for any costs incurred.

Donations can be made of a variety of organs: liver, heart, kidneys, bones and tissue (including cartilage, marrow, skin, eardrums and corneas). Human tissues include pituitary glands, the dura mater and other brain tissues, middle ears, ear bones, heart valves and other organ subparts.

Two physicians with no interest in the transplant must find the patient “utterly and irretrievable deceased.” After being declared brain dead, the organ donor is placed on a respirator until the organs are removed.

Refusal to Donate
If you decide you do not want to donate any organs, to be sure, fill out a Refusal to Donate form revoking any previous organ donation forms and have it properly signed and witnessed. Inform your family and physicians. Carry it in your wallet.

Funeral Home Arrangements
You may want to make selections and desires known to a funeral director. The information generated by this program can assist you for future reference.

Some funeral homes and memorial parks offer prepaid funeral plans. If you make prearrangements, choose a reliable funeral director (one whose business will still be in existence at the time of your death). Also, you should be sure that your funds are paid into a state-regulated trust fund. This assures that the funds are available when they are needed. Verify how this fund is handled and what happens to your prepayment if the funeral director’s business is sold or the director goes out of business.

If such a plan is chosen, you should be sure to attach proof of such purchase to this document. A description of pre-need arrangements will be necessary to assure that your loved ones know you have already paid for certain items. As you make your plans, find out if adjustments can be made at the time of your death. Some pre-need plans permit you to transfer the arrangements from one funeral home/cemetery to another. You should also ascertain if a pre-purchased lot can be transferred or sold if circumstances change.

When choosing a casket, consider that there are a variety of prices within each type of the various materials of which they are made, it is not just the material that determines the price. Funeral providers are prohibited from misrepresenting protective features of caskets, outer burial containers, vaults and grave liners, which is another reason to pre-plan rather than your family having to make a hurried, uniformed decision. Providers may also not state that the law requires a casket for direct cremation, and are required to offer inexpensive alternate containers.

Many funeral homes will provide pallbearers at an extra charge; certainly family members and friends may be pallbearers. In places like New York City, paid professional pallbearers are required by the pallbearers union, unless you can obtain a waiver.

You may also decide which clothes you want to be buried in, what kind of grave marker and what will be written on it, what your obituary will say, who will be invited to your funeral, and anything else you want to make decisions about beforehand.

Funeral homes provide copies of the death certificate for a charge.

If you have questions about the laws in your state, you may contact the licensing board that regulates the funeral industry in your state. If you have a problem concerning funeral matters, first attempt to resolve it with your funeral director. If you are dissatisfied, contact your local consumer protection agency or the following organizations:

Conference of Funeral Service Examining Boards
520 East Van Trees Street
P.O. Box 497
Washington, IN 47501
(812) 254-7887

ThanaCAP
135 West Wells Street, Suite 600
Milwaukee, WI 53203
(414) 276-9788

Treatment of the Body
This section concerns the selection of a final resting place for the body or remains. Survivors can visit this place to mourn or reflect in a quiet, contemplative setting. Burial plots may be purchased from cemeteries, memorial parks, cooperative groups, as well as governmental agencies. Above ground burial or entombment is also an option. A mausoleum tends to serve not only as a burial place, but also as a monument to the deceased individual or family.

Cremation is the reduction of the body to minerals through intense heat. The ashes and bone fragments that remain after cremation are called “cremains.” These cremains are placed in an urn or other container for burial, storage or scattering. Most states allow cremains to be scattered if the bone fragments in the cremains have been pulverized. Ask a funeral director or crematorium about local rules.

Embalming involves injecting a dead body with chemicals to retard decay. Routine embalming is generally not required by state law. However, death from a communicable/contagious disease or transportation by a common carrier requires embalming in some states. The type of embalming used to delay funeral arrangements for several days does not preserve a body much beyond that time. Funeral providers are required by the Federal Trade Commission Funeral Rule to provide information about embalming so that a consumer can make an informed decision on whether to purchase this service (including that embalming is not required by state or local law for direct cremation, immediate burial, a funeral using a sealed casket, or if refrigeration is available and the funeral is without viewing or visitation and with a closed casket).

Memorial Services
The purpose of this document is to leave instructions regarding your desires for your final arrangements. Memorial ceremonies are for those who survive the death, and this should be taken into consideration when pre-planning. Those who make plans ahead of time relieve their families of having to make crucial decisions under the influence of grief. It is best to talk about these arrangements with your family so they are aware of what you want them to do when the time comes. This is also the time to talk about the kind of music you want and whether flowers or charitable donations are preferred.

Some people would prefer to have their memorial service before they die, which could be called a Living Funeral. Rather than have their friends and loved ones gather round and express their feelings for them after death, they would rather hear what they have to say and be able to say good-bye before they die.

A living funeral or memorial service can be a moving, personal ceremony. So that you may have the kind of remembrance that you want, provide a copy of this document to your family or other appropriate person(s) and discuss your desires with them. If you do not wish to discuss your wishes with your family, at least advise your family or other appropriate person(s) regarding the location of this document.

Realistic planning may be difficult for an event that may not take place for many years, and of necessity plans must be made on a tentative basis. Circumstances may require that changes be made in your plans. If you provide guidance to your family, and yet indicate that you understand that changes may need to be made, they will feel more comfortable in making your arrangements.

If you are in the terminal stages of a disease, your needs are more immediate and you need someone you can talk to about how you want to spend your last days and how you want to die. Don’t let concerned loved ones tell you you’re not going to die or everything will be all right if you want to be in control of your own dying process. Loved ones don’t dismiss the dying person’s need to talk about their death. This is something we all have to do, and we need to talk about it and make it a special time of closure.

You may have a preference for a certain religious service, a military funeral (vets contact the VA for details, benefits, etc.) or a private family service. You may want your ashes kept in a pre-selected urn on the mantel or scattered at sea or sprinkled in your rose garden. You may want to personalize your service to reflect your life in some way. You may want balloons or white doves to be released, or request a Reggae band, or pass a talking stick to share stories about you around a campfire. A memorial service can also be the celebration of a Soul being reborn into pure joy, urged on by the laughter and tears of loved ones.

Notification
A number of alternatives are available to notify individuals and institutions of a death. Many times the immediate notification of the Declarant’s clergy person permits such person to assist the bereaved family and friends.

Family and close friends are telephoned immediately. If desired, this program’s “Exhibit” document can be used to list everyone who should be notified. Or, you may refer to a list or other form that contains such names, such as an address book. Formal printed announcements, usually used by businesses to inform colleagues or clients, are sometimes sent.

Public announcement of a death can be accomplished through publication in local newspapers. A death notice is a paid announcement, an obituary is usually printed without charge. You may want to write your own or write down certain pertinent information to be given to the newspaper.

In addition to family and friends, there will be others who need to be informed of the death. For example, banks, credit card companies, and organizations. The Personal Fact Sheet identifies important information which can be used to ascertain who should be notified.

Additional Information
from Diane Goble

Whether you have been diagnosed with a terminal illness, are losing your physical and/or mental abilities to old age or simply realize you could die at any moment due to an accident or acute illness, my book, Through the Tunnel provides the information about what you can expect to happen as you make your transition and provides guidelines for you to write instructions to yourself (to be read during your last moments and after death) to keep you on track during your journey. These instructions may be read into a tape recorder and played as you enter the dying process or they may be read by a friend, loved one or a Transition Specialist or Guide (it is probably better to have someone who will not be caught up in their emotions as you are dying) who will be at your side as you cross over.

This information and the pre-planning it provides offers the opportunity for you and your family to be fully prepared when the time comes for you to leave this world and move on the next experience of life. It will help reduce the trauma associated with death, though not necessarily the grief over the loss of a loved one, and helps the family accept your death and get on with their lives knowing that you are also getting on with yours and that you will be together again.

©1996 Diane Goble
Links

Bereavement Hospitality Services – PRE-PLAN your bereavement travel needs, ground transportation needs and hotel
Compassion in Dying Federation – improving care and expanding options at the end of life (plans to unify with End of Life Choices)
Corporate Trustees, State Directory
End of Life Choices – working for the freedom to choose a dignified death and for individual control concerning death (plans to unify with Compassion in Dying Federation)
Estate Planning Encyclopedia
Final Passages – dedicated to a compassionate and dignified alternative to current funeral practices
FuneralPlan.com – planning, grief support, funeral home locator, obituaries and more
final arrangements Funeral Planning 101 – a comprehensive online resource for planning a funeral
Heirs, Inc. – Helping beneficiaries with complaints about trusts and estates – was formed in February of 1991 expressly to address the grievances of trust creators and beneficiaries.
Final Arrangements Network – Final arrangements preplanning information, help, advice and tutorials for a funeral, burial or cremation, also cemetery lots for sale and guidance on handling grief with friends
Legacy Sites – celebrate the life of your loved one on a web site
My Final Planner – a workbook designed for the sole purpose of recording your life history in an organized manner to aid you in pre-planning your own funeral and finalizing your affairs
The Last Email – write messages, which will be delivered after your death to the ones you’ve chosen. You will also be allowed to change the messages anytime you need from anywhere you want, adding images, videos, music or anything else you would like to.
Not Dead Yet – people with disabilities oppose legalized assisted suicide and euthanasia
Planning Ahead – article by Diane Goble
Understanding Cremation – MasterTouch Cremation Learning Center looks at cremation in-depth and features an array of resources for your own investigation