Preparing for death is something we all should do. The following guest post about preparing for death is by Chris Sipola, a reader I met while we were stuck in Frankfurt after our plane back to San Francisco broke down. We drowned our sorrows over free drinks at an airport hotel courtesy of United. At least we got a ~$800 travel voucher.
The purpose of this post is to help readers prepare for a parent’s death. But really, this post can help someone prepare for any family member's death.
The preparation is very simple – Talk openly and often about all issues related to death in advance of the inevitable so the survivors have a game plan and time to grieve.
Open discussions about illness and death related items (medical decisions, wills, etc) seem unsavory and an invasion of privacy – trust that not having a game plan makes the situation much more unsavory. The survivors will find out more private items than they care to know.
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Background On Preparing For Death
I got a call from my father’s neighbor who had taken my dad (Jim) to the ER the Saturday after Thanksgiving, 2015.
Jim spent a week in ICU, a week in a regular hospital room, a few days in a nursing facility and died on December 13, 2015.
Over the course of those three weeks my brother and I learned several things about preparing for death that we’d like to share so that others can avoid some of the same missteps we made.
Trusts And Wills Are Just The Beginning
All personal finance experts recommend a Revocable Trust, a Will, a Health Care Directive and Durable Power of Attorney (POA) – below are some notes on why these items are just a start and why regular maintenance is required.
Jim created his trust in 2005, when my brother and I read it in 2015 we found the trust included real estate that Jim sold years before and bank accounts that he’d closed since he created the trust.
See: The Benefits Of Setting Up A Revocable Living Trust
Jim had very detailed instructions about how he wanted his assets distributed upon his death, he even sent my brother and me regular updates to be sure we understood his wishes. The problem was that the cumulative (the original will + the regular updates) had distribution conflicts and included distributions to people that had died.
Health Care Directive
Jim’s directive indicated “DNR” (do not resuscitate), which seemed clear and complete. When my brother and I met with the ICU nurse she asked for clarification of the “DNR,” for example: administering oxygen, intravenous hydration/nutrition and blood transfusions since all could be considered “life-saving” and not “resuscitating.”
Durable Power Of Attorney (POA)
Jim’s Durable POA (a document essentially allowing me or my brother to sign docs and make decisions on behalf of Jim) only went into effect when he either became incapacitated or died. When Jim was coherent he made it clear he wanted all of his bank accounts emptied.
The Durable POA was useless (since he was neither incapacitated or dead) so I had to have a public notary come to the hospital to execute another POA – the notary had to be convinced that Jim was not under the influence of meds before executing the POA.
Had my brother and I met with Jim about these documents on a regular basis (annually?) we would have known Jim’s wishes and operated according to a pre-prescribed game plan. Another reason why preparing for death is so important.
Please put together a death file to make it easier for your survivors. The death file will have all the usernames, passwords, and instructions for where to find things.
Medicare is complicated. There are several parts (A, B, C and D), it’s essentially government-sponsored health insurance with all sorts of interpretations, stipulations and limits that are all dependent on how the care is characterized. A few general concepts:
Medicare Parts – Jim had Part A and chose not to pay for Part B – news to me and my brother and had we known Jim’s health care coverage we may have helped him make different choices.
Medicare Website – The site is concise, informative and written in fairly straight-forward language. My brother and I referred to the Medicare site often during my Jim’s care and it helped us make good decisions, for example what care facility to put Jim into after his hospital stay… more on this topic below
Medicare General Overview – Medicare is quite generous with end of life benefits (hospice, pain medication for comfort, etc) and can be quite expensive for on-going diagnosis and treatment.
Long-Term Care Facilities
Hospitals are for sick people and hospital administrators want patients out of their hospital when the patient no longer needs treatment ASAP.
After Jim left ICU and was deemed “stable” the Discharge Nurse started finding a place to send Jim – it came down to two choices: a skilled-nursing facility or my house.
Jim was diagnosed as terminal with six months or less to live – his care was characterized as “end of life” so Medicare would cover hospice services costs. The caveat is that Medicare does not cover “the bed” in a skilled-nursing facility and a “bed” costs $4k-$8k+/month.
Jim had Medicare Part A and was not considered a great candidate for a skilled-nursing facility – couple Jim’s coverage with a shortage of beds at skilled-nursing facilities and suffice it to say the Discharge Nurse was hard-pressed to find a bed for Jim.
The Discharge Nurse found a few facilities that would accept Jim but they were 100’s of miles away; on the Medicare website we found that Medicare rules allowed us to “reject” distant facilities so Jim stayed in the hospital until a closer facility could be found.
Care Facilities Are Expensive
Eventually the Discharge Nurse was able to find a local skilled-nursing facility that would accept Jim – bear in mind that we were not really able to shop for skilled-nursing facilities either on quality or cost considerations, under considerable pressure from the Discharge Nurse (I recall her saying, “This is really your only option”) all we were able to do was a quick internet search on the candidate facility before saying, “ok” and having Jim moved to the facility.
The skilled-nursing facility charged $4,500 per month for a shared room and we were fortunate enough to be able to cover those costs. In the skilled-nursing facility our father had 24 hour care, if we had to move him into my house a nurse would have stopped by for a few hours several times per day and I would have been responsible for the rest of his care.
See: The Cost OF Long-Term Care
Bills, Accounts, Monies and Stuff
In the midst of dealing with care, our own grief and the rest of life, my brother and I had to figure out how to manage our father’s financial life.
Our father was conscious, he just wasn’t mobile or capable of executing checks – Jim was often medicated so his instructions on handling his finances were often unclear.
I found that even with the Power of Attorney it was difficult to get banks or creditors to assist with account information. In several instances I simply impersonated my father (especially on the phone) and was able to take care of what I needed – it wasn’t legal, it was just effective.
I had just left the skilled-nursing facility when a nurse from the facility called to tell me our Jim had passed away. It was about 4PM on Sunday. It hit me like a ton of bricks. The nurse informed me I had four hours to move Jim’s body.
I had no idea what to do and the nurse offered to call a local mortuary on my behalf and have Jim moved, I agreed without question or protest.
Jim had purchased a plot where he wanted to be buried – when I reviewed plot documents and Jim’s burial instructions I figured it was all pretty complete. Wrong.
The mortuary charged $500 to move Jim’s body from the skilled-nursing facility to the mortuary – a hefty fee for a 5-mile trip. The charges to prepare the body for burial, a casket and then transport to the burial site added up to about $3,000. Again, we really weren’t in a position to shop based on quality or cost considerations, so we just went along.
Related: Final Expense / Burial Life Insurance
Even though Jim had bought his plot, the cemetery charged approximately $1,500 for the burial, casket liner and headstone, so again we just went along.
We did not have a service as per our Jim’s instructions. A co-worker told me that he recently planned a service for his father-in-law that cost $20k+ – he likened it to throwing a big wedding with two days advanced notice. Preparing for death earlier would have been helpful.
It’s been a few months since Jim passed and my brother and I are working through estate issues – paying hospital bills, canceling accounts (very important because identity thieves scour obituary columns looking for targets) cleaning up Jim’s house for sale, donating monies and items as per our Jim’s instructions and learning a lot about the life our father led.
Everyday there is a new piece of mail – something from Jim’s trade union, a card from one of Jim’s friends that neither my brother nor I have met or a bill for something that causes a curious pause.
My brother and I worked very well together. I handled day-to-day stuff since I am local. My brother did lots of internet research and made lots of calls since he lives on the East Coast.
As part of forward planning for a parent’s death we recommend that all related parties (sibling, spouses, etc) be part of regular discussions on medical decisions and material possessions so there are no misunderstandings or arguments when the day finally arrives.
While Jim was in the hospital, my brother and I had to make decisions about Jim’s care. After Jim passed away we had to make decisions about what to do with all of his “stuff.” This included his vehicle, housewares, and more.
I have heard horror stories about family members fighting over medical decisions and sentimental items. The one thing my brother and I got right along this journey was we did not argue – not one time – about Jim’s care or what to do with Jim’s stuff.
Preparing For Death Ahead Of Time
Frank dialogue and forward planning is invaluable when a parent becomes ill, incapacitated or dies. There are lots of decisions to be made. The more decisions that can be made in advance the better the survivors will be.
Here’s your checklist for preparing for death ahead of time:
1) Make sure Revocable Trust, Will, Durable Power of Attorney and Health Care Directive are complete, detailed and up to date. A revocable trust is huge because probate court is costly, stressful, and takes a much longer time.
2) Know what health care coverage your parents have. Also know the relevant information (premiums, deductibles, stipulations, etc) about each form of coverage.
3) Look into Long-Term Care coverage. It is expensive for sure and may be worth it depending on you or your parents’ situation.
4) Have a plan on how you’ll operate your parents’ financial life while they’re unable to do so. The more you know about their current situation the better.
5) Make as many decisions as possible regarding final resting (cremation, burial, etc) in advance.
6) Make sure to involve siblings, spouses, etc. in all discussions. This way, all instructions and plans are well understood and agreed in advance.
7) Talk to an estate planning lawyer so you understand all your options. The estate planning lawyer will allow you to better prepare for the financial complications of death.
8) Know your life insurance options so beneficiaries can receive a death benefit. There are some life insurance options that require no medical exams. They include: simplified issue life insurance and final expense life insurance.
9) Understand what accidental death insurance covers and doesn't cover. The more you know about the various benefits, the better.
Now, go have some frank conversations with your parents.
Preparing For Death With Life Insurance
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If there's one thing we've learned during the pandemic, it's that life is not guaranteed. Anything could happen. Preparing for death is a wise move, especially if we have children. Get life insurance, update your umbrella policy, and update your homeowner's insurance policy as well.
37 thoughts on “Preparing For Death: A Checklist For The Inevitable”
My father is terminally ill, that’s why he’s doing his best to fix everything he could especially the real estate before he passes away. I agree with you that trust, medicare, and will be maintained regularly. Speaking of will, maybe it’s best if we’ll just hire an estate planning service so he’ll be guided thoroughly.
It is interesting that experts recommend revocable trusts and wills. My father shared his will with me a couple of days ago and I didn’t consider asking if it was revocable. If I were preparing a will, I’d probably reach out to a lawyer for recommendations and to help make it legal.
Thank you, Chris, for approaching a difficult subject with compassion and concise information. You were fortunate to have a partner (your brother) to navigate this unknown territory with you. Thank you for the solid tips to help the rest of us navigate when the time comes.
I think this article is timely for everyone. You do not have to be old to become sick or die. I think the first thing a person should perform estate planning for themselves. Many middle age people are sandwiched between taking care of their parents and helping their young adult children. If you are are young and working, you should have enough insurance to bury yourself. Your parents should not have to suffer the loss of a child and their debts.
I would first like to preface the following comments by stating that I do not sell and never worked for an insurance company. I am not a believer in long term care insurance (LTI). In order to file a claim you have to satisfy the elimination period and not be able to perform the activities of daily living (ADL). An elimination period can be zero to 180 days A longer elimination period can reduce premium costs. The ADLs are eating, bathing, dressing,walking, continence and toileting. Most LTI requires that you can not perform at least 2 ADLs. Not all LTI will allow a family member to be paid for providing care. I would rather use my Social Security, IRA, 401K, savings, take a cash advance on my life insurance and use a reverse mortgage to provide in home care. If I am still alive,Medicare would my final option in a skilled nursing facility. I realize that many people have few assets and this might not be an option. I am not interested in leaving an estate for my children. My primary goal is not to be a financial burden to my children.
I have had several working friends who became sick and died in their 50’s. They used their job benefits such as vacation,sick days and disability insurance for in home care. My mother died at the age of 82 and father-in-law died at 93. They both were able to perform ADL until 3 weeks before they died. They did not have LTI and would not have qualified for a benefit if the elimination period was more than 21 days.
This is a great article and I have had to deal with this situation twice in the last 15 months.
However, there is some incorrect information as it related to Medicare. Medicare does pay for stays in a skilled nursing facility. There is criteria to be met and the benefits can be somewhat limited depending on the length of stay.
Your costs in Original Medicare
Days 1–20: $0 for each benefit period.
Days 21–100: $161 coinsurance per day of each benefit period.
Days 101 and beyond: all costs.
See the link for the full details here
New helpful article to share http://www.nytimes.com/2016/04/16/your-money/when-dividing-assets-the-little-things-matter.html?_r=0
It’s strange, I’ve tried to talk to my mother about this, but she always blows me off as “I don’t have anything anyway”. If only she knew how much “stuff” there is, between end of life care and arrangements – to say nothing of the distribution of assets upon death.
I’ll keep pressing the issue and maybe have her read this. Maybe then she’ll see what my sister and I will have to deal with. Great post Chris, and deep condolences.
Good topic, a bit uncomfortable but absolutely necessary. As a sole bread earner, more than death, I fear a critical illness or a state which inhibits me from earning.
I had to write a similar post to take the burden out after meeting an ex-colleague who is going through a rough patch.
I am in the process of updating these documents since I’ve had several friends have to deal with parents not having them — and it’s a nightmare. I also talked to my parents and they will be updating their documents.
On a related, practical note, I’m also creating a disaster file with all the details my wife/heirs need to know what I have, where it is, etc.
Sam, if it’s ok with you, here’s the link to what I’m doing (if not, you can just delete this part of the comment in moderation and no one will be the wiser):
This “disaster file” is a very good idea, since a standard will may not include this information. It is similar to the sealed document I deposited with my lawyer as I discussed above. All my accounts, all my passwords, the locations of all my assets, and contact information for all my beneficiaries are included.
But once again, no one should pretend that planning of this sort applies only to one’s parents. Everyone also needs to get a set of estate documents for themselves in order, no matter what your age and mental or physical condition.
This is a great list.
You really don’t think about these things at this level of detail until you find yourself in the midst of it all. And it’s so much easier to deal with before you need to.
Thank you for putting this together.
Let me start with saying, Chris, I am sorry for your loss.
I lost my sister last month. When she was diagnosed with terminal cancer she called me to help her plan her end of life. Now I had no knowledge other than having created some of the documents suggested in this post for myself, so it was eye opening experience to say the least. The only thing I can add to your check list is to make sure you have a POD (Payable on Death) listed for all open accounts. This states who can have access to the specific account upon your death and it was the one item we missed. It also keeps the account out of probate. She didn’t have many assets since we disposed of everything we could before she passed, but she did have a checking and savings, and it was the account missed. So that account is still locked to her only son until we can get copies of the death certificate.
An additional note, in order to not pay for the full funeral, people can option to have their bodies donated to science. Both my sister, and my father 2 years before her, donated their bodies to the University of Cincinnati. The cost to transfer was minimal, and the service was a simple memorial not a funeral. Of course, you have to live in a city where there is an active medical college that participates in such a program. Since these two members of my family did this, 3 more members of the family have signed up in the program. Total funeral cost for my sister was less than 1k just as she wanted it.
I have since initiated conversations with my Mom on her plans. First on her list is to determine what she wants done with her assets (a home), so we are at least on the way.
Thank you for sharing…
I wish we could choose when we die. That will make the list if it is law.
If you do not have a trust look into your employer’s benefits and see if they have a legal plan benefit. My company has one and for $200 I got access to make a free trust from a company that charges over $3,000.
I’m verry sorry for your loss. This list is a good one, unfortunately, some older folks don’t want to discuss or prepare for the inevitable. I have a feeling it is going to be very overwhelming when my in laws pass, as my MIL does not like to discuss this or even take the appropriate paperwork with her to the hospital for my FIL, who has dementia. It is a very sad thing to see.
This is huge. Both my husband and I are the older, smarter siblings of the family, so most likely when parents die, we will have to take care of items. I know for sure it will be me with my parents. My parents refuse to talk about anything related to end of life. Superstitions. I know they don’t have a will, etc. Still working to convince them that it’s needed.
I know my in-laws have stuff set up but again they don’t like talking about end of life items and just say we have a will. What’s in the estate plan who knows. I think it’s important for my husband to find out because my in-laws are in their mid 60s, so they are no spring chickens. But, it’s not a fight he finds imperative since he still thinks his parents will live forever.
Thank you for sharing your story and experience. I am very sorry for your loss. All readers can now benefit from your insight and advice. The checklist will be something we will all need to deal with, as difficult as that reality might be. I think your intro says it all, frank conversations need to happen early and often. Thank you for sharing.
I could question some of the specifics here and there (most importantly, a good case can be made for not necessarily needing a revocable trust), but mainly this is good advice IMO.
But it’s advice that should be followed not only for one’s parents but for one’s self. I’m 67 and I have to face the inevitable, but people far younger than myself have died too. In my opinion everyone should at least have a will, a financial power of attorney, a living will, and a health care proxy. I have all of these but on the advice of my estate lawyer I have not created a trust, as he considers it superfluous in my situation. I also have a sealed document deposited with my lawyer listing all my financial accounts and an extensive personal inventory of my possessions; this is to help my POA if needed and my executor to distribute my assets when the time comes.
I suppose going through some inexpensive on-line service is better than nothing, but I really think an estate plan is something that needs expert assistance. So spend the few hundred $$ you’ll need to have your documents drawn up by a qualified attorney, and have them reviewed and updated every few years or as circumstances warrant. It amazes me that people will plunk down $25K for a car but will balk at getting a proper estate plan which can be drawn up for under $1000. And this is not something that any one can afford to be sentimental or fearful about; it’s something everyone will have to face and the consequences for not having a proper estate plan are far worse than the discomfort you’ll feel on preparing one.
Also be careful how your siblings get involved and “manage”. My mom and dad were in skilled care center due to dads struggle with dementia. This is up in the rural NE in a rustbelt town that lost all 100 of its factories, and is 4000 miles from California. I have always kept as close touch as I could with my parents and sisters up there by phone and mail. Mom passed away last year, and oddly, the sisters pounced on the opportunity to control the funeral. They did some pretty weird things like legally barring my parents’ long time church members from attending the funeral or the care home (like huh? seems they didn’t agree w my parents values?), and they had my mom buried the very next day before any of the other 3 sibling could travel to get there (“by the way, did you know mom died?”). It was quite surprising to all the rest of us! Pretty sure dad wouldn’t have put up with that stuff if he was able, but there was nothing he could do – they had power of .
Thanks for this Sam! I appreciate that you are willing to bring up these uncomfortable but important topics! I am helping my mom with this process right now as she works through the sudden death while on (vacation!) of my father…. We know none of his passwords-banking, cable etc
I think this is a very good article as there’s a ton of things that people need to be aware of before and after their relative has died. There are a few things that are different between USA and Australia, but most of those things need to be considered well in advance.
Thanks for posting this,
Death and taxes!?! wow. My brother used to sell cemetery plots and that was always something he recommended doing before they were needed. The other thing about them is that cemetery plots are owned by you for years and can be re-sold if you move or anything like that. Its always good to get ahead on expenses like this. Thanks for the post – I do need to talk to my aging parents and my siblings about all this. Cheers!
Thanks for the reminder.
My grandfather passed away 2 years ago resulting in a month long stay with my grandmother while her children went through this process with her. It was traumatic but educational to have a ringside seat to the entire thing. It prompted some frank discussions with my mother afterwards.
It’s probably time to revisit it all again.
Tough topic. I’m always surprised on how differently people react to this kind of conversation. Sometime the culture, the traditions and the religion make an explosive mix and people just refuse to talk about the topic. Call it “irrational”, call it “stupid”. I call it “human”.
I went through this same thing in the fall of 2014 the estate just finally closed out. Being an executor is tough and even with a huge amount of planning and order, the executor still gets left with hard decisions and unfamiliarities. Nursing home to funeral seemed pretty straight forward (and expensive). But what about filing the will with the local court house? Do you need you need to place notifications in the local journals? How do the taxes work if income is received after death but to their SSN#, it goes on and on. Additionally, since it varies from state to state the information is dynamic. The first time through it is pretty bad. The second time should be cake.
I’m 22 and don’t even want to think about all of this. Though, if anything did happen, I wouldn’t want my family to be stuck with a bunch of bills for funeral service, etc.
Thank you for sharing this story.
My parents are starting to think about this with my Grandma (who recently moved into their house) and I forwarded it over to them.
I am worried that all of the responsibility for my wife’s parents is going to be put on us (over her step siblings) and further that she will rely on me (being the one who handles finances)….. How do you ask your in father in law if he is prepped for death……
When discussing things with my MIL I used her experience with her mother’s funeral and my parent’s recent passing to open or extend the conversation to her plans. For example, “I’m thinking of updating my will, do you have one?” “I’m just giving my kids equal shares, they can figure out how they want to divide it.” “How did that work out for you and siblings when your mother passed?” “Not so great now that you mentioned it, there was a lot of fighting for certain heirlooms and we disagreed on the costs of a number of things. My brother had to lay everything out and we drew straws on picking order. I don’t think anyone was happy with that.” “What do you wish they could have done different?” etc.
It won’t solve everything, but can help them at least think about it and at least my MIL would discuss it with me. My mother, for example, wouldn’t discuss the issue at all with me, she wouldn’t tell me her doctors, wouldn’t discuss power of attorney or living will, wouldn’t tell me what bank accounts she held, etc. and ignored any advice I provided in at least listing those things along with her wishes and putting them into a safety deposit box for when she did pass. Oh well, it was her right and it wasn’t like it was worth a massive argument to me to try and force it out of her. So instead I told her years before she passed that if she wanted anything specific to go to my kids, me, or my siblings, she had better give it to them while she was alive and not wait until she was dead because there was no guarantee they’d get it otherwise. Sure enough after she passed one sibling was hunting around the home for some of the heirlooms and wanting their share only to be disappointed in learning she’d given them to my kids over a year before she passed away.
Great post and a good list. I would add managing one’s “digital legacy” to this list. Gmail, Facebook, password managers, and many other websites offer ways to manage when and who will receive access to your passwords/accounts upon one’s death or prolonged inactivity.
hahahaha, I might just let my “digital legacy” die off with me. Don’t know that I’d want all that out in the open…kidding.
Great article, and definitely a lot to consider. Good reminder of the things you need to do to cover your bases.
This is one area where I can’t deal with things. My dad is terrible at communication and he doesn’t want to talk about any of this stuff. I’ll see him later this year and I’ll try to talk about this. He lives in Thailand so I have no idea what all the rules are.
Getting old sucks.
What a heart-wrenching story. I felt ill just reading through the difficulty you and your brother endured, Chris. Sam, thanks for encouraging such an important guest post.
I would like to echo the recommendation regarding long-term care insurance. I think it is vital for anyone over 65 to have such a policy in place. We all would prefer to think that our parents’ golden years are going to be rainbows and butterflies, but that is naïve.
Additionally, for those who have young-ish parents: It is not too late for them to have term-life insurance in place. Even if they purchase a policy that is only sufficient enough to cover the costs of a funeral, burial, and any outstanding debts, that is perhaps the best way they can say “I love you.”
My final thought: Even if you are young, you should go through the checklist for yourself and ensure that your house is in order in the event of your untimely passing. Don’t leave your loved ones to deal with grief AND your lack of planning!
Since I’m single, no kids and don’t own real estate I don’t have a will but have beneficiaries listed on all my saving and investment accounts and I have a health care directive. I should get a durable power of attorney as also.
Very helpful post! Thanks for sharing. My older sister and I just had a brief conversation about our parents on this topic less than a week ago. My wife and I need to take the time to sort these issues out with both of our parents and we will be referencing this post.
This is a good checklist so people who are left behind or who will be left behind know exactly what they are going to do or aware what they are going to face.
Death is never an easy thing to go through especially when you are bombarded with scenarios that need immediate decisions without fully understanding what you are getting into. It’s tough and that’s why it is really important to have a checklist like the one stated above. This way the family or the person left behind know exactly what to do, when to do, and how to do it.
Death is a painful thing to go through, that is, for the ones left behind. It is always good to prepare even when you don’t know when your time will be up.
This is a good checklist for all these decisions I put into the bucket of “End of Life,” it’s sometimes scary to think about but that’s a good thing because it makes you take it seriously. Just don’t avoid thinking about it because it makes you uncomfortable.
Thanks Chris for sharing important details about such a difficult period. Your comments are concise, actionable, and remind us the difficult conversation is necessary to avoid disasters down the road.
My family went through three sudden deaths in the course of 3 years. The first involved a funeral much like the 20k one described above. The widow was making decisions about funeral preparations and no expense was spared. Less than a year later, the lessons had been learned and the 2nd funeral was not the same type of bank robbery.
Everyone close began to prepare for their worst case scenarios. When a 3rd funeral came up, it was a sight to see how everything simply went into motion without the added level of financial stress involved.