As you read this particular blog post, please keep this very important point in mind: 

~I am not giving up, we just need to prepare for every possible outcome.~

Now, before reading on please take a deep breath and try to clear your mind of all other issues or concerns for a moment.  Without meaning to be overly dramatic, note that these particular steps can be very distressing in light of the nature of this subject matter with bringing TiLOs, caregivers and loved ones face-to-face with the realities of the possibility of death and dying within a relatively short period of time of six months or less.  However, once these very important steps are completed, in the absence of making any changes, this phase of the EOL (end-of-life) planning will be in place.

Please note that I cannot emphasize enough just how important these challenging, yet, essential steps are once a terminal prognosis has been received.  All that I share, as with my other blog posts, is based upon my experiences with my five departed TiLOs.

As shared above, please keep in mind, “I am not giving up, we just need to prepare for every possible outcome.”

Once you get the caregiving team in place (see my second post, Take My Hand…), it would be a good idea to get the pre-planning in place for the funeral and burial arrangements, as well as the end-of-life care plan.  The sooner that this process is completed the better so that the TiLO may still be able to clearly communicate his/her wishes with respect to these extremely important issues.

Please note that each individual TiLO is different and their wishes as to their end of life care should be documented using the standard forms used in his/her respective state or country.  I have included links in Part 2 of this blog post (Post Terminal Prognosis: Topic No. 5 (Part 2 of 2) – Pre-Planning for Funeral/Burial and EOL Care) to PDF versions of these three documents which are used in the State of California.

Most importantly, once these forms have been completed with the assistance of the TiLO’s primary care physician (PCP) or authorized personnel under supervision of that PCP, it is imperative that these three forms be readily available and with the TiLO at all times in the event that emergency and/or medical personnel may need to render health care related services. This is where my recommendation in earlier posts about the importance of being organized will come into play, as well as being prepared at all times.

Pre-Planning Funeral and Burial Arrangements

If your TiLO does not wish to participate but has provided feedback as to their wishes, you may wish to take another loved one or friend along to meet with the funeral home representatives.  You may also wish to meet with several in order to determine which firm you and your TiLO will be most comfortable with handling the final arrangements.

While this can be a very difficult task to work on and complete, I would strongly recommend that the final arrangements be put in place so you, the caregiver, won’t have to think about it again until your loved one passes.  At that time, you will appreciate having completed the arrangements with the funeral home in advance as you will only need to make a phone call in order to have the remains transferred to the funeral home once hospice confirms the passing of your loved one, assuming the death occurs at home.

In the event that hospice is not involved with the care of your loved one at the time of death and, again, assuming he/she passes at home, a coroner may have to be contacted prior to removal of the remains.  Your medical care team can provide assistance as to the necessary steps to take under these circumstances.

Please know that it may take two to three meetings to get all of the arrangements in place depending upon a variety of factors such as type of burial (i.e. in ground, above ground, cremation, location, etc.); casket or urn selection; military accommodations, if applicable; graveside and/or church service; grave marker options; viewing; after service gathering; financial considerations; etc.  When you meet with the funeral home, you should be prepared to complete some preliminary forms (general information about your TiLO), as well as start to address some of the above list of items based upon the wishes of your TiLO.

In all of my experiences except one, I was able to make all of the arrangements in advance which enabled me to focus on tending to the details of floral arrangements, coordinating the scheduling with the respective churches, writing the obituaries, collecting memorial pictures, planning for the after service gathering, etc.  Note that, in my father’s case, he wanted me to write his obituary in advance when I was putting all of the major plans in place with the funeral home, as he wanted to review it beforehand.  Unlike with my other TiLOs, this was a very unusual request, however, it actually helped my father come to terms with his impending demise.

Again, each TiLO is different.  The objective is to try to carry out their wishes to best of our ability.

Great big hugs to one and all!!! ❤ ❤ ❤

~D. Toru White~