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Frequently Asked Questions

View our Frequently Asked Questions (FAQs) to help discover answers to End of Life Management questions you may have. We add new topics frequently, so please check this page often.

What is End of Life Management?

Simply put, End of Life Management is the planning, discussions and decisions you need to make to put your affairs in order and ensure your final wishes are honored. End of Life is an important passage and there are many important issues to consider that include health care needs, final wishes, asset distribution when you pass away and other related decisions. Facing End of Life and talking about End of Life Management with your family and loved ones can be as empowering as it is inevitable.

What are the Topics to Consider in End of Life Planning?

End of Life planning may seem challenging. It’s often easiest to start by thinking about your preferences. Consider these End of Life questions:

  • Whom do you want to make decisions about your healthcare and finances if you are unable to do so?
  • What medical treatments and care are acceptable to you? Are there any you are certain that you do or do not want?
  • Do you want to be hospitalized, stay at home or go somewhere else, if you are seriously or terminally ill?
  • How will you pay for End of Life care and funeral arrangements? Do you have adequate medical, life, or funeral insurance?
  • To whom might you want to leave personal assets and heirlooms after you pass away?
What is a Celebration of Life?

Today, more people are planning End of Life celebrations instead of traditional funerals. A Celebration of Life commemorates the deceased person’s life and accomplishments and is intended as a unique tribute. A celebration is a carefully planned event to help mourners reflect on the life their friend or loved one lived.

What is the Difference Between a Funeral and a Memorial?

A funeral offers family and friends the opportunity to say goodbye to their deceased loved one. A funeral typically takes place a few days following the death, before the deceased is buried or cremated.

A memorial may occur several weeks after the death, giving family and friends more time to plan and gather. Memorials may also take place in a different and separate location where the physical body is cremated or interred. Memorials typically occur once the deceased’s body is cremated or buried.

Both funerals and memorials are celebrations of life.

What is a Viewing?

A viewing or “visitation” is an established event during a specific timeframe when family and friends can gather to see the deceased loved one and pay tribute. A viewing may take place at a funeral home, in a family home, or at a church, chapel, synagogue or other venue, or another location prior to a funeral service.

What is a Wake?

Similar to a viewing or visitation, a wake is a gathering of family and friends before the burial or cremation of their loved one. Wakes generally occur over a longer timeframe than visitations. Usually, the body is present at a wake. Often, family and friends attending a wake bring food and drinks to share.

What is the History of Wakes?

Historically, wakes were held as all-night prayer vigils where family stood watch over the body of their loved one, offering prayers, telling stories, and saying their goodbyes. Viewings and visitations serve a similar purpose, but are now typically held at a funeral home or other venue for a set period of time.

What are the Options to Traditional Funerals?

There are less-conventional ways of honoring a loved one’s life that can be a cost-effective way to honor the deceased loved one. Some options include less formal gatherings without the deceased, present at any location, including parks or outdoor venues, or, hosting a memorial service or reception, or a home funeral.

What is a Home Funeral?

Home funerals and memorials can be held at a family member’s home. Some states require the supervision or involvement of a funeral director, but most do not require that a funeral home be involved. The family must submit the required documentation to the county, obtain the legal permits for disposition, provide a suitable casket or alternative container, and make arrangements directly with the crematory or cemetery. A funeral director may be hired to assist in these matters, even as the family cares for the body of their loved one at home.

Who Should Speak at a Funeral or Memorial?

A clergy member, spiritual advisor, family member or a celebrant can lead a funeral. Often, immediate family and close friends may also choose to speak. A funeral director can help you determine how best to organize the service, including deciding on a program and speakers.

What Types of Flower are Appropriate for Funerals?

Flower arrangements today often reflect the personal taste of the deceased or their family. Traditionally, funeral flowers consist of wreaths, freestanding sprays or casket sprays. Flowers in a vase or basket are also appropriate. Living plants are also good ways to commemorate the deceased and allow family members or friends to bring home or to donate the plant to charity as a living representation of the loved one.

Are Certain Flowers Popular in Funeral Arrangements?

The most common flowers used in funeral floral arrangements are lilies, roses, chrysanthemums, carnations, and gladioli, although any flowers may be appropriate based on the tastes of the deceased and the family.

White flowers symbolize innocence, purity, and reverence. Pink flowers signify remembrance, love, grace, and gentleness. Blue flowers evoke peace, serenity, and calm. Purple flowers represent royalty and dignity. Red flowers reflect courage, love, and strength.

What role does music play at a ceremony or service?

Music is a very important part of the funeral or memorial service. In addition to flowers, the venue, and the service, music helps to set the tone of the event and pay tribute to the deceased. Music also helps mourners to express and process their emotions.

What are Some Music Considerations?
  • Choose musical selections that reflect the life of the deceased.
  • Compile a playlist of music that was meaningful to the deceased.
  • Ask immediate family members and trusted friends for suggestions.
  • Contact musicians who are friends or family members to sing or play a special song.
  • Hire a musician or DJ that is familiar with funeral or memorial service-appropriate music.
  • Ask a funeral director for referrals of a trusted, reputable DJ or musical artist.
What are Appropriate Food and Beverages for a Funeral or Memorial?

Sometimes churches donate food to events for families of the deceased, so check with your loved one’s church or faith community if applicable. Other options include catering services from a favorite restaurant or pub. It is also common to ask family and friends to bring food and drinks to share. Your decision should be based on what is appropriate for your family and friends.

Who Pays for Funeral or Memorial Arrangements?

The person arranging the funeral or memorial service is usually responsible for payment. This is often a family member. It is important to note that payment for a funeral or memorial is typically due at the time of, or before services are provided.

The deceased may also have made provisions for funeral costs, relieving some or all of the financial burden on their family members. Often a deceased’s Living Will, Estate Plan, or Burial Trust may give specific instructions for funeral expenses, as well as general instructions on End of Life wishes.

What Financial Options Exist for Final Arrangements?

There are many options to finance a funeral or End of Life celebration, including establishing a payable-upon-death (POD) bank account, establishing a Burial Trust, or obtaining a life insurance policy. Other options include purchasing a pre-paid plan from a funeral home. Pre-paid funeral insurance or annuity plans can be paid off over a period of time to help offset funeral costs. Insurance plans may cover merchandise and services from the funeral home, as well as related charges like catering, flowers, music, and even travel expenses.

What if I Can’t Afford to Pay for a Funeral?

A personal heart-felt funeral or memorial does not need to cost more than you or your family can afford. The most important element is the event that brings family and friends together to honor a loved one. The event or ceremony is intended to create a meaningful experience for all who attend and in honor of the deceased, and does not need to be expensive.

When are Funeral Payments Due?

Funeral homes are not required to provide payment plans to families or friends of loved ones. Many funeral homes require payment prior to providing services.

What is the Difference Between a Casket and a Coffin?

A casket contains the body and is used for burial purposes. A casket typically has four sides and may be constructed of wood, steel, stainless steel, copper, or bronze.

Coffins serve a similar function to a casket, but have six sides. The shape of a coffin resembles the shape of a body. Coffins, like caskets, may be simple or elaborate.

Both caskets and coffins may be personalized through engravings, embroidery or screened images on inside panels, or include pockets to hold memorabilia, pictures or notes.

What is a Vault?

Vaults are sometimes required by a cemetery to encase and protect the casket and to help support the weight of the soil. Vaults may be plain concrete or lined concrete for added protection of the casket, and may be covered with stainless steel, copper or bronze sheeting for an enhanced appearance.

What is Embalming?

Embalming is a process that is used to temporarily inhibit the decomposition process. Generally if a public viewing will be held, it is both recommended and common practice to embalm the body. Alternatively, refrigeration can preserve the body temporarily. Embalming is not required by law in any state, except under very specific circumstances.

What are the Regulations for Scattering Ashes?

Regulations concerning the scattering of ashes vary by state and location. If you plan to scatter the ashes of your loved one, it is best to consult the town, city or county ordinance. If you are planning to scatter your loved one’s ashes on public land, it is recommended to obtain permission beforehand.


What is an End of Life financial plan?

End-of Life financial planning is a process that includes reviewing your financial situation, evaluating choices and making decisions that will comprise your plan for how you will fund your End of Life expenses. There is no one End of Life financial plan that fits everyone’s needs. Each person’s plan varies according to age, health, financial situation and your wishes for your final care and services, and how you want your assets distributed after you pass away.

How do I start my End of Life financial plan?

Begin by gathering and organizing important financial documents to get a clear picture of your financial situation and to determine your assets (what you own) and your liabilities (what you owe). Review your income and debt statements, insurance and investment documents, government insurance information and tax return statements. Next, identify other potential sources of value like the contents of safe deposit boxes, personal safes and storage units. Then talk with loved ones and professional advisors to help you develop your End of Life financial plan.

What are the main elements of an End-of Life financial plan?

Important End of Life financial decisions and tasks include appointing a person you trust to manage your medical and financial matters if you become unable; completing legal documents to provide for loved ones and protect your assets; and preplanning and/or prepaying your funeral or final services. Research and estimate costs associated with final care and services. Review your health, long-term care and life insurance plans, personal financial resources and government programs to assess benefits to which you may be able entitled. Make a budget to determine if you can pay for End of Life expenses.

What are some examples of End of Life legal documents?

An Advance Healthcare Directive or living will provides your directions for what kind of treatment you want if you become unable to make your own decisions; a Durable and Power of Attorney (DPOA) which gives a person you appoint legal authority to make financial decisions for you if you become unable; and a will which includes your final wishes for your final services and for distributing your financial and digital assets after you pass away.

What are the main financial sources to pay for End-of Life?

The three primary resources to manage End of Life costs include personal funds, insurance policies and government programs like Medicare and Medicaid or Social Security.

What’s the difference between long-term care insurance, Medicare and Medicaid?

Long-term care insurance is private insurance that you or an employer may purchase. Medicare and Medicaid are government healthcare insurance programs. Medicare is federal health insurance for people age 65 and older and for some people with disabilities. Medicaid is a federal and state health insurance program for people with limited income and resources. For more information visit www.medicare.gov and www.medicaid.gov.

What are some ways to pay for funeral costs?

You may choose to prepay your funeral with funeral insurance to freeze today’s prices and protect your family from tomorrow’s rising funeral costs. Payment plans are available. Life insurance benefits are also commonly used to cover funeral costs.

What financial resources are available to US Military Servicemembers and Veterans?

The US Department of Veterans Affairs provides Servicemembers and Veterans and their families with many End of Life benefits and services, including End of Life care, pension, and life insurance and burial benefits. Call 800-222-8387 or visit: www.va.gov for more information.


What is Intestate Succession?

If you die without a will, then you are said to have died “intestate”.  In general, intestate succession is a default order that instructs who gets your assets. It invokes the same process and procedure for every person. The rules vary by state, so check with an attorney or legal advisor for more information.

What is Probate?

Probate is the court-supervised process by which your assets and debts are inventoried and paid, and any remaining assets are distributed.  Probate is technically defined as the court procedure by which a will is proved to be valid or invalid. The term “probate” generally refers to the legal process wherein the estate of the deceased is administered. Most people want to avoid probate because it is expensive, time-consuming and public.

How is Probate Initiated?

Probate is initiated by someone who files a probate petition, along with a copy of a will drafted by the decedent.  Often, an attorney representing the person named in the will or a named executor will file probate. A decedent’s spouse or child can file probate as well.

What is the Probate Process?

Once the probate petition is filed, copies of the petition are mailed to everyone named in the will, as well as all the intestate heirs.  A copy of the petition must be published in a local newspaper.  Typically within four to six weeks after the petition is filed with the court, the court holds its initial hearing to determine who shall be named the Executor or Administrator (an Administrator works just like an Executor and is the term used if there is no will) of the estate.  Once this person is chosen, anyone who believes the decedent owes them money may file a creditor claim.

Why is Probate Generally Undesirable?

The main reasons to avoid probate are that it is expensive, time-consuming and becomes public record.  Its main benefit is court-supervision, which for most people is not a benefit.

What is the Role of the Executor or Administrator?

An Executor or Administrator is responsible for managing the decedent’s assets and evaluating all creditor claims.  Valid claims are paid and there may or may not be litigation over disputed claims.  Once all claims are resolved, assets have been properly appraised and evaluated, and any challenges to the will itself have been resolved, the Executor or Administrator then proposes a distribution plan to the court.  Once the court approves it, the estate is distributed and probate is closed.

How Expensive is Probate?

Probate can be expensive. Probate costs typically consist of court fees, attorney fees and Executor fees.  The costs vary by case and may depend on the complexity of the assets. Additional charges and fees may include filing fees, publication fees, probate referee fees, bond fees, appraisal fees, moving fees, storage fees, among others.

How Long Does Probate Take to Complete?

Each estate is different depending on the size, complexity, and other factors. Creditors have a set period to file creditor claims once the probate petition is filed.  Estates can take months to years to be resolved. Consult a legal advisor or attorney for more information.

What Happens to Assets During Probate?

During the probate process, no one has access to any of the assets until an Executor is named.  When a will is contested, the naming of an Executor is often the issue for the will being contested. Once an Executor is named, the Executor may only use the assets for the purposes of completing the probate process. Probate assets do not become the property of the beneficiaries until the probate process is complete and a judge approves the final distribution.

Do Probate Documents Become Public Record?

All documents that are filed with a probate court are assessable to the public for access and viewing of these documents. Documents made public include a copy of the will, along with an inventory and appraisal of all probate estates assets, and all other relevant documents filed during probate. Documents filed with the court are mailed to all beneficiaries, family members and ascertainable creditors.

Should I Agree to Serve as an Executor or Trustee?

This is a personal decision. An Executor or Trustee is generally compensated for their time and effort, although you may be held personally liable for mistakes. If you agree to serve in this role, we recommend you engage an attorney. Agreeing to become an Executor or Trustee is a significant and serious decision.

What Factors May Impact the Role Executor or Trustee?

As Executor or Trustee, the size and time commitment of your role may depend on several factors:

  • How much property is involved.
  • How long the process is likely to take.
  • Whether there may be parties who question your decision.
  • Whether there are special considerations such as the care of minor children or incapacitated parties.
What are Some of the Responsibilities of Executor or Trustee?

As an Executor or Trustee you have fiduciary responsibilities to the beneficiaries. You may be required to:

  • File a will with the court to start the probate process.
  • Locate and take control of assets.
  • Run a business or hire a business manger.
  • Assume responsibility for the care of children or incapacitated parties.
  • Pay debts and collect proceeds of insurance policies.
  • Sell assets not used and reinvest the assets wisely.
  • File tax returns and prepare accountings for the probate process.
  • Distribute the assets to the beneficiaries.

If you agree to serve as an Executor or Trustee you may want to consider hiring an attorney. The estate will cover the legal fees and having an attorney can help you manage any fiduciary duties assigned by the court.

What is an Estate Plan?

An estate plan is a statement of what you want to happen to your assets and your remains once you pass away.  An estate plan generally includes a will in addition to other relevant documents that help maximize your control of the distribution of your assets, while minimizing taxes and stress on your family and loved ones.

What are the Goals of Estate Planning?

Some of the main goals of estate planning include avoiding probate, providing for minor children, and efficient tax planning. Depending on your goals and the nature and quantity of assets, the resulting necessary documents may vary.  Some estate plans are relatively simple while others are extremely complex.

What Documents are Included in an Estate Plan?

Each estate plan is different, depending on the goals, priorities and wishes, along with the nature and quantity of assets.  Estate plans most often consist of a trust, will and often power of attorneys or living wills.  An estate plan may help to coordinate retirement funds, IRA’s, beneficiary designations on bank accounts and life insurance policies.

Effective estate planning takes the laws of wills, taxes, insurance, property and trusts into account to gain the maximum benefit by law, while carrying out your wishes for the disposition of your property upon death.

Who Needs an Estate Plan?

Generally, most people benefit from proper estate planning simply because everyone will eventually pass away. Often, people begin the estate planning process when they are older and/or they have acquired multiple assets, however everyone should consider their options.  When someone does not have an estate plan, the government decides who receives your assets on death and will take a significant tax percentage.

Why Don’t More People Have Estate Plans?

One of the most common reasons people give for not having an estate plan is thinking they do not have enough money or assets to justify an estate plan. This commonly held belief is not true, as it is often people with moderate assets who would most benefit from having a properly planned estate.

What Happens If You Do Not Have an Estate Plan?

If you do not have an estate plan, your family heirs may need to probate some or all of your estate. Probate is the legal process in which the state gathers your assets, pays any creditors, and distributes any remaining assets based on the laws of your state.  Probate often is an expensive, complicated and time-consuming process.  If you do not have an estate plan, then you die intestate, and your assets are distributed under the rules of Intestate Succession.  This is a default distribution by which the recipients of your probate estate are chosen.

Do Any Assets Avoid Probate?

Certain types of assets avoid probate, called “will substitutes.” Most retirement plans and insurance policies are considered will substitutes. You can designate a beneficiary as part of the plan or policy and pass the assets directly to that beneficiary.  Typically, a beneficiary submits a claim form along with a death certificate copy to receive payment.

Another example of a will substitute is any real property that is held in joint tenancy or as community property with right of survivorship.  If real property is owned this way, the surviving owner files an affidavit of death with the county recorder and a new deed is issued in their name.

What is a POD or TOD Beneficiary?

For any financial account, including a checking account or an investment portfolio, you can designate a pay-on-death (POD) or transfer-on-death (TOD) beneficiary.  Designating a beneficiary is easy to do yourself and costs nothing through your financial institution or investment broker or firm. Unlike a joint account in which both parties have access to the account during their lifetime, a POD or TOD does not give anyone access while you are alive, yet enables a direct transfer of account funds upon your death.

What is a Will?

A will is an instrument by which a person makes a disposition of their real and personal property, to take effect after their death, and which by its own nature is ambulatory and revocable.

What is a Living Will?

A living will is a set of pre-written instructions regarding life-sustaining measures you would want to receive or not receive and under what conditions.

What is a Trust?

A trust is a fiduciary relationship with respect to certain property wherein the trustee holds legal title subject to enforceable equitable rights of the beneficiary.  A trust can hold property, enter into agreements, sue and be sued, pretty much anything an actual person can do.

What is a Living Trust?

A living trust is a document that is most often used to avoid probate. A living trust transfers assets into a trust (a separate legal entity) where a Trustee who controls the trust is named (usually you). Once you pass away, a Successor Trustee has the instructions about whom to transfer the trust assets.

How Does a Living Trust Work?

A trust essentially separates legal ownership from beneficial ownership.  The trust property is owned by the trust and controlled by the Trustee. This division of ownership has many beneficial applications in estate planning.

The standard revocable living trust allows for the transfer of your assets into a trust. When you pass away, your assets are owned by the trust and not you, and therefore do not have to go through probate.

What Type of Trust is Right For You?

There are many types of trusts, depending on your goals. The most common goals of trusts include:

  • Avoid probate.
  • Provide for minor children.
  • Protect assets from creditors.
  • Provide a plan in the case of incapacity.
  • Reduce taxes when possible.
  • Allow for flexibility.
What is Power of Attorney?

A Power or Attorney is a document by which you give another person the ability to make medical decisions for you when you are unable.

What are Durable Power Documents?

Durable power documents, such as a Durable Health Care Power of Attorney allow you to designate a party to communicate your express wishes.  Durable power documents are often included in estate plans.  When a document is titled “durable,” this means that is remains effective even after you lose your mental or physical capacity.

What Assets are Managed in an Estate Plan?

To create an effective estate plan, all your assets and debts must be considered. Different assets work differently, and some will be governed by a trust, some by a will, and some by will substitutes. Determining what assets should be managed by your estate plan is entirely up to you, but ideally all your assets should be considered.

Who Should You Choose as Executor or Trustee?

This is an important and personal decision.  You may want to nominate a family member or select a professional third-party.  It is important to select someone whom you trust, as there are many personal criteria to consider. An attorney can help you with an evaluation and decision.

What if You Want to Make Changes to Your Estate Plan?

Most estate planning documents are revocable and can be easily changed. Even with careful planning, laws may and circumstances in life may change. It is wise to review your plan whenever there is a significant change in your life.

Where Should You Store Estate Plan Documents?

You want to keep the original documents in any safe place. Many people keep a copy with an attorney or home with their other important papers.  It is also advisable to provide copies to your Executor or Trustees. It is important to tell your loved ones, family and attorney where the original document is stored.

Who Should You Notify about Your Estate Plan?

It is important that your Executor or Trustee(s) along with a trusted friend or family member know where to obtain both the original and copies of your estate plan documents. Informing others about your estate plan may be uncomfortable, however it is helpful to everyone concerned if events dictate.

What kinds of funeral options are available?

You may plan many of the details for your ceremony or service, including:

  • Ceremony or service type - traditional funeral, graveside, or committal service, direct burial or cremation, memorial or home funeral services, or non-traditional services like green funeral options.
  • Personalization options - casket, flowers, music, scripture or poetry reading selections, religious symbols, technology options like videos or slideshows, and catering for gatherings or memorials.
  • Final resting place options - burial or cremation, or non-traditional options like transforming your remains into art or jewelry.
  • Physical or virtual memorial options - plaques, headstones, memorial funds, or website tributes.
  • Pre-payment options - funeral trusts or funeral insurance plans.
What does pre-planning a funeral mean?

Pre-planning means planning a funeral before death occurs. Without a funeral plan, the details of your funeral are left to family members who may have no notice or time to plan this important end of life event. Pre-planning provides you and your family with peace of mind that options are considered, decisions made and wishes honored.

How much do funerals cost?

According to the National Funeral Directors Association (NFDA), the average funeral today may exceed $7,000. Funeral costs vary depending on the region and state where you live, and the type of services, events and products you choose.

What are my payment options?

You may choose to pre-fund your funeral with funeral insurance or a funeral trust to freeze today’s prices and protect your family from tomorrow’s rising funeral costs. Payment plans are available. You may also choose to pre-fund your funeral with private resources, like a payable on death account reserved for funeral costs that is not subject to probate. Life insurance benefits are also commonly used to cover funeral costs. It is important to note that unless specified by a pre-paid funeral contract, funeral costs will not be locked in and will rise with inflation over time.

If I choose to pre-plan and/or pre-pay, what happens if I move?

Your pre-planning preferences may be transferred at any time. If you are traveling outside your area when death occurs, your loved ones should contact the funeral service provider you chose immediately; they may help with necessary transfer arrangements. If you choose to transfer your pre-paid funeral contract to another funeral home, you should contact the insurance company or trust manager that issued your policy, annuity, or trust account. If your original funeral provider guaranteed the cost of the funeral, your new funeral provider is not bound by the guarantee, yet may choose to honor it. If the policy is current and has not lapsed, any amount that has been paid into the account by the policyholder or purchaser will be transferred to the new funeral home. Policy growth will be transferred according to the laws of the originating state.

How do I start planning my funeral?

Contact a local funeral service provider to discuss your options by clicking on www.Passare.com and then click on Providers. A funeral planning professional can assist you by helping you understand all your options. You may also choose to write your final wishes into your will, state your preferences in a video or voice recording, or use a funeral planning guide to plan yourself. You may also read this eBook, “How to Plan Your Funeral,” and then go to www.passare.com for more help and information.

What if I change my mind about my funeral plan?

You may adapt plans to meet your changing needs or wishes any time. If you use a funeral service provider, remember that funeral homes are based on service to families. They should respect your wishes at all times and strive to meet any special needs and requests from you and your family, whether planning ahead or at the time of need. You may adapt plans to meet your changing needs or desires. If you need to cancel a pre-funded plan, note that refunding pre-paid plans depends on the laws in your state and the type of pre-paid policy or contract you own. Ask your local funeral director or prearrangement specialist to explain how refunds are handled for your particular preneed contract.

What if I have more questions on other end of life issues?

If you have more questions, go to: www.passare.com for a comprehensive collection of end of life planning and information.


What type of long-term care is most often needed?

The most common type of long-term care needed is personal care if you are elderly or become ill or injured. Personal care includes help with everyday activities, including dressing, bathing and eating.

What factors may determine when to initiate long-term care?

If you or a family member can no longer care for yourself on your own or live safely in your own home without support, then long-term care may be an option.

With whom should I discuss long-term planning decisions?

As you consider your preferences for End of Life healthcare, talk with trusted friends and loved ones who may be affected by your choices. You may want to discuss options with your healthcare provider and/or consult with a legal professional. Identify a decision maker or “healthcare proxy” if you become unable to speak for yourself. You may also consider talking with neighbors or relatives who may help you care for your children, pets or home if your healthcare needs warrant long-term care.

What's the difference between long-term care insurance, Medicare and Medicaid?

Long-term care insurance is private insurance that you or an employer may purchase. Medicare and Medicaid are government healthcare insurance programs. Medicare is federal health insurance for people age 65 and older and for some people with disabilities. Medicaid is a federal and state health insurance program for people with limited income and resources. For more information visit www.medicare.gov, www.socialsecurity.gov and www.medicaid.gov

How can I help an elderly adult be more receptive to long-term care?

Encouraging elders to consider long-term care may be challenging. They may be frightened or confused about how it may change their current routine or independence. They may be concerned about cost. Memory loss may make it difficult for them to understand why they need help. Choose a time to discuss long-term care when they are relaxed. Ask about their preferences for healthcare or comfort care. Explain how long-term care may help them retain their independence longer. If your loved one isn’t receptive at first try again later. Advice from a doctor, lawyer or an elderly friend may be welcome.

What is Medicaid “spend down” and how does it work?

You may have too much income to qualify for Medicaid. This amount is called “excess income.” You may qualify for Medicaid if you spend your excess income on medical bills. This is called a “spend down.” Spend down works like an 6. insurance deductible. When you have accumulated paid or unpaid medical bills that are greater than your income, Medicare may pay for bills that exceed your income.

Where can I find more information about long-term care?

There are many long-term care resources. Visit the US Department of Health and Human Services at www.longtermcare.gov. For information on government long-term care plans visit www.medicare.gov (Medicare) and www.medicaid.gov (Medicaid).

To learn about long-term care services in your community call Eldercare Locator at 800-677-1116 or visit www.eldercare.gov. Visit the National Association for Professional Geriatric Care Managers website at www.caremanager.org for information and resources on geriatric care. The US Department of Housing and Urban Development provides housing options for eligible seniors. Go to portal.hud.gov/hudportal/HUD?src=/topics/information_for_senior_citizens


What is End of Life care?

End of life care is the support provided after an End of Life prognosis is made, when care goals transition from curative measures to comfort and quality of life. It may include hospice and palliative care. It can be provided at home, in hospice care centers and nursing homes, or in a hospital.

What emotional challenges may affect my loved one?

Emotions like depression, anxiety or fear are common at End of Life. Many people worry about loss of control and dignity as their physical abilities decline. Some patients fear being a burden to loved ones, while also fear being alone. Encourage your loved one to talk about their feelings, either with you or a close friend, or religious or spiritual advisor.

How can I comfort my loved one when End of Life is near?

Each person’s needs differ in the final stages of life. Some ways to provide support include being physically present and listening without interruption. Promote a calm environment through music and art and lighting. Surround your loved one with comforting remembrances like family pictures, artwork, flowers, and other personal items. If End of Life is close, reassuring your loved one that it is okay to pass away may help both of you at this emotionally challenging time.

What is respite care and how can it help caregivers?

Respite care can help families rest and recover from the intensity of End of Life caregiving. Respite care providers can ease the day-to-day demands of caregiving by assisting with bathing, medication, housecleaning and other tasks. A person may receive respite care in their home, adult day centers and in nursing homes.

How can caregivers best enlist the help of friends and family?

Ask friends and family for help with specific tasks such as grocery shopping, preparing a meal or helping with laundry or childcare. If you know someone who enjoys reading, ask them to read to your loved one. Someone who enjoys cooking may be happy to prepare a meal for you and your family.

What should I do right after someone passes away?

Your loved one’s remains do not have to be moved immediately. Any action taken should be consistent with your deceased loved one’s final wishes. Family members and caregivers may get comfort from taking time to say final goodbyes, talk or pray before proceeding with final arrangements.

How does a death become official?

As soon as possible after your loved one passes away, a person with legal authority should “pronounce” the death, like a healthcare provider or hospice nurse, for example. They will complete the forms certifying the cause, time and place of death. Pronouncing the death is required in order for an official death certificate to be prepared. A death certificate is a legal form that is required for many reasons including filing a life insurance claim and settling financial and property issues. If your loved one’s passing happens at home without hospice, contact a healthcare provider, local coroner or medical examiner, health department or a funeral home representative and ask how to proceed.

What resources are available to help my family manage grief?

Multiple resources exist including support hospice providers, bereavement support groups, books websites and more. A trained counselor can provide therapy individually or in a group setting. Your religious or spiritual community may also help you process your grief and accept your loss.

What support exists for caregivers?

Community-based services can supplement the support from family caregivers. They may offer companionship visits, meal programs, caregiver respite, adult day care services and transportation. To find community-based support services, consider contacting the Eldercare Locator at 800-677-1116 or visit www.eldercare.gov.

How can I best communicate with my loved one at End of Life?

When a loved one is nearing End of Life, try to be physically present if you can. When you enter their room, identify yourself and let them know you’ve come to see him or her. Always talk to, not about, your loved one who is nearing End of Life. Allow them to guide the discussion toward what seems to best suit their emotional needs, and try to listen without interruption. It’s sometimes helpful to ask someone else to write down notes about what is said at this time, and these words may provide later comfort.

What is an Advance Directive (AD) and whom should have one?

We recommend that adults complete an AD to properly plan for End of Life. An AD or living will includes instructions for the type of care you want if you are seriously ill or nearing End of Life, and appoints a health care proxy or Medical Power of Attorney to make decisions if you are unable to do so.

What other End of Life legal forms should we consider?

In addition to an AD or living will, some End of Life patients choose to complete a Do Not Resuscitate (DNR) order, and/or Physician Orders for Life-Sustaining Treatment (POLST), and/or an Organ Donor Form. Visit: www.passare.com for more information on many End of Life topics, including important End of Life legal documents and tasks.

What financial resources can you use to pay for end of life care?

People typically rely on a variety of payment sources to pay for end of life care including personal funds, government health insurance programs such as Medicare and Medicaid, and private financing options such as long-term care insurance. Medicare is the primary funding source for hospice care.

What if I don’t agree with my loved one’s End of Life choices?

It’s important to remember that every one deserves a peaceful, comfortable End of Life experience according to their own choices, even if those differ from your own. Try to respect your loved one’s care preferences and their physical and emotional needs. Speaking with a hospice professional or a counselor trained in End of Life transitions may help you moved toward acceptance of your loved one’s final choices.

How can I support my loved one when I have difficulty accepting that their End of Life is near?

Everyone manages the End of Life experience in his or her own way. As challenging as this is for you, do what you can to provide support. Phone, write or visit or coordinate a delivery of food, flowers or other support. Remember that friends and family sometimes avoid loved ones with terminal conditions, leaving them more lonely and depressed. Finding some way to let your loved one know that you care may help you both process feelings of loss during this challenging time.


How do I confirm eligibility for VA benefits and services?

For information about compensation and pension eligibility, payment rates and application processes, go to: www.vba.va.gov/VBA/

I am a survivor of a deceased US Veteran. Where can I learn about benefits?

The Office of Survivors Assistance (OSA) is a VA program that provides dedicated and comprehensive support to Survivors and dependents of deceased US Veterans. For more information please go to: www.va.gov/SURVIVORS/

As a survivor of a deceased US Veteran, am I eligible for compensation in the month of death?

The VA will quickly identify and pay surviving eligible spouses the deceased Veteran’s VA compensation or pension benefit for the month of the Veteran’s death.  For more information please go to: iris.custhelp.com/app/ask/session/L3RpbWUvMTM5ODM3MjU1Ny9zaWQvUGFvUVZDU2w%3D

What is Dependents Indemnity Compensation (DIC)?

DIC is a tax-exempt, monetary benefit paid to eligible survivors including the spouse or unmarried children of certain deceased Servicemembers and Veterans.  For more information, please visit: www.vba.va.gov/bln/dependents/dic.doc

Where can I learn more about long-term care options?

The VA provides comprehensive support services and benefits for aging Veterans and their survivors. Go to: www.va.gov/GERIATRICS/Guide/LongTermCare/index.asp for more information.

What are the eligibility requirements for the Hospice or Palliative Care Program through the VA?

Since Hospice and Palliative Care are part of the VHA Standard Medical Benefits Package, all enrolled Veterans are eligible to receive this if they meet the clinical need for the service.

How does a beneficiary file a death claim for Veterans’ Group Life (VGLI) Insurance?

The beneficiary files a claim for VGLI proceeds by submitting a Claim for Death Benefits Form SGLV 8283 to the Office of Servicemembers’ Group Life Insurance (OSGLI.) For more information, go to: benefits.va.gov/INSURANCE/forms/SGLV_8283_Bene_ed2012-11.pdf

How may my family request Military Funeral Honors?

Families of eligible Veterans may request Military Funeral Honors through their funeral director. Families in possession of their Veteran loved ones' remains that wish to have a Military Funeral Honors burial ceremony may contact the appropriate Military Service Coordinator. For more information, please go to: www.dmdc.osd.mil/mfh/selectStSvc.do

What is a Presidential Memorial Certificate and who is eligible to receive this?

A Presidential Memorial Certificate (PMC) is a certificate expressing the nation's grateful recognition of an honorably discharged, deceased US Veteran's service. The Veteran's name is inscribed and the Certificate bears the signature of the current President. A family member or friend may request the certificate in person at any VA regional office or by mail. For more information please go to:www.cem.va.gov/pmc.asp

Can I schedule or reserve a burial in a National Cemetery?

Gravesites cannot be reserved in advance. To ensure your burial wishes are carried out after your death, inform your family of your wishes and where your funeral plan, will or discharge papers are kept. At the time of need, your funeral service provider may assist with making burial arrangements at a VA National Cemetery.  Contact the National Cemetery Scheduling office at 866-900-6417.

Who is eligible for VA grief counseling?

Surviving family of deceased Veterans and Servicemembers are eligible. Schedule an appointment or visit any VA center and request grief counseling services. For more information, please go to: www2.va.gov/directory/guide/vetcenter_flsh.asp


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