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If you do opt for DNR, you should also obtain an easily identifiable MedicAlert-type bracelet, anklet, or necklace so that in the event you are in an accident or taken ill suddenly, those who respond to your emergency will be able to see your wishes clearly and not do anything extraordinary to keep you alive.
Your Durable Power of Attorney for Health Care
You can use a durable power of attorney for health care to name someone you trust as your health care agent. Your assigned agent will oversee your health care wishes such as the DNR and POLST (Physician Orders for Life-Sustaining Treatment) and make any necessary medical decisions for you if you are unable to do so yourself. Note that if you are conscious and can speak for yourself, they can’t override your decisions even if they do not agree with them.
If you are not conscious, your agent can consent or refuse consent to any medical treatment as long as it doesn’t violate the terms of your other documents. They can decide on doctors and facilities, access your health information as needed, and visit you even if visiting hours are restricted.
Who should you name as an agent?
Choose someone you trust who will be assertive in carrying out your wishes. They should live near you and be fully aware of your decisions. They can also be your financial agent if you wish, to take care of all money matters while you are ill such as paying rent/mortgage, utilities and so on while you are unable to do so. If you have a different financial agent, choose two people who can work together as a team.
The American Bar Association offers a PDF toolkit of ten forms that can help you with Advanced Care Planning.
Requirements will vary depending on where you live, but can be used as the starting point for what you need to organize.
The Maine Legal Services for the Elderly also offers practical step-by-step guidance.
Organ Donation and Body Disposition Paperwork
Most of your agent’s authority under a durable power of attorney for health care will end once you have died. It might be a good idea to also give your agent permission to oversee the disposition of your body; that is, what happens next. Some people choose organ donation, in which case professional staff would take the items that can benefit others and then release the body for funeral arrangements. One donor can save eight lives and help up to 50 people through corneas, tissues and more.
Be sure your wishes are clear – they ask on your driver’s license but you should also have your wishes stated clearly so there is no doubt, because time is of the essence to keep the organs usable after a person dies. For more information, visit the United Network for Organ Sharing at: https://www.unos.org/donation/ Once the organs have been “harvested”, your body can be released for burial or cremation, as you choose.
Leaving your body to medical science
Medical schools always need bodies for research and instruction. If you decide to do this, you would need to find out the rules in your state and find a medical school which wishes for the donation. No money is paid to your family for the body but they will take care of all aspects of transportation. They will also arrange for cremation and the burial of the ashes or scattering of them.
Families may request that they have a chance to receive the ashes. This can take one to two years. Consult with your nearest medical school as to what paperwork will be required and their rules and regulations for accepting the body.
In addition to all of the end of life decisions that need to be made and the paperwork for them, there are a number of key considerations once you die. This includes funeral arrangements and administering the money and possessions you leave behind. Let’s look next at decisions about your funeral arrangements.
PLANNING IN RELATION TO FUNERAL ARRANGEMENTS
Some people shudder at the very idea of their own funeral, while others have very clear wishes and preferences they will itemize and then expect to have someone carry out. This could be your healthcare agent or financial agent, or a member of the family that you trust can handle the responsibility and also carry out your wishes.
Paperwork after You Pass
The hospital or hospice where you die will give your next of kin or agent a death certificate stating date and time of death. When you start to make funeral arrangements, the funeral parlor will ask a range of questions and file for certified copies of the death certificates.
Your family will need certified copies for many purposes, such as closing bank accounts, notifying pension plans and so forth. Therefore, order at least six copies, or more, if the estate will be complicated. They cost $22 each and will be included in your itemized funeral bill if you are using funeral services.
Burial or Cremation?
This choice will be determined in part by whether or not you have donated your organs or your body.
Most people think of funerals as a coffin with an open lid, but you can have a closed coffin if you wish. It makes sense depending on cause of death and if a donation has been made. From a purely practical point of view, an open coffin will cost more compared to cremation due to embalming (using a chemical solution so the body does not decompose too rapidly), cosmetics and so on.
On the other hand, the loved ones you have left behind might get a better sense of closure if they can see you after you have passed away. The choice is up to you, but the final say should
be on the part of the person in charge of your affairs in the event that, for example, you were in a serious accident and an open casket would be a lot more upsetting to your family and friends than a closed one.
There are a range of options for burial depending on one’s faith and budget. For example, Jewish funeral arrangements will happen as quickly as possible after death. They will not include embalming and the coffin will be as simple as possible due to the belief that the body should decompose and return into the earth as soon as possible.
Some people get squeamish at the idea of burial and decide on cremation. Others cannot bear the thought of it. For example, cremation is now widely accepted by the Catholic Church, but some Catholics still get worried about the idea.
Cremation can work out less expensively depending on the casket you choose. It will be a wooden one that will be taken to the crematorium chapel and from there to the facilities for cremation. You will usually get the ashes a few weeks after the cremation.
Most states have regulations about scattering ashes – including if, when, where, and by whom. If you are in a state that does not permit scattering, you will need a niche to place the ashes in. Most cemeteries have a memorial garden for this purpose, with prices ranging depending on the size of the niche (single or double) and the location, such as inside a particular building or outside in the open air.
Funerals can be as simple or as elaborate as you like. You can choose items one by one, or go with one of the packages that most funeral parlors provide as a convenient way to make sure that nothing is overlooked.
The packages will usually involve memorial cards with your name and dates on one side, and perhaps a photo on one side, and a religious or nature-based image on the other. They will also include a guest book for people to sign when they come to the viewing/wake and a box of thank you cards for those who send flowers and other tributes. The printing costs and arrangements will all be taken care of for you.
The hearse, cars, limousines and so will also be taken care of according to your wishes. The funeral parlor vehicles will take you to and from the parlor to the church if there is a service at a house of worship, and from there to the cemetery or crematorium. You can also have a service at the funeral parlor and/or at the crematorium or graveside if you don’t wish to go to a house of worship.
Each cemetery has different rules and regulations you should check before you purchase a plot or a niche. For example, in some cemeteries there are headstones, while in others there are memorial plaques made of bronze. Some plots will hold two people, others as many as three.
The headstone will be the most expensive option and usually has to be contracted by an outside stonemason, or one that the cemetery recommends. If the cemetery stipulates a plaque, find out if it is included in the price of the plot.
The plaque will usually have a maximum letter limit, so they will usually offer “templates” of choices in terms of name, date, a saying (such as “In Loving Memory”), and a logo sometimes (such as a seal or flag for a veteran, a rose, lily and so on). Some plaques actually have a built-in vase you can pull in and out of the plaque, making it easy to leave flowers.
In terms of a niche in a memorial garden, the price should include an inscription on the wall. You can arrange with the crematorium as to when you wish to put the ashes in the niche. You can then invite people for a memorial service on that occasion as well. Some memorial gardens permit flowers, others do not. Once the ashes are in the wall, the inscription will be created. It will usually be name and date only.
If you are planning ahead and making these purchases prior to your passing, be sure your family knows all of the arrangements and has the deeds to the plot or niche. There will usually be an “opening fee” required to inter someone in the location, so be clear about what additional fees will be involved.Other Details
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