Most older adults have spent years working, acquiring assets and making connections. If life insurance policies and retirement accounts are in place too, it’s likely the policy owners have designated beneficiaries to these items.

What many people don’t know is that these designations override a will, and the type of account on which a person is named a beneficiary makes a difference in how it is treated after the owner’s death. This is a public step in transferring assets, whereas naming a beneficiary is a private, direct process of transfer to the beneficiary.

What is a beneficiary?

A beneficiary is a person or entity that will receive a death benefit from an account owner at the time of their death.

Designating beneficiaries

Financial institutions will provide beneficiary paperwork for account owners, and the full name and Social Security number for each beneficiary is required. Upon death of the account holder, named beneficiaries can present a death certificate to the financial institution and receive their payout.

The way payouts take place varies from account to account. For instance, some accounts might offer lump-sum payments while others pay out over a certain amount of time.

Four asset categories to consider

Bank accounts

Without a beneficiary, money in a checking account will become part of the deceased’s estate, meaning it could get tied up in probate. Designating a beneficiary through a Totten trust form allows any remaining funds in the account to pass directly to a beneficiary. To claim these funds, the beneficiary must prove his or her identify and produce a legal copy of the account holder’s death certificate.

Life insurance policies

Life insurance policies allow owners to name two types of beneficiaries: primary and contingent. Typically, the primary beneficiaries receive the proceeds or payout. If they die, the contingent beneficiaries receive the benefit.

To collect the benefit, the beneficiary must provide the insurance company with a legal death certificate. The company will verify the claim and pay out the death benefit.

Retirement plans such as Traditional IRA or Roth IRA

The way a beneficiary receives assets depends on the type of individual retirement account inherited and the relationship that person has to the original owner. These rules changed in 2019, so IRA owners should consider a discussion with a lawyer or financial planner to fully understand them. In short, now, IRA distributions must be completed within 10 years when going to a non-spouse. Also when going to a non-spouse, required minimum distributions should start no later than Dec. 31 of the year following the original account owner’s death.

When a spouse inherits an IRA, he or she can designate themselves as the account owner, roll it into another qualified plan or treat themselves as a beneficiary.

For more on IRAs, visit the IRS website.

Annuities

The beneficiary of an annuity can receive the greater of either all the money left in the account or a guaranteed minimum. After an annuity owner (annuitant) dies, the insurance company distributes payments to beneficiaries in a lump sum or stream of payments.

What if there’s no beneficiary?

What happens to assets if there’s no named beneficiary depends on the type of account.

• Retirement plans and life insurance policies will have a default beneficiary, not necessarily someone intended.

• Accounts without a beneficiary might incur tax penalties that could have been avoided.

• If a person dies without a will (intestate), the courts will sort out who gets what.

Other considerations

• In many cases, an account owner can set provisions for beneficiaries, outlining how much money they take out and when.

• The beneficiary form provided by the financial institution may not be detailed enough to fully outline an account owner’s wishes. In this case, working with a lawyer to craft exactly what is wanted is important.

• Having outdated beneficiaries listed can cause problems. Forgetting to remove a former spouse or add a new child can have negative consequences. It’s important to review beneficiaries after big life events.

Everyone’s situation is different, and after building a life with assets and loved ones, it’s important that account holders understand the intricacies of beneficiaries. Speaking with a representative of the financial institution where the asset is held, a financial adviser or a lawyer is a smart step in managing beneficiaries.

An estate consists of a person’s property of every kind, including real estate, bank accounts, retirement accounts, investments, life insurance, vehicles, jewelry, and all other possessions. Preparing one’s estate plan requires some thought about how these items will be administered and distributed after a person’s death.

One option for organizing an estate is a last will and testament, simply referred to as a will.

What is a will?

A will indicates how assets will be distributed after a person’s death, and it may name guardians for minors. The creator, or testator, names an executor, or personal representative, who is in charge of distributing assets. State laws vary on how a will should be formalized, but many states require it to be signed by the testator in the presence of witnesses.

A will can be changed as long as the testator retains the mental capacity to make changes. If probated, this document becomes public upon the creator’s death. Once the assets go through probate and are awarded to the beneficiaries, the will has served its purpose.

Why is a will important?

• Having a will allows a person to appoint an executor to administer the estate and provide a plan for the distribution of probate assets to desired beneficiaries. A will can also be used to create a plan to help reduce estate tax and create a plan of protection and management of assets for the benefit of minor or adult children who cannot safely manage money.

What happens without a will?

The process of “intestate succession” takes place after death if there is no trust or will. Procedures vary by state, but the goal of this process is to distribute assets in a way the average person would likely have wanted his or her estate to be distributed. Many states have adopted The Uniform Probate Code, which provides rules on who can administer the estate and how assets will be distributed. For a married person, the distribution could include turning over all estate items (after taxes and debts are settled) to a spouse.

How to get a will

1. Meet with a lawyer. Bring along a list of all assets (personal property such as vehicles, real estate, bank accounts, investments, insurance policies and heirlooms) and debts. Have names and birth dates for beneficiaries, guardians for children and the desired executor or personal representative.

2. If meeting with a lawyer isn’t feasible, online options also are available.

3. Make sure the will is formalized properly. This process varies from state to state, but it generally includes signing the will in the presence of disinterested witnesses.

What to do once it’s in place

• Provide loved ones with a copy and the location of the original.

• Review on occasion (yearly is a good option) and update as needed. For instance, if the owner of the will purchases or sells property, is married or divorced or has more children, each change should be accounted for in the will to ensure that assets are distributed as desired.

The information in this article is for general educational and informational purposes only. The information may not reflect the current laws in the state in which you reside. This information should not be construed as legal or tax advice from Prosper, nor is it intended to be a substitute for legal counsel from a qualified estate planning attorney or tax advice from a qualified tax professional.

An estate consists of a person’s property of every kind, including real estate, bank accounts, retirement accounts, investments, life insurance, vehicles, jewelry, and all other possessions. Preparing one’s estate plan requires some thought about how these items will be administered and distributed after a person’s death.

One option is a revocable living trust.

What is a trust?

A trust is a written agreement between the creator and the appointed trustee that can be used to manage trust assets during the creator’s lifetime and after death. The creator of a trust, or grantor, may function as the administrator, or trustee, but the arrangement also allows for someone else to step in upon incapacitation or death.

Generally, a trust remains private, and the items within it do not go through the probate process.

There are many kinds of trusts, but the revocable living trust is one option for people who have long-term goals for their assets — even after death.

Why is a trust important?

• Like a will, a trust designates how trust assets are distributed, and it can be used to create a plan to help reduce estate taxes and create a plan of protection and management of assets for the benefit of minor or adult children who cannot safely manage money.

What happens without a trust or will?

The process of “intestate succession” takes place after death if there is no trust or will. Procedures vary by state, but the goal of this process is to distribute assets in a way the average person would likely have wanted his or her estate to be distributed. Many states have adopted The Uniform Probate Code, which provides rules on who can administer the estate and how assets will be distributed. For a married person, the distribution could include turning over all estate items (after taxes and debts are settled) to a spouse.

Beyond the court process, loved ones may not be able to close accounts or receive benefits without a trust.

How to get a trust

1. Meet with a lawyer. Bring along a list of all assets (personal property such as vehicles, real estate, bank accounts, investments, insurance policies and heirlooms) and debts. Have names and birth dates for beneficiaries and the trustee.

2. If meeting with a lawyer isn’t feasible, online options such as Trust & Will, a Prosper exclusive provider, also are available.

3. Fund the trust. Some assets can simply be listed in a trust; in other cases, the grantor will need to contact banks, insurance companies and transfer agents to issue new investment certificates, re-title cars and sign new deeds.

4. Make it official. A declaration of trust, deed of trust, or trust instrument is needed to formalize the trust. Online platforms should include this with their offerings, but working with an in-state attorney can help ensure nothing is missed.

What to do once the trust is in place

• Make sure loved ones have a copy or know where to find the original.

• Review on occasion (yearly is a good option) and update it as needed. For instance, if the creator of the trust purchases or sells property, gets married or divorced or has more children, each change should be accounted for within the trust to ensure that assets are administered as desired.

• What makes a revocable living trust special is that the provisions within it can be changed or canceled at any time before the grantor’s death or incapacity. Once the grantor dies, a revocable trust becomes irrevocable.

The information in this article is for general educational and informational purposes only. The information may not reflect the current laws in the state in which you reside. This information should not be construed as legal or tax advice from Prosper, nor is it intended to be a substitute for legal counsel from a qualified estate planning attorney or tax advice from a qualified tax professional.

What is a living will?

Unlike a last will and testament, a living will doesn’t specify a person’s requests regarding their estate and dependents. Rather, it focuses on the level of care they’d like to receive in the event of a health crisis, accident or end-of-life care.

A living will is one part of an advance directive, which should also include a durable health care power of attorney, also sometimes called a medical power of attorney.

Why set up a living will?

A living will allows a person to make certain decisions regarding health care and medical treatments in advance, so their choices can be carried out by a caregiver even if they are unconscious or unable to make a decision at some later time.

How does a living will work with a health care agent?

A living will may not cover every possibility. That’s when the health care agent named in a medical power of attorney steps in to fill the gaps. The health care agent, often the person’s lead caregiver, will consider their loved one’s desires and make a decision on their behalf.

Who should set up a living will?

Everyone should have a living will. Even if an individual is young and healthy, an accident or illness could leave them unable to make decisions for themselves. As a caregiver, it’s even more important to make sure a loved one has a living will, since the chance of a debilitating medical event increases with age.

What happens when someone doesn’t have a living will?

If something were to happen and a loved one becomes incapacitated, there may be no indication of what medical treatment they would want. If the caregiver is not a legal health care agent, they would have little to no say in making decisions for the person.

Without a living will or a health care agent, there could be disputes or even litigation over the person’s medical condition and treatment.

An estate consists of property of every kind, including real estate, bank accounts, retirement accounts, investments, life insurance, vehicles jewelry and all other possessions. Preparing one’s estate plans requires some thought about how these items will be administered and distributed after a person’s death.

Two options are a will or a trust.

A will indicates how a person wants his or her assets to be distributed upon his or her death.

A revocable living trust is a legal agreement between the creator and the appointed trustee that indicates how the trust assets should be managed during the creator’s life, and then administered after death when it becomes an irrevocable trust.

Trusts are generally selected by people who desire more privacy in the administration of their estate and more control over assets after their death, including by whom and how they are accessed. That also means trusts are generally more expensive to set up and often are used for complex estates.

Both documents can be changed as circumstances dictate.

The two options have a few differences, including costs, privacy, administration, planning and more.

Costs

Legal fees for the preparation of an estate plan vary by lawyer or preparation service. For the creation of a revocable living trust, separate fees may apply when retitling assets in the name of your trust (for example, real estate transfer fees, title change fees, etc.).

Legal fees for the administration of an estate plan also vary by lawyer. In addition, a qualified tax consultant should be consulted and will have fees that vary by firm.

A will is administered through a court process called probate. For a will, in addition to legal fees, the estate may have to pay court filing fees, and the executor of the estate may also request to be paid executor fees.

A revocable living trust is administered by the Trustee. The Trustee may require fees for administration of the trust. The creator of a trust can avoid probate if assets are titled correctly, which can save time and court costs. The Trustee may also require ongoing fees for continued administration of the trust.

Timelines

The administration of an estate will vary based on the value of the estate, the amount of debt in the estate, the complexity of the plan being administered, and other factors. Typically, the administration of an estate plan will take 12 to 18 months after someone dies.

Asset Protection

Both wills and revocable living trusts can be used to create an estate plan that provides asset protection after death, such as protection from creditors of the beneficiary.

Privacy

A will becomes a public document at death when it is submitted for probate, meaning anyone can see it. A trust generally remains private.

Incapacity

Because a will takes effect at death, it does not allow a person’s executor to manage assets if he or she becomes incapacitated. A separate property power of attorney can be created by the person to appoint an agent to manage assets if he or she becomes incapacitated. If the creator of a trust becomes incapacitated, the trustee continues to manage trust assets and ensure individual and family needs are met. The creator of the trust should still consider creating a separate property power of attorney that appoints an agent to manage assets that may remain outside of the trust (for example, personal retirement accounts), if he or she becomes incapacitated.

Control

Both wills and revocable living trusts can be altered during one’s life.

The information in this article is for general educational and informational purposes only. The information may not reflect the current laws in the state in which you reside. This information should not be construed as legal or tax advice from Prosper, nor is it intended to be a substitute for legal counsel from a qualified estate planning attorney or tax advice from a qualified tax professional.

Power of attorney (POA) gives a caregiver the legal authority to act on someone else’s behalf, including participating in decisions about property, finances or health care. It can be used to ensure someone’s wishes are carried out.

There are different POA categories available, and each has to do with when the document goes into effect and for how long. Caregivers need durable powers of attorney, which means they remain in effect if your loved one becomes incapacitated. The two main types to consider are medical and financial powers of attorney.

Medical POA

A medical power of attorney allows a person to name someone to make health care and medical decisions on their behalf. This person may be called a health care agent or attorney-in-fact. In some states, the medical power of attorney may be a part of a living will or advance directive.

Financial POA

A financial power of attorney designates someone to handle financial, property and business decisions for the person. Financial powers of attorney may be broad and apply to nearly any non-medical decision.

What can a POA agent do?

The person granting someone else power of attorney privileges has significant control over what that person, called an agent, may do on their behalf.

The authority given to an agent may be either broad or limited to specific uses. An agent’s powers may be effective immediately, or they may only become effective if the person is unable to make decisions.

The agreement may also include an expiration for the agent’s powers, which allows the powers to terminate after a specific time period or if the person becomes incapacitated. In some cases, the person covered by the POA may also rescind powers, as long as they are still capable of making decisions. The guidelines for “capability” must be outlined in the POA.

Designating an agent who is authorized to make decisions regarding medical treatment, ongoing operations of a business and paying personal bills is an essential step in preserving a person’s legacy.

Advance directives can help ensure your loved one’s wishes are carried out. It’s important to talk about this with family members before a crisis arises.

What is an advance directive?

An advance directive is a legal document that provides written instructions for the care of a person’s health if they become temporarily or permanently unable to make decisions or communicate their wishes. Some things to consider are:

Items to include in an advance directive

• Living will

• Do not resuscitate (DNR) orders

• Power of attorney (POA) for health care and finances, including property and businesses

• Hospice care considerations

• Organ donation desires

• Religious or cultural practices

• Funeral preferences and preparations already in place

• Account information for banks, computers and life insurance policies

• Decisions related to specific conditions, diseases, terminal illnesses and life-sustaining treatment options

Why is an advance directive important?

An advance directive gives people control over their medical care if something happens and they can’t advocate for themselves. Doctors and loved ones can use the information provided to give care and make plans based on the documentation in the advance directive.

What happens without an advance directive?

If patients cannot make their wishes known, doctors must turn to family and friends to help guide their plans for treatment. According to the American Bar Association, most states have laws that designate who makes these decisions. The laws typically start with a spouse and move through family ranks from there.

While family members might think they know what a person wants, they might not all agree.

How to get an advance directive

The first step is considering the types of medical care desired in the case of an emergency or at the end of life. Next, people should talk with their loved ones about these desires. Once these decisions have been made, paperwork can be requested from most hospitals or health care providers.

Each state has laws regarding how advance directives are drawn up and executed, and AARP has compiled all state forms. Prosper also provides referrals to several financial services that include advance directives.

What to do once it’s in place

Keeping a note about the advance directive in a wallet or purse can help medical professionals during an emergency. Reviewing the document annually can help ensure it remains aligned with medical wishes. If decisions are updated, a conversation with loved ones can help keep everyone informed.

Life support is a medical intervention when basic bodily functions no longer work. These measures include resuscitation through chest compressions or drugs, artificial ventilation or artificial nutrition.

People have a right to choose which, if any, life-sustaining measures they want, and it’s important to understand these concepts when preparing medical documents such as an advance directive.

What is a do not resuscitate (DNR) order?

If a person’s heart stops, medical professionals will begin cardiopulmonary resuscitation (CPR) or other measures, such as drugs, to start the heart again. A do not resuscitate order is a request not to have CPR or drugs.

What is a do not intubate (DNI) order?

If a person stops breathing, medical professionals may use CPR or drugs to stimulate breathing function again. A DNI order requests that no breathing tube is placed within the patient to assist with breathing, but it does allow for CPR or use of drugs.

Why are DNR and DNI orders important?

If a hospitalized patient has not specified his or her DNR or DNI wishes, health care providers will automatically begin CPR immediately if the person needs it and may also administer drugs or intubation. Without these orders in place, care providers are required to do what’s necessary to preserve life functions. These legal documents make a patient’s wishes understood and give health care workers clear direction.

How to get a DNR or DNI

Within a hospital setting, a doctor can write and include a DNR or DNI order in a patient’s medical chart.

Before receiving care in a hospital or clinic, people can complete their own DNR or DNI forms online or request one from their state’s department of health. A separate form is needed for DNR/DNI orders in a community setting (rather than a hospital setting). Those who create DNR or DNI orders might want to carry a card or medical identification information to make their wishes known.

What to do once they’re in place

DNR and DNI regulations vary by state and in some places might expire after a certain period of time. It’s important to review these documents at least annually to ensure they are up to date.

A copy of this paperwork should be kept in a wallet or purse and given to family members or caregivers. The orders should also be on file with all care providers and health systems providing care. Simply filing with the primary care physician is not enough.

Caregivers often are chosen because their loved one trusts them. But even with that, care recipients must have certain legal documents in place to help make their wishes known and empower their caregiver to advocate for them.

This page will help you navigate legal and medical documents for your loved one. Remember, your needs may vary based on your circumstances and where you are on your caregiving journey.

One place to start is to make sure your loved one has a will in place.

Three legal documents to guide medical care

• Advance directive

This document tells health care professionals what a patient wants or doesn’t want in emergency situations.

• Durable health care power of attorney

This document names someone to make health care decisions for a patient if they are incapacitated.

• HIPAA authorization

This document created through the Health Insurance Portability and Accountability Act allows a patient to specify which people or parties can access certain medical information.

Additional medical documents to consider

Other legal documents ensure everything is in place for a person to receive the medical care they want and need. This can include the following documents:

• Physicians order for life-sustaining treatment (POLST) form

• Do not resuscitate or do not intubate forms

What happens without legal medical paperwork in place?

Each of these documents authorizes various people and actions. Without them in place, a person might not be able to get the care they want, or a caregiver might not be able to act on behalf of their loved one.

Without an advance directive, medical professionals may not know patient wishes for end-of-life or other emergency care. This could result in treatments that go against the patient’s desires.

Without a durable health care POA, family members might be asked to step in and make decisions for the patient. These could run against the patient’s wishes and lead to conflict among family members who disagree about which course of treatment is best.

Without a HIPAA authorization, caregivers and other parties who may need access to medical records will not be granted that access.

Why these documents matter

In an emergency or at the end of life, people may not be able to make their wishes for medical treatment known to doctors or loved ones.

Having these documents in place ensures a person’s wishes are clearly and legally stated so they can be followed.

What to do once these documents are in place

These documents allow your loved one to have his or her wishes carried out, and they offer power and peace of mind for caregivers. Here are more tips to stay organized and empowered:

Put originals in a safe place

• Many states require original documents, not copies.

• A safe deposit box will ensure security, but this option can bar others from accessing the document(s). If using a safe deposit box, make sure a trusted person can access the box during emergencies.

Tell important people where to find the originals

This includes a spouse or partner and any children or caregivers, but it should also include financial professionals.

Provide copies to those who need them

Anyone who is named as a health care proxy or a financial decision maker, or a trustee or executor should know they will be expected to act in this position. They should also receive a copy of the document naming them as such.

Review as needed

Updating these documents is important if circumstances change. Providing updated documents to all necessary parties should be part of the review process as well.

Documents should be reviewed at least annually, or as health conditions or lifestyle options change. When updated, old versions should be destroyed so there’s no confusion about what is the most current and desired document. If new copies are put in place, stakeholders should receive updated information and new copies.

A person’s health information is private, which is why patients must consent to sharing it. This kind of consent is called a HIPAA authorization.

Signing a HIPAA authorization can help ensure the right people receive necessary medical information.

What is a HIPAA authorization?

The Health Information Portability and Accountability Act (HIPAA) sets the legal standard for what medical information is private, what can be released, to whom and under what circumstances.

HIPAA was put into place in 1996 to help ensure privacy and ease of access to medical records. A HIPAA authorization form allows a designated person or entity to share specific health information with another person or entity.

How to get a HIPAA authorization

Patients need a separate HIPAA authorization for each care provider. A care provider will furnish an authorization form, which the patient signs. This patient designates authorized contacts and the information that may be shared. Caregivers who have been granted access to medical information through this form are allowed to receive the information, but they are not considered representatives or agents for the patient. This means they cannot make medical decisions for this person. For those wishing to designate such a representative, a durable health care power of attorney must be in place.

Authorized contacts

Partners, family members, friends or anyone else identified by the patient may receive the information allowed by the patient. If the patient is present and can make health care decisions, providers may discuss medical information with those authorized to receive it. This can also include sharing information for a purpose not otherwise allowed by the HIPAA Privacy Rule.

Doctor visits and results

As with other medical information covered by a HIPAA authorization, doctor visits and results of care may be disclosed to authorized people or entities. However, if a HIPAA authorization form has not been completed but the patient is able to provide consent to the sharing of information, a provider may share this information with someone authorized by the patient. This could include a doctor discussing the patient’s pain medication with a friend who drove the patient to the emergency room for an X-ray.

What to do once it is in place

Health care providers will keep a signed HIPAA authorization form within patient medical files. Patients should let authorized contacts know they have this authorization in place. Keeping the form updated is important so all loved ones who may need access to a patient or their medical information have it.

What happens without HIPAA authorization?

Legally, if a provider shares a patient’s protected health information (PHI) without HIPAA authorization, it could result in a financial penalty or be considered a criminal act.

On a personal level, if a HIPAA authorization form is not completed, a patient’s medical information may not be shared with loved ones or other potentially important entities.

Here are the top legal documents to help caregivers gain peace of mind.

Power of attorney (POA)

This document educates caregivers about what kind, if any, power of attorney they may need.

Living will or advance directive

Documentation from the care recipient that includes wishes for end-of-life decisions such as life support when they are no longer able to make decisions for themselves.

Living trust

A document that puts financial and physical assets in a trust and appoints a trustee who can manage the decision-making for those assets.

Will

A will names an executor to manage the estate at the time of death and beneficiaries who receive assets from the estate.

Other considerations

HIPAA authorization

This document authorizes an appointed person or entity to share specific health information with another person or entity.

DNR or DNI

These medical orders, written by a doctor, specify types of life-sustaining care a person wishes to receive.

POLST form

This document is used by the terminally ill to state end-of-life wishes. It does not replace an advance directive.

In end-of-life planning, healthy people may not put a lot of thought into their desires for emergency situations. But for those with advanced illnesses, thoroughly documenting care wishes is crucial. One way for critically ill people to do this is through a physician order for life-sustaining treatment (POLST) form.

What is a POLST form?

The POLST is a portable, legal medical form that states a person’s wishes for medical care in an emergency situation or at the end of life. Because it is portable, it can be used across multiple care settings.

While a POLST complements an advance directive, it does not replace this document.

Why is a POLST important?

This documentation of medical care desired is immediately accessible by health care personnel, whereas an advance directive may be reviewed after an emergency to determine a course of treatment. Being kept alive while an advance directive is reviewed may go against the wishes of a critically ill person.

What happens without a POLST?

Because the POLST states both desired treatments and those the patient would like to avoid, there is clarity about what a person wants.

For example, without this document in place, a critically ill person might have a do not intubate (DNI) form in place and may wish to die where they are, rather than going to a hospital. Emergency personnel might be able to access this form and determine whether to begin CPR or transfer the person to a hospital.

Or a patient might wish to go to a hospital but not go into intensive care. With just a DNI to guide them, medical professionals might not get this specific request.

How to get a POLST

Patients and care providers first discuss the diagnosis, prognosis, treatments, alternative treatments and any advantages or disadvantages of those treatments. Together they develop a plan for medical care based on the patient’s goals and wishes. The patient completes the form, and the care provider signs it, making it valid.

Regulations and popularity vary from state to state. In some states, people may request a form from their health care provider. The Polst Paradigm Program lists state information here.

What to do once it’s in place

This form is intended to be used by those in advanced stages of illness or with critical conditions, so it should be reviewed regularly, as the patient’s medical condition or goals change. If care levels change — if the person enters the hospital, for example — the POLST should be reviewed and revised to include updates to health status, desires or goals.

If the patient wishes to cancel the POLST, they should discuss the decision with their care providers, void the form and update the state registry, if living in a state with a registry system.

Dealing with death is difficult even when the deceased has lived a long, fulfilling life.

One way to ease the pain for loved ones is to create a final arrangement document and tell family members about final wishes. This type of pre-planning for a funeral can ease the decision-making process during a time of grief, and it also helps ensure that a person’s wishes are carried out in the way he or she wants.

What is involved in pre-planning a funeral?

A funeral is a remembrance or celebration of a person’s life and his or her interests. Pre-planning a funeral may include exploring the following areas:

What service options are available?

• Funeral

• Graveside service

• Memorial service

• Wake / reception

• Viewing

• Visitation

• Committal service

• Celebration of life

• Colorful funeral

Choosing a service location

• Funeral home

• Religious places of worship

• Cultural considerations

• Chapels at cemeteries

• Gravesite

What to do with the body

• Cremation

• Burial

• Donation

Who will be involved?

• Officiant of the service

• Pallbearers

• Delivery of eulogies

• Readings

• Musician / vocalist

• Guests

Personal touches

• Flowers

• Music

• Personal touches

• Address for condolences

• Address for memorials or donations in lieu of flowers

• Military Final Salute

Other Considerations

• Obituary

• Gravestone / headstone

• Burial clothing

How to plan in advance

• Talking with loved ones about personal wishes is the first step in helping others understand why pre-planning is happening and what is already in place. This conversation allows caregivers to understand what’s desired and in place, as well as what they will need to put in place on their own.

• In some states, such as New York, people who prefund their funerals are protected by state laws. These laws protect individuals and may provide relief to loved ones, who know that final expenses are taken care of.

• Working with a funeral director can provide price lists, services and available facilities. It also can help create an itemized statement listing the items, services and facilities that have been chosen. It should also include a pre-need agreement stating terms, rights, costs and items to be provided.

• If working with a funeral home is not part of person’s wishes, in addition to creating a will or a trust, providing family members with a list of desires is important.

What happens without advance planning?

• Pre-planning can take some of the logistical and financial stresses off of the family after a loved one’s death.

• If no conversations have happened, loved ones will make decisions about cremation or embalming, memorial service or church service on their own, which may not be what their loved one wanted.

No matter how diligent a person is, there may be elements of funeral planning that slip through the cracks. Using a checklist can ensure some possible scenarios are discussed and that basic elements of funeral planning are covered.

Michelle’s journey

In the fall of 2013, Michelle D. watched her oldest son launch a career from afar. She had just sent a second child off to college and was enjoying her youngest’s final year of high school. It seemed as if the bulk of her caregiver days were over.

And then, Betty, her mom, fell.

Michelle became a caregiver in a new way, and like nearly 45 million other unpaid family caregivers in the United States, this meant checking in on her mom and helping her as she recovered. It meant stopping by Betty’s home after work to do laundry and take stock of the fridge, the bills on the table and her mother’s overall health.

A new role

Unpaid caregivers like Michelle frequently feel overwhelmed. Often, they are thrust into this position during a crisis, with no say in how to handle finances, medical care or even the level of care a loved one can receive.

But Michelle was prepared. When her mother began to decline, she made sure to set up a power of attorney, so when the time came, she could make financial decisions for her mother. She asked Betty to complete HIPAA paperwork, so when complex medical situations arose, Betty’s doctors could talk to Michelle about them. And she asked her mom to go over her living will again to clarify what kinds of medical actions Betty wanted.

Finding balance

Today, Betty lives in an assisted living community designed for people with dementia. It’s been difficult for Michelle to see her mom move from her home to a care setting, but she has peace of mind knowing her mom is getting the care she needs, and her affairs are in order.

Michelle doesn’t think of herself as “lucky,” just prepared. Unlike many other caregivers, she had time to plan.

Caregivers need legal status, such as power of attorney, to legally make decisions for someone else, but simply knowing what kind of accounts a loved one has and how to access them is a good first step to getting organized.

Accounts and access options take many forms.

Physical documents and storage

Know where the following items are kept or make copies:

• Driver’s license

• Social Security card

• Insurance cards

• Birth certificate

• Marriage/divorce certificates

• Organ donor card

• Will/estate documents

• Power of attorney

• Home, auto, life, disability and long-term care insurance policies

• Burial plot and headstone documents

• Loan documents

• Mortgage or lease information

• Trusts

• Safety deposit box and key

• Cash, stocks and bonds

Financial accounts

Although many of the above items will indicate the institution used to draft them, many financial accounts are accessed and managed virtually today. These include items such as:

• Checking accounts

• Savings accounts

• Credit cards

• Certificates of deposit

• Money market

• Roth and traditional IRA

• 401k, 403(b), 457 or others

• Pension

Other accounts

The following are often easily documented through repeat bills, which also makes them good candidates for an automated bill pay service.

• Water

• Electric

• Gas

• Trash

• Services (lawn, snow, maintenance)

• Cellular service provider

• Apple or Android phone access

• Cable TV, telephone, internet, streaming services

• Donations

Social media

A final area to consider is social media. Facebook and YouTube are popular among older adults who use them to stay connected with friends and family. Although Facebook does have a process for turning a person’s page into a memorial page after their death, being able to access an account can make closing the account or setting up a memorial page much easier.

Other sites to review include:

• Email accounts

• Digital subscriptions (newspapers, magazines, etc.)

• Twitter

• Instagram

• Blogs (WordPress, Tumblr, Blogspot, etc.)

• Websites/web hosts (Bluehost, GoDaddy, Wix, WordPress, etc.)

Not everyone will have all of these accounts, but using the items listed here as a starting point or guide can start a conversation and help ensure nothing falls through the cracks.

Are you getting ready to have a challenging conversation? The following tips are good to review to make sure you make the most of your discussion.

Tips for talking — how to bring up difficult topics

Topics from taking away car keys to encouraging help at home to considering moving to assisted living can be challenging to broach. But it’s important to find a way. Here are some tips:

• Be straightforward and compassionate.

• Normalize the topic as a normal part of health care and well-being.

• Remember, sometimes your loved one has been wanting to talk about this, and he or she didn’t know how to bring it up.

• If you have another family member or friend with a better or different relationship with your loved one, maybe that person can begin the conversation.

• Sometimes it’s helpful to have someone in a neutral position or a position of authority bring up the topic – such as a doctor or other medical caregiver.

• Begin with a clear expectation – does your loved one understand what you’re REALLY talking about? When you say “hospice,” for example, does he or she understand what that is? You can eliminate a lot of early frustration by being clear and up front.

• A good opening line could be, “Hi, I’ve been a little worried that I don’t know what you would want to do in certain circumstances. It would be helpful if I knew what you wanted.”

• Make sure your loved one knows he or she is in control – you are just there to make sure their needs and wishes are met, not to tell them what to do.

• It’s important to remember this is all an ongoing dialogue – if wishes or medical needs change, these documents can be updated.

• If someone is very resistant to the conversation, don’t push. Instead, offer to share some information and allow them time to think about it, then try again at later date.

Tips for listening — how to ensure understanding and respect

Empathic listening is a gift you can give your loved one – and it can help you ensure you understand his or her wishes. One tip is to repeat back what you heard, to make sure you understand. Use phrases like:

• I feel like what I heard you say is … .

• I understand, but what I think you’re saying is … .

• Is this right?

• I want to make sure I know what you would like to happen.

• Make it personal: If someone has COPD, you say, “if you stop breathing, what would you want us to do?”

For caregivers and their loved ones, the key to all these conversations is straightforward, loving communication, and a knowledge that, above all, what matters most is how we make one another feel.

Caring for a loved one might be an infrequent thing, like helping wash windows in the spring or picking up groceries on occasion. But as a loved one begins to need more help, caregivers may find themselves spread thin by managing their own responsibilities and those they’ve taken on for a loved one.

Putting together a care plan is a way for caregivers to track what they’re doing, find support and build in some time for self-care.

What is a care plan?

• A care plan is a list of needs, desires and goals developed by the care recipient and caregiver.

• Corresponding to each item should be a listing of who will help with that goal and how.

• The plan doesn’t need to include every situation that could arise, but it should cover immediate needs and any anticipated needs.

How to create a care plan

Start by having a conversation

• This includes talking with the care recipient about their needs and desires, but it should also include talking with other family members and potential caregivers, such as neighbors, support service providers or community resources such as meal delivery services.

• Caregivers who are working should also consider having a conversation with their employer about their caregiver responsibilities outside of work. This can help them find resources at work or discuss potential shift changes as needed.

What happens without a care plan?

• The greatest benefit of having a care plan is organization. Without one, needs could fall through the cracks, or caregivers may not notice changes to be addressed.

• Some care recipients may have several caregivers. A plan helps keep people organized and accountable.

• Others might have just one caregiver, and with multiple responsibilities, it could be difficult for that caregiver to keep track of everything.

• Without a plan, your loved one may be left guessing or trying to remember who helps with what.

What to do once it’s in place

• Post a copy where your loved one can view it. This can provide peace of mind, so your loved one knows what to expect.

• Provide all caregivers with a copy. Keeping it in a log book and asking all caregivers to add notes after providing care is a good method.

• Update as needed.

• Take to medical appointments.

What to Know

• A care plan is a fluid document. It can change with a change in diagnosis, increased care needs, change in finances, caregiver circumstances and other life changes.

• A care plan should be revisited whenever circumstances change or at a minimum on a yearly basis.

• A care facility or agency may create its own care plan, ensuring the family’s plan for care aligns with the outside caregiver’s plan for care. It is important to be part of this process to ensure that all parties hold the same expectations of care responsibilities.

On top of keeping their own lives organized, caregivers must find ways to maintain — or establish — order within their loved one’s life. A personal inventory is a great way to keep from being overwhelmed – and it’s a useful document to have at the end of life.

What is a personal inventory?

A personal inventory is a basic accounting of important items in a care recipient’s life.

Other inventories to consider include checklists for financial assets, a list of documents, accounts and how to access them as well as a list of other information.

You can do this in whatever way works best for you – whether that’s paper and pencil or a digital document.

Why is a personal inventory important?

The benefits of a personal inventory include helping the caregiver understand basic things like email accounts and passwords, where the dog goes for shots and where important documents are kept.

What to do once it’s in place

• Make a copy for other caregivers, or share access if it’s a digital document.

• Place the original in a safe deposit box or with other caregiving documents.

• Update the lists as items are added or removed.

• Consider taking photos of the most valuable items for insurance purposes.

What happens without an inventory?

Organization and ease of access are the greatest benefits of having an inventory. Without one, caregivers might scramble to find military discharge paperwork, vehicle titles or the combination for a safe.They might also miss important payments or deadlines.

If the care recipient eventually needs more care than can be provided at home, caregivers will need to complete an inventory of clothes and items that move with their loved one. Having one completed will save time.

Navigating the end of the life with your loved one can be emotionally overwhelming.

That includes both sharing final thoughts and feelings with someone and helping understand how they want their last days to be spent. Both conversations can be a challenge to initiate.

Asking about end-of-life wishes

• Have a practice conversation with someone else first, or write a letter as a “warm up.”

• Accept that opinions may differ — it’s good to learn this before a medical crisis.

• Consider this statement: What matters to me at the end of life is______________.

Why it matters

Even with an understanding of what needs to be discussed and a conversation kit, talking about end-of-life wishes can be difficult. But preparing for this discussion while a loved one is still medically stable and has mental clarity is worth some of the discomfort.

After the initial conversation

It may take several attempts at conversation to successfully cover everything needed to honor a loved one’s wishes at the end of life. However, each conversation should offer some insights. Caregivers might want to write down notes about the conversations, including areas of discussion that went well or were more challenging, ideas that were not fully developed and any questions that came up for discussion next time.

Tips for final conversations with loved ones

It’s good to remember that it’s never too late to tell someone how you feel and find a way to feel at peace together.

Susan Lueckenhoff, who has more than 25 years of experience in managing hospice and critical care, says it’s important to tell someone what they mean to you – or to find a way to get closure on difficult or complex relationships. She encourages people to “be real.”

“In bereavement counseling, I hear people say, ‘If I knew she was going to die this day, I would have told her this,’ and you think, ‘Tell them!’ People carry this regret, and they don’t have to.”

• This is a gift to you and your loved one – not saying those things will stay with you. Sometimes, if people have had a conflicted relationship, it’s easier when the loved one can’t have a dialogue back.

• If there’s something you want to say, and you don’t want to engage in a dialogue, go ahead and write and send a letter. “Whether they accept it or not, you’ve put it out in to the universe.”

• As patients begin to slip away, hearing is always there. This is where you can have that one-way dialogue – where your loved one isn’t going to say, “Oh, don’t go there.” You can tell them the things you’ve wanted to tell them.

• Do it in whatever way you can, to put those words and feelings out there. And if you’ve let things slip, don’t wait another day.

• Nothing is promised to us. Let a person know you love them. Or if you’ve had conflict, acknowledge those differences and say, “that’s no longer on the front burner for us.”

• It’s a great life lesson – let people you love know you love them, all the time.

“Some people are just afraid,” Lueckenhoff said. “And it all comes down to communication. Everything in life that I thought was so urgent – most of it was just trivial.”

According to a 2020 report from the AARP, about half of caregivers say someone else is working with them to coordinate care.

The following steps may be helpful in determining roles when that’s the case.

Developing a care plan

Sit down with the care recipient and any potential caregivers. Discuss what the care recipient needs and who is best able to address each area. Creating a care plan may be part of this step, but honest self-reflection should also take place at this point.

Areas to consider:

• Who has medical knowledge? Can they organize and be in charge of medical documents, appointments, paperwork?

• Who is good with financial matters? Are they able to focus on bills, reimbursements and tracking income?

• Does someone enjoy working with their hands and doing-task oriented work? Who enjoys shopping and preparing meals?

By discussing who is most equipped for or interested in the tasks needed to assist the care recipient, caregivers can be involved in ways that speak to their strengths.

Talk about time and money

Some care teams may find that the person best suited to handling medical information doesn’t have the flexibility to take the care recipient to doctor appointments. Is it possible that they are able to organize medications lists, medical bills and insurance statements so that this information is current but then rely on someone else to get a loved one to the appointment?

What if the person who can best track expenses and income lives out of state? How will they receive copies of the bills and track all income? Some of the best solutions may require creativity from the care team.

Being realistic about not only what each caregiver is good at but how much time, mental energy and financial assistance they can provide is important.

Don’t forget long-distance caregivers

While it’s easy to think of caregivers as those who are involved on a physical, day-to-day basis, don’t discount the value of a family friend, former co-worker or relative who lives at a distance.

• Could this person check in with a daily or weekly phone call?

• Could they organize transportation for doctors’ appointments and regularly scheduled appointments such as getting groceries?

• Maybe they are able to set up and monitor an online bill pay service, thus taking on a responsibility that doesn’t need a physical presence.

• Maybe they can work with the loved one to create a grocery list and then order the groceries online and have them delivered.

Finding unique ways to incorporate the help of someone from afar can give everyone on the team more room to focus on their role and their own personal responsibilities.

Caring with siblings – tips

The Family Caregiver Alliance suggests rethinking how old roles can be reimagined and offers these and other tips:

1. Accept siblings and parents for who they are, not who they could be.

2. Remember that each sibling and each parent has their own relationship to each other.

3. Determine what is personally needed from each sibling — and what the care recipient needs.

4. Check criticism. Is it that they’re doing things “wrong,” or is it that more support is needed?

5. Don’t use guilt and anger.

6. Seek professional mediation if needed.

7. Discuss parents’ estate plans with them, not with siblings.

8. If a sibling is taking advantage of a parent financially, contact an attorney.

Setting up support services

For many families, an aging parent may be the primary caretaker of another aging parent or relative. Even with additional assistance from friends and family, the daily work of caring for another person can wear on their health as well. It’s important to watch for signs of caregiver burnout.

As part of this effort to coordinate care, caregivers should look for local services that can come into the care recipient’s home and help with a variety of tasks. Supplemental service programs today can even offer much-needed breaks to a primary caregiver.

The Family and Medical Leave Act (FMLA) was established to help workers balance their jobs with leave time for things like having or adopting a baby, recovering from a major illness or caregiving for a family member with a serious health condition. It ensures the employee maintains their job, health insurance and financial security by guaranteeing up to 12 weeks of unpaid, job-protected leave to care for themselves or a spouse, son, daughter or parent with a serious health condition.

Am I FMLA eligible?

You are eligible if you meet these three criteria:

• You work for a covered employer. Generally, employers with more than 50 employees are covered employers.

• You have worked for your employer for at least 12 months. The months do not need to be consecutive. Breaks of more than seven years do not count in the 12 months.

• You have worked for your employer for at least 1,250 hours in the past 12 months.

As a caregiver, when may I use FMLA leave?

If you work for a covered employer and qualify for leave, you may take up to 12 weeks of unpaid FMLA leave in any 12-month period. You may use your time in a single block, smaller blocks, and on a part-time basis or for appointments (called intermittent leave). However, you must try to schedule appointments at a time that minimizes the disruption to your employer.

Conditions that quality for use of FMLA include if you, a spouse or parent has:

• A health condition that requires an overnight stay in the hospital or care facility

• A condition that incapacitates you or a loved one for more than three consecutive days and requires ongoing medical treatment

• A chronic condition that causes incapacitation or treatment by a health care provider at least twice per year

For whom may I provide care under FMLA?

Besides yourself, you may provide care for a spouse or parent under FMLA.

A spouse is defined or recognized in the state where the person was married and includes individuals in common-law marriages or same-sex marriage.

A parent includes biological, adoptive, step or foster father or mother, or any other person who acted in a parental role to the employee when the employee was a child. It does not include parents-in-law, unless that person served in a parental role to the employee.

An eligible employee is entitled to take FMLA leave to care for a person who provided such care to the employee when the employee was a child. In those cases, the employee may be entitled to take FMLA leave even if he or she also has a biological, step, foster or other parent, provided that the relationship existed between the employee and the individual when the employee met the FMLA’s definition of a “son or daughter.”

Do I get paid with FMLA?

FMLA leave is unpaid leave.

However, if you have sick time, vacation time, personal time, etc., saved up with your employer, you may use that leave time along with your FMLA leave so that you continue to get paid. To use such leave, you must follow your employer’s normal leave rules such as submitting a leave form or providing advance notice.

Even if you do not want to use your paid leave, your employer can require you to use it during your FMLA leave. For example, if you are out for one week recovering from surgery and you have two weeks of paid vacation saved up, your employer can require you to use one week of your vacation time for your FMLA leave.

When you use paid leave for an FMLA-covered reason, your leave time is still protected by the FMLA.

How am I protected under FMLA?

Job security: As long as you are able to return to work before you exhaust your FMLA leave, you must be restored to your original job or to an equivalent position with equivalent pay, benefits and other terms and conditions of employment.

Standing: Time off under the FMLA cannot be held against you in employment actions such as hiring, promotions or discipline.

Health insurance: It is your right to maintain your health benefits through your employer. However, you may be required to make premium payments.

How do I request FMLA leave?

You must provide your employer with appropriate notice:

• If you know of your need to take FMLA, you must give your employer a 30-day notice.

• If you learn of your need to use FMLA less than 30 days in advance, you must give your employer notice as soon as possible.

• When you need to take leave unexpectedly, you must inform your employer as soon as you can. You must follow your employer’s usual notice or call-in procedures unless you are unable to do so.

What do I do if FMLA was denied?

Request an inquiry to learn from your employer why your FMLA was denied.

If you have questions or you think that your rights under the FMLA may have been violated, you may contact the U.S. Department Of Labor’s Wage and Hour Division (WHD) at 1-866-487-9243. You will be directed to the WHD office nearest you for assistance.