Once your loved one has received a terminal diagnosis, it is imperative that you talk to that person about his or her final wishes, finances, and most importantly, end-of-life care.  This should be done soon after the doctor’s diagnosis but give the patient time to think about what his or her thoughts are and the implications of the diagnosis.  The discussion should occur in a pleasant setting with perhaps one or two family members present.  You could do it after dinner or while enjoying a pleasant summer evening outdoors watching the sunset.  You could start the conversation by asking your family member if he or she has thought any more about the diagnosis and what their wishes are.
Some things to talk about are assuring them of how much you love them and will be there for them, arranging for transportation needs, in other words, giving up the car in a tactful way, disposing of assets and memorabilia, his or her desire of care to be given, and who he or she wishes to handle final matters including funeral arrangements.  Please be aware, this is a lot to discuss, especially for someone who is ill and trying to handle the emotional trauma of failing health.  It would probably be best to have several short discussions which are not as overwhelming.  You might want to reassure this person that you want the best for him or her and that they can talk to you about these things whenever they feel up to it.  One thing not to do is have a heated discussion telling Mom or Dad what they should do.  Remember, this is their life and their assets.  They should be allowed to make their choices, even if family members don’t agree.
When you talk about giving up the car, you should give them choices.  Perhaps there is a grandchild getting ready for college who could use it for transportation.  Another choice might be to donate it to a favorite charity, where your loved one feels he or she is doing some good.  Once again, it should be the charity of their choice.  Finally, the vehicle could be sold and the money used perhaps for a family activity or other event your loved one would enjoy.
As for disposition of assets and memorabilia, your loved one should be encouraged to make those decisions while he or she is still able.  Perhaps there is a wedding ring or other item that a grandchild would love.  If the grandchild is old enough to care for it, your loved one could give it to the child while he or she is still well enough to see the beneficiary enjoy it.
Regarding disposition of assets such as the family home and bank accounts, this should be discussed with an attorney.  Make sure you select one who has experience as an eldercare attorney and is familiar with both revocable and irrevocable trusts as well as other ways to protect the estate.  The attorney should also be able to counsel your family member regarding other documents such as end-of-life care.
Finally, you should discuss with your loved one what his or her desires are regarding care as their health fails. Choices should be made regarding dying at home vs. a nursing home, Hospice care, palliative care, organ donation, funeral arrangements, and treatments to keep him or her alive including CPR, ventilator use, tube feeding and intravenous fluids.  Your loved one should be allowed to choose the person he or she most trusts to carry out his or her wishes regarding these matters.  And remember, this person could be a family member, a friend, or someone else.  All these matters should be decided before seeing an attorney.  An excellent source of information regarding advance care planning is the website for the U.S. Department of Health and Human Services National Institute on Aging,  (https://www.nia.nih.gov/health/publication/advance-care-planning).
All of this sounds overwhelming and confusing, especially for your loved one.  Home Assist Senior Care has a medical social worker.  Why don’t you give us a call and we can arrange for her to talk with your loved one regarding these wishes and decisions?  We can also arrange to have a caregiver spend a few hours or more a day or week providing companion care and as the need arises, bathing, hygiene or other services to keep your loved one safe and happy when family members are not able to do such.  Our occupational therapist can also help by providing activities your family member can and will want to do.  Call us at (716) 648-2273.

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