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Life After Cancer A Roadmap for Cancer Survivors

Planning for Your Future by Getting Your Affairs in Order
Adapted from Everyone's Guide to Supportive Cancer Care by E. and I. Rosenbaum
Ernest H. Rosenbaum, MD, Alexandra Andrews and Isadora Rosenbaum, MA

How You Can Help Your Survivors

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Whether you are healthy, just growing old or nearing the end of your life, it is a wise move and a gift of love to your family and friends to make arrangements for end-of-life care before you are either gravely ill or dying.

Your Legacy of Love for your family and friends can, with careful thought and compassion, be one of clear decisions and planned social and financial arrangements'a house swept clean of personal, financial and business cobwebs. By sorting out your affairs now, you can spare your survivors an inheritance of scattered papers and countless confusing details to be waded through. Instead, you can bequeath to them the gifts of clear direction, rich memories and unique insights.

Life is full of unplanned events. Perhaps the most challenging of these events to cope with is the death of a loved one. It's been estimated that 85-90 percent of families are not prepared when a relative dies. Important documents need to be located, funeral arrangements need to be made and vital matters need to be attended to. The following suggestions can be helpful.

It's important to realize that death is actually a shared experience. Although each of us must face our own death, our survivors are also affected and suffer. They are left to cope with both the emotional adjustment of losing a loved one and the responsibility of dealing with someone else's affairs.

How You Can Help Your Survivors
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Many of the decisions that must be carried out by your survivors typically occur at a time of great stress. They often have to come up with answers to troubling questions'such as what last-minute medical treatments to accept or reject on your behalf, whom to notify if you die, what burial arrangements to make, how to pay tribute to your life, how to settle liabilities and disperse assets, and what memories to embrace in order to best remember you.

By taking time and care now to attend to each of these areas of importance, you'll be providing benefits to yourself and those you love. In the short term, you'll reap the benefit of peace of mind, which comes from organization and control of your affairs, and in the long term, you'll know that what will be done is what you would have wanted.

Before considering the areas listed below, first plan where you are going to store this information file so that those who will need it will know where to find it easily. Then be sure to tell those who need to know the location of your records and safety deposit box and key.

Advance Directives
By completing a Durable Power of Attorney for Health Care form or a Natural Death Act Declaration, you are providing both your family and your health care and hospital team with guidance about your medical decisions. Forms are available at any hospital. Here are some of the treatments you might choose (or reject) in a Durable Power of Attorney for Health Care or a Natural Death Act Declaration.
CPR: Chest compressions, electric shock to keep your heart beating and drug supportive therapy.
Mechanical breathing (respirator, ventilator).
Feeding and hydration through a tube in your veins, nose or stomach.
Kidney dialysis, chemotherapy or radiotherapy, pain medications, or the use of antibiotics.
Painful diagnostic tests - should they be performed?
I do not want efforts made to prolong my life, and I do not want life-sustaining treatments to be provided or continued.

Be sure to include the name, address and phone number of your primary care doctor, any specialists, family members and your executor or trustee of your estate to have this medical information in their files. Have the advanced directive notarized or signed by two witnesses.

Your advance directive should be as clear as possible and kept available. In an emergency situation, there is often confusion and action is often needed immediately. Advance directives maybe difficult to interpret and can prevent your true intent from being carried out. A new directive form has been developed that will clearly communicate your choices for end-of-life care. It is called a Physician Orders for Life-Sustaining Treatment (POLST) form and can be found at

Legal Will
Preparing a legal will is one of the most important responsibilities you have. Make this a priority. Get in touch with your attorney. Be sure to review your will periodically to keep your information up to date. If you divorce, separate, or remarry, or if the status of your named heirs changes, be sure to revise your will appropriately.

Be prepared to include information about an executor (the person you name to carry out the terms of your will), your family and children, anyone you wish to disinherit, your assets, tax implications, gifts, trusts, revocable living trust, life insurance and charitable contributions.

Persons to notify
Include the names, addresses and phone numbers of doctors, attorneys, employers, relatives, friends, business associates, the executor or trustee of your estate, religious and social organizations.

Arrangements for your body
It is important to make decisions regarding organ donations and burial.

You can help your family by providing information about your place of birth, career background, education, special achievements, military service, involvement with organizations, hobbies and memorial contribution preferences.

Memorial service and funeral instructions
Your clergy can help provide guidelines regarding mourning or burial rituals. Notify a family member or friend regarding this information.

Benefit information
List benefits from life insurance, pension and profit-sharing plans, including Keogh plans, IRAs, Social Security, Medicare, supplemental medical insurance, veterans' benefits or workers' compensation benefits.

Assets and liabilities
Include information about bank and savings assets, loans and first or second notes.

Insurance information
Provide the documentation for each insurance policy as well as contact names, addresses and phone numbers.

Home and personal property inventory
A household inventory is a practical way of listing your belongings, identifying each item, specifying its location, estimating its value and naming the heir to whom you're giving it.
Computer Accounts and Email Information
List computer passwords including email accounts and email passwords.

Your personal or ethical will
This is a rare opportunity to take the time to express your innermost thoughts and life philosophy for your family and friends. You might also want to write a personal note or a rich family history for your loved ones or specific personal messages to each of them. You might want to record your thoughts on audiotape, videotape or DVD. Include any diaries, pictures or personal stories you'd like to pass on.

The goal is to live and die with dignity, minimal suffering, and a feeling of deserved honor, respect, and esteem.

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