Because You Asked: How Do We Prepare for Death?

Not really, though, because virtually NO ONE wants to ask or even THINK about that question!  But as fiduciary financial advisors (CFP®), we have a responsibility to ask that or similar questions of our clients normally around estate planning issues or concerns.

I first wrote about the subject of preparing for death over a year ago, but have recently had some experience with clients that have reminded me of the importance of it.  Given that this is Hospice and Palliative Care Month, I decided it was time to revisit this topic, as it relates to hospice services.

Unavoidable Experience:

One of the greatest, unexpected gifts I have received in my life was the opportunity to work in hospice for a couple of years.  My work was in an administrative capacity, but I absorbed so much from the interactions with our care teams about the process of death and dying that it radically changed my perceptions. The biggest change for me was coming to the realization that death is just another phase or final transition of our lives.  It will happen to all of us, and though we do not all get the choice (as in the case of sudden or accidental deaths), in many cases we get to decide how we embrace this change for ourselves and our loved ones.

The Goal of Hospice:

Once a patient has been referred and accepted to hospice with a terminal diagnosis, the goal of hospice is to provide comfort and reassurance for the patient and family and to ease the transition as much as possible.  It is not designed to treat the terminal illness, and in fact, all such treatments such as chemotherapy are stopped in order to qualify for hospice, unless needed for pain.

Hospice providers will often help the family and patient to openly talk about their impending death, and to share their thoughts and feelings with one another as they are working through it.  To share memories and regrets.  To ask for and receive forgiveness, when needed.  In essence to gain closure; to make their peace within themselves, their loved ones, and their God.  My belief is that this process is the most valuable service that hospice provides and that people who wait until the patient’s death is imminent, or just a few days prior to death to start hospice services never receive it.  Most people truly need this time to prepare themselves, if they have the option.

Angels in Disguise:

I came to feel that many of the hospice nurses and CNAs that I knew were what I would call “Angels in Disguise”.  They truly believed that it was a privilege to be with a patient and their family at the time of death, and relished the opportunity to provide medical and emotional comfort.  Many equated it with a spiritual experience and endeavored to help facilitate what they called a good or peaceful death.

More recently, the patients I have known who have passed while on hospice were able to be much more physically comfortable, especially related to pain control.  This in itself enabled them to pass so peacefully that in one case, the spouse who was holding their hand was unaware of their death until the nurse pronounced it.  I will add that I wish that these patients had started receiving hospice services earlier than they did, as services are available for up to six months prior to death, and I think the families could have used that time to prepare themselves.

I firmly believe that as friends and family, we need to be advocates for our loved ones who have terminal illnesses, and should be proactive in asking physicians about referrals to hospice much sooner than we do. If you have questions, you can also call a local hospice provider directly and they will provide information and walk you through the process.

If you would like to read more about how hospice works and the services it provides, you can go to this link: