Planning for Advanced Cancer

Planning for Your Family

Careful planning reduces the financial, legal, and emotional burdens your family will face after you're gone. For many people, it's hard bringing up these subjects. But talking about them now can avoid problems later.

Complete Advance Directives

If you have not done so already, it's important to fill out advance directives. These are legal papers that tell your loved ones and doctors what to do for you if you can't tell them yourself. Making these decisions now keeps you in control of how you want to be treated, and who you choose to be in charge of your care. By filling out advance directives, you're making your wishes known for all to follow. For more details, see Advance Directives.

Clear Up Insurance Issues

Contact your health insurance company if you decide to try a new treatment or go into hospice. Most insurance plans cover hospice. They may also cover brief home visits from a nurse or a home health aide several times a week. But it's wise to ask in advance. This may prevent payment problems later. For more details about insurance, see Managing Costs and Medical Information.

Put Your Affairs in Order

You can help your family by organizing records, insurance policies, documents, and instructions. You may want to call a lawyer or financial planner to make sure you have taken all the right steps in doing these things. Your bank can answer questions about how to change accounts and credit cards. Other steps to take may be:

• Make a list of where your family can find important papers.
• Keep your papers in a fireproof box or with a lawyer.
• If your papers are in a safety deposit box, make sure that a family member or friend has access to the box.
• Although original documents are needed for legal purposes, give family members photocopies.

There are many different types of papers your family will need. You may not need all of the items on this list, but here is a guide. Write down contact information and what needs to be done for the following:

• Banks, savings, and loans
• Safety deposit box information
• Life insurance company
• Health insurance company
• Homeowners’ or renters’ insurance company
• Attorneys
• Accountant
• Pension or retirement plans
• Investment companies
• Credit card companies
• Employer

Making Funeral Arrangements

You may want to help your family plan a funeral or memorial service that has meaning to you. Although doing so may seem hard, planning this ahead of time will help your loved ones after your death. It will ease the burden of their having to make these choices during a time of strong emotions and stress. Some people plan services that are celebrations, while others prefer something more subdued. Talk with your family about the type of service you would like.

Looking for Meaning

Many people who have advanced cancer look more deeply for meaning in their lives. They often want to:

• Understand their purpose and their legacy
• Examine the things they have gone through in life
• Look for a sense of peace or a bond with others
• Seek to forgive themselves or others for past actions
• Look for answers and strength through religion or spirituality

Being spiritual can mean different things to different people. People have different ideas about life after death, miracles, and other religious beliefs. This is a very personal issue. And everyone has their own feelings about the meaning of life. Some people find meaning through religion or looking to a higher power. Some people find it by teaching or through volunteer work. Others find it in different ways, such as being in nature or through meditation.

Having advanced cancer may cause you to rethink what you believe. It may bring up anger, doubt, or other strong emotions. You may think about God or wonder about an afterlife.  This can bring a sense of peace and acceptance for some. For others, it can raise a lot of questions. Sometimes people feel they are being punished by God or have a loss of faith.  For some, once they learn of their advanced cancer, the beliefs they have may affect their treatment choices or how anxious they feel about death.

Learning you have advanced cancer may change your values. The things you own and your daily duties may seem less important. You may decide to spend more time with loved ones or helping others. You may feel like you’re learning what things are most important to you and who in your life you want to be with the most.

You may have already given a lot of thought to these issues. Still, you might find comfort in exploring more deeply what is meaningful to you. You could do this with someone close to you, a member of your faith community, or a mental health professional.

Or you may just want to take time for yourself to reflect on your experiences and relationships. Being in nature or spending time in places that bring a sense of calm and peace can help you reflect. Many people find that prayer, meditation, writing in a journal, or talking with others has helped them cope and explore their lives.

Celebrating Your Life

Having advanced cancer often gives patients and family members a chance to look back on life and all they have done. They rethink the things that are important to them. Some like to:

• Look at the different roles they have played throughout life
• Think about what an event or certain time of life meant then, and what it means now 
• Gather things that have meaning to them to give to their loved ones
• Share memories or create projects with people who are close to them

Doing these things is often called "making a legacy.”  Your legacy can be anything you want.  Some examples of ways people have looked back on their lives include:

• Making a video or recording of special memories
• Reviewing or arranging family photo albums or creating ones online
• Charting or writing down your family’s history or family tree
• Keeping a daily journal of your feelings and experiences
• Making a scrapbook
• Writing letters to loved ones and children
• Reading or writing poetry
• Creating art or jewelry
• Giving meaningful objects or mementos to loved ones
• Writing down or recording funny or meaningful stories from your past
• Planting flowers with people close to you
• Making a recording of favorite songs
• Gathering favorite recipes into a cookbook

You can do whatever you want that brings joy and meaning to you. Some people with cancer also make what is called an "ethical will." It's not a legal paper. It's something you write yourself to share with your loved ones. Many ethical wills contain the person's thoughts on his or her values, memories, and hopes. They may also talk about the lessons learned in life or other things that are meaningful. It can say anything you want, in any way you want.