Contact Hospice of the Shenandoah

End of Life Planning

We offer this checklist as one way to begin the planning process. Be sure to include important decision makers as you work through the list. Let them clearly know your wishes and how to access your documents.

Your Story

  1. What is the story of your life? Who might want or need to know it? Can you write or audiotape or video tape or draw your story? Do you have photos, letters, other documents or records that are important to your story?
  2. Genealogical matters - do you have a family history or family tree?
  3. Community and church - Are there important records or connections outside your immediate control?
  4. Interests, accomplishments and hobbies?

Your Estate

Legal Matters

  1. Do you have a will? Where is it?
  2. Are you a trustee, guardian or committee?
  3. Are you responsible (legally or otherwise) for other persons or property?
  4. Name of the Executor of your will
  5. Name of your Financial Power of Attorney
  6. Name of your Medical Power of Attorney (5 and 6 are not the same!)
  7. Name of your Lawyer
  8. Name of your Estate and/or Financial planner

Insurance

Locate and identify policies and specific contact information

  1. Life insurance
  2. Homeowner or Renters insurance
  3. Medical insurance
  4. Accidental death insurance
  5. Business insurance
  6. Automobile insurance
  7. Disability
  8. Funeral policy
  9. Other

Taxes

Locate and identify previously filed tax returns and documents

  1. Personal income tax
  2. Property taxes
  3. Business and other taxes
  4. Other

Finances

Locate and identify specific account numbers, institutions, account passwords and access codes, etc.

  1. Credit cards
  2. Bank and Credit Union accounts (savings, checking, money market, other)
  3. Loans (Auto, personal etc)
  4. Stocks, Bonds, Investments, Certificates of Deposit
  5. Annuities
  6. Debts owed you
  7. Debts you owe
  8. Investment manager or Financial advisor
  9. Brokers
  10. Banker
  11. Pension plan, Retirement benefits
  12. Safety Deposit box
  13. Other

Documents and Certificates

Locate and identify.

  1. Birth certificate
  2. Wills that affect your property and other interests
  3. Marriage certificates
  4. Social Security
  5. Deeds and leases
  6. Homeowners Association bylaws
  7. Notes and security agreements
  8. Mortgage(s)
  9. Military discharge papers
  10. Financial instruments (See Finances above)
  11. Vehicle and personal property titles

Personal Information

Organizations, Associations and Memberships

Name, certificates, identification numbers, other documents that may be important

  1. Civic and Fraternal
  2. Military/Veterans
  3. Business
  4. College/School
  5. Clubs
  6. Union
  7. Boards
  8. Church
  9. Other

Utilities and Maintenance

Who is responsible for these?

  1. Electricity
  2. Gas
  3. Water
  4. Trash
  5. Phone
  6. Internet (access codes, passwords)
  7. Cable TV
  8. Auto club
  9. Lawn and home maintenance
  10. Other

Medical Information

  1. Primary physician
  2. Physician specialists
  3. Dentist
  4. Pharmacy
  5. Hospital/Health clinic
  6. Living will (where)
  7. DNR/DNI orders (where)
  8. Home Health Agency/Hospice Agency
  9. Other

Employment Information

  1. Employer
  2. Supervisor
  3. Date started, stopped
  4. Pension plan
  5. Other

Information Needed After Death

Surviving relatives and important people

Contact information, phone numbers, addresses

  1. Father
  2. Mother
  3. Husband
  4. Wife
  5. Sons
  6. Daughters
  7. Brothers
  8. Sisters
  9. Grandchildren
  10. Great-grandchildren
  11. Friends and important others

Funeral

  1. Funeral home
  2. Casket, vault, clothing, blanket or robe
  3. Cemetery or other location
  4. Specific instructions for body (cremation, embalming, etc)
  5. Minister
  6. Church or memorial service
  7. Graveside service
  8. Music (special selections; instruments, singer)
  9. Readings and other elements of service
  10. Active Pallbearers
  11. Honorary pallbearers
  12. Flowers
  13. Memorial donations
  14. Obituary
  15. Memorial marker
  16. Veteran (war, unit, service number)

Vital Statistics

Information required for death certificate in Virginia. Get at least 10 sealed copies: needed for burial, insurance, and all government matters.

  1. Hospital (if any) of death
  2. County/city/town of death
  3. Street address of death
  4. Legal name of decedent e. Residence (non-resident give city and state)
  5. Place of death
  6. Date of death
  7. Age, Sex of decedent
  8. Name of decedent's father
  9. Maiden name of decedent's mother
  10. Citizen of what country
  11. Race/Country of origin of decedent
  12. Education (highest grade completed)
  13. Social Security number for Decedent; Spouse; dependent children
  14. Birthplace
  15. Usual or last occupation; Kind of industry
  16. Marital status (name of spouse)
  17. Name of Informant (person supplying information)