Preparation at the End of Life

Despite our best efforts and hard work, cancer treatment sometimes stops working and a cure or long-term remission is no longer possible. This stage of cancer is called advanced, terminal, or end stage cancer. This article offers suggestions for helping you find peace and meaning as you approach the end of life.

Grieving your losses

Learning that your cancer has become terminal can bring about intense feelings of anger, fear, grief, regret, and other strong emotions. It is normal to grieve and mourn the days you will not have, the loved ones you will be leaving behind, and the loss of your abilities and your future. Talking about your feelings and concerns with family, friends, and caregivers can help bring you comfort. Getting your affairs in order, completing unfinished business, and reviewing your life are important steps in accepting death and finding peace.

Getting your affairs in order

For many people, worrying about what will happen to their surviving family members is one of the most difficult aspects of dying. Planning ahead to settle legal, financial, and business affairs can also free you and your family to concentrate on the emotional aspects of completing your life.

Settling your affairs may include locating and organizing important legal and financial documents, such as your will, marriage and birth certificates, social security card, insurance policies, bank statements, and investment summaries. If you have complicated finances, or are concerned about leaving your family with high medical bills or debts, consider talking to a financial advisor or social worker. Financial professionals cannot eliminate bills or debts, but they can help you sort out your finances and lessen the stress of financial worries for you and your family. Some people also find it helpful to plan some aspects of their own funeral. This can be done with a set of written instructions, or by talking to your family or close friends about your wishes.

An important end-of-life step for many is to create, or perhaps make changes to, an advance directive. An advance directive is a legally binding set of instructions that explains the kind of medical treatment you want and do not want if you become unable to make those decisions for yourself. Advance directives provide a way for you to communicate your wishes to your family, friends, and health-care professionals ahead of time to avoid confusion later on. Although an advance directive can be oral (spoken) in most states, an advance directive is less likely to be challenged if it is in writing. It is a good idea to discuss your advanced directive with your family to clarify your decisions and the values underlying them. For more information on advance directives, see the Cancer.Net Feature: Understanding Advance Directives.

Completing unfinished business

As you approach the end of your life, there may be certain things you wish to accomplish in the time you have left. These tasks can help bring a sense of meaning and completion to your life, and may range from fulfilling a lifelong dream to more simple experiences, such as rereading a favorite book or spending time with your grandchildren.

Finding peace in important relationships and saying the things that matter most are also significant aspects of life completion. There may be conflicts you wish to resolve or apologies you want to make. You may want to say goodbye to special people and tell family members how much you love them. If you are able, you may want to accomplish these tasks in person, or you may want to pass on a message in writing, by telephone, or through a family member. It may be possible for you to travel to visit special people, or for them to travel to you. Keep in mind that, despite your best efforts and perhaps elaborate arrangements, people may not respond the way you want them to. Some people may not feel comfortable visiting you or may be afraid they will say the wrong thing.You may be comforted by knowing that you have done all you can to heal a troubled relationship.

Reviewing your life

It is only natural to want to leave a legacy: evidence that your life mattered and that you made a difference in the world. Take time to reflect on and celebrate the events in your life—the things you have accomplished, the people you have loved, and the individuals and events that have shaped you. Talk to your loved ones about the times you have spent together and the memories and events you have shared. You and your loved ones will not only be honoring memories of the life you shared together, but also creating new memories for your loved ones to cherish. As you review your life, you may want to record your memories. You can write down your memories, record them on tape or video, or ask someone to write for you as you talk. Talking about or recording your wishes and dreams for loved ones in the future can help ease regrets about having to leave them, and help them feel connected to you at important times throughout their lives. For young children, it may be enormously helpful to leave videos and albums that remind them of your love and connection. Creating opportunities to celebrate your life, even if it means "making up" a reason to have a party, will also offer an opportunity to record happy moments family and friends will cherish after you are gone. Read more about Leaving a Legacy.

Religion and spirituality

For some, organized religion is a central part of life and the support of faith and clergy members are an important source of comfort at the end of life. For others, spiritual comfort may lie in a sense of connection to nature or people. What matters is finding such comfort, completion, and peace, which will sustain hope and meaning.

Additional resources

Lance Armstrong Foundation: What Hospice Care Means for Survivors

Lance Armstrong Foundation: Planning Your Medical Future

Lance Armstrong Foundation: Finding a Guardian For Your Children

Lance Armstrong Foundation: Creating a Will

Lance Armstrong Foundation: Funeral and Memorial Service Pre-Planning

National Cancer Institute: Advanced Cancer: Living Each Day and Cancer Facts: Advance Directives

National Coalition for Cancer Survivorship: End-of-Life Issues

American College of Physicians: Home Care Guide for Advanced Cancer—Caregiving

AARP: Grief and Loss

More Information

End-of-Life Care

Grief and Bereavement

Financial Support Resources