Preparing for the End of Life
- Katharine Esty
- Aug 31
- 4 min read
Why Planning Ahead Matters — and How to Start the Conversation
This story was recently passed around my retirement community: a son asked his dying father, “Do you wish to be buried or to be cremated?” The father pondered the question for several minutes and then finally replied, “Surprise me.”
While it’s a funny response, it isn’t very helpful. Many of us, of course, lack clarity about what we will want for ourselves at the very end of our lives. However, taking the time to decide and making our wishes known to our families is a huge gift to them.
About five years ago, as I was recovering from surgery, I shared a room in the hospital with a woman I will call Bev. She was 95 and very ill. I overheard Bev’s doctor tell her that she was dying and that she had only a short time to live. The doctor gently told her to put her affairs in order when she went home and enjoy her remaining days with her six daughters. Bev replied, “I am ready to go, and I am at peace.”
Over the next two days, each of Bev’s daughters visited her one by one. The first daughter told her mother about a supplement that her mother must try. The second daughter insisted that Bev follow a special vegetarian diet when she returned home. Another said she was trying to get her Mom into a new clinical trial. The next suggested a new drug she had heard about, and the last daughter told Bev about a new exercise regimen. Not one of them responded to the fact that their mother was dying. None of them asked her about her wishes for her last days now that the end was near. I was horrified. I wanted to shout across the curtain that separated us, “No more fixes… Just be with her.”
As we face the dying days of a family member, many of us, like Bev’s daughters, direct our energy towards battling the illness, viewing it as a medical problem to be solved. Too often, this focus delays preparing for our inevitable loss, and we forget that death is not a failure.
It is not easy because talking about death and dying is almost taboo in our culture. But I urge you not to avoid talking about it. While many of us are not afraid of dying, many of us are fearful about our last days. Taking some basic steps now can ease the burden for you and your loved ones. If you have aging parents, I recommend discussing care options and end-of-life planning with them before a crisis occurs.
I first became aware of different approaches to the end of life after reading Atul Gawande’s book, Being Mortal. As my husband John was dying, I gave each of our four sons a copy of the book. To my surprise, they read most of it and found it helpful. It helped me understand how to support John during his final days. We wanted his last days to be filled with quality time, surrounded by the people he knew and loved. Our sons and daughters-in-law visited regularly during his last weeks, and close friends also spent time with him. Some of them read to him, while others sang to him.
The end goes better when some basic preparations have been made in advance.
Make a will.
Too many of us put off creating a will, even though we know it’s essential. According to a Caring.com 2025 survey, a whopping 76% of Americans die without having made a will. If you can afford it, consider hiring a lawyer to assist you with this process. Alternatively, you can find templates for standard wills online and complete one yourself. If you don’t have a will, your assets will be distributed according to the laws of your state, which may not be the same as your preferences. This could result in your assets being frozen, causing delays and other negative consequences for you and your family.
Select a healthcare proxy, a power of attorney, and an executor.
A health care proxy is a person designated to make medical decisions on your behalf if you are no longer able to do so. Similarly, a power of attorney can make decisions about health, as well as manage legal and financial matters. An executor is responsible for ensuring that the wishes outlined in your will are carried out after your passing. We often choose younger family members or trusted friends for these roles, and this selection is usually done when creating your will.
Share with those closest to you your wishes about some key end-of-life questions.
What kind of care do you want for your last days? At home? At the hospital? Palliative? Hospice?
What are your wishes in terms of your body? Your ashes?
Do you want a burial or cremation?
Do you want a funeral, a memorial service, or another kind of event to mark your passing?
Do you have specific speakers, music, or readings that you’d like to be included?
You may have very detailed thoughts about some of these questions and none on others. However, do communicate to your loved ones any preferences that really matter to you.
For example, I have made some decisions regarding my service. I wrote an email to my sons outlining my preferences for the location, who I would like to lead the service, and my desire for each of them to say a few words. I believe some of you might find it useful to use a planner like The Ultimate End-of-Life Planning Guide by Nicole Leap, which came out in 2025.
There is always uncertainty about our final days. With some basic planning and ongoing communication among your family and friends, this last stage can be a time of love and great meaning for the dying and those gathered. It can be a good death.
#aging #psychology #deathanddying #relationships #family #funerals #estateplanning #retirement #lastwillandtestament
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