Guide
Financial Guide
Phase 3: End of life - The transition out of caregiving
Written by Suzanne Boutilier

As end-of-life nears, more medical treatments, equipment, hospital stays, and medications may be required. This can mean added healthcare costs, though Medicare will cover most of them. It can also mean we spend more money on travel to the hospital or our parent’s home. And we may need to take more time off work if we still have a job. If that time isn’t covered by paid family leave, we’ll lose that income. Some of these care questions may be answered if our family member has an advance directive in place.

What is an Advance Directive?

An advance directive is a legal document that provides instructions on medical care and only goes into effect if the person is unable to communicate. It may include a living will and/or durable power of attorney for healthcare. It can provide instructions on forgoing life-extending care and instead providing palliative care—care that will keep them out of pain, but won’t treat their health condition(s).

As family caregivers, we should become familiar with our loved one’s advance directive as soon as we take on caregiving duties. If they don’t have one, they and we can work with an elder law attorney to draw one up for them.  The advance directive should lay out what kinds of treatment they want or don’t want in various health scenarios as they near the end of life.

Palliative care is usually delivered via Hospice. Medicare part A covers palliative/Hospice care if our loved one meets these three conditions:

  • Their hospice doctor and regular doctor (if they have one) certify that they’re terminally ill (with a life expectancy of 6 months or less).
  • They accept palliative care instead of care to treat their illness.
  • They sign a statement choosing hospice care instead of other Medicare-covered treatments for their terminal illness and related conditions.

Medicare-certified hospice care can usually be delivered at home, in a facility where they live, or in an inpatient hospice facility. The Hospice nurse will visit to ensure pain is being managed and advise us on what to expect in the coming days, weeks, or months.

What is a Death Certificate?

This is a legal document that proves someone’s death. It can be prepared by the hospital or Hospice, depending on where the death occurs. We’ll need copies of the death certificate to:

  • Arrange for burial or cremation
  • Claim any Medicaid, Social Security, or pension benefits
  • Access their financial accounts (if we’re not already their durable power of attorney)
  • Start the probate process of distributing their property according to their will
  • Notify creditors
  • Transfer non-probate assets like life insurance policies, retirement accounts, and payable on death (POD) or transfer on death (TOD) accounts
  • Transfer ownership of their house or a car

The cost of a certified death certificate can range from $5-$30. And we’ll need about 10 copies to deal with all of the legal details.

Funeral Costs

If a will or living will exists, it may include instructions for a funeral or cremation. The average costs for an all-inclusive funeral in the U.S. can run between $7,000 and $10,000, Cremation costs less than burial, as there’s no need for embalming, a casket, a hearse, or a burial plot. However, a simpler funeral can provide the same emotional healing with lower costs.

  • Consider a funeral without a viewing or embalming
  • Hold the ceremony at home or graveside
  • Choose a simple casket
  • Keep flower arrangements simple (doing them ourselves can be therapeutic)
  • Opt for a direct burial or cremation without a ceremony
  • Create a memorial page via social media or free obituary website, in place of a newspaper obituary

At RubyWell, we’re building tools to help family caregivers save, find, and earn money while providing care. Right now, you can access coupons for up to 80% of prescription prices with our prescription savings tool. And we’re currently building a comprehensive and easy-to-use MA benefits navigator, where you’ll be able to discover unused Medicare Advantage Supplemental Benefits. If you’d like to be among the first to hear about future products, join our waiting list

Continue reading:

Phase 4: Post-caregiving - Tying up financial affairs after death

Phase 5: Retirement Reset - Planning For Our Future Care

Review:

Introduction: What to Expect on the Financial Journey Through Family Caregiving

Phase 1: Oh! I’m a caregiver - The early days

Phase 2: In the trenches - The daily challenges of providing care

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Phase 4: Post-caregiving - Tying up financial affairs after death
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Written by Suzanne Boutilier
Suzanne Boutilier has been working and writing in the caregiving space since 2021. She also helps her sisters care for their aging father.
Reviewed by Elyse Dasko
Elyse Dasko is a leading communications strategist in age tech, caregiving and the longevity market.