Terminal Illness Checklist

If you have received a diagnosis of advanced stage cancer or another terminal illness, first, we are very sorry to hear that you are going through this.  Feelings of overwhelm, fear, panic and anger are all normal during this time.  It can also be a time of wanting to do something, yet not knowing what needs to be done.  Below is a guide to provide you with a clear list of action items to help ensure your financial life is in order.  Making sure these items are tended to can reduce the stress on you and everyone involved.

  1. Review your estate documents. Estate documents help you control what happens to your body, things, and – if applicable – children, if you are unable to. If you have estate documents in place. Read through them to make sure that everything still aligns with your wishes. If your estate documents were not professionally prepared or need updates, schedule a time to meet with an estate attorney. The estate documents that you should be sure to have in place include the following: last will and testament (“will”), healthcare power of attorney (POA), financial POA, and living will. Some of the most important items you’ll need to decide when creating or updating estate documents are who will serve as the executor of your will, the trustee of your trust(s), and the guardian of your children. When one’s assets are being distributed to heirs, emotions tend to run high and heirs’ desires may clash, so it’s important to choose the individuals or companies who will execute your wishes wisely to help avoid disputes among your loved ones.
  2. Review your account beneficiaries. Review who you have listed as beneficiaries on your retirement accounts (401(k)s, IRAs, Roth IRAs, annuities, etc.), life insurance policies, and bank accounts or brokerage accounts with a POD/TOD designation on them. These types of accounts will pass to heirs outside of your will. Make any beneficiary updates that are needed. For any accounts that it makes sense with your overall estate plan, add a POD designation to any bank accounts and a TOD designation to any non-IRA investment accounts.
  3. Review disability insurance benefits. If you are still able to work and feel well enough, that’s a great way to be productive and get your mind off things. However, there will likely be a day that you are not feeling well enough to work, so review any disability insurance benefits that may be available to you. This benefit may be available through employer coverage, a personal disability insurance policy, and in some cases, the Social Security Administration.
  4. Review health insurance coverage. Health insurance coverage for you and your dependents will become an important thing to consider. Hefty healthcare bills can negatively affect one’s financial situation, so take the time to review what doctors, facilities, medications, and treatments will be covered by your health insurance. If you have dependents that are on your health insurance policy, help them evaluate what their future health insurance coverage options will be, whether COVID, the Exchange, an employer, or another option. If you have been saving in an HSA during your career, this may be a time to consider using those funds.
  5. Consider estate tax. If your estate will be greater than the federal estate tax exemption, which in 2022 is $12.06 million and scheduled to drop to $6.2 million in 2026, then your estate will pay 40% tax on any amounts over the estate tax exemption. If your estate falls above that amount, you should consider ways to reduce your taxable estate. This may include a family or charitable gifting strategy. Talk with a financial planner and/or estate attorney about the best ways to reduce your taxable estate. Additionally, many states also have an estate or inheritance tax that you should be aware of.
  1. Have important conversations. This step is one that is easy to avoid but incredibly valuable. Many family wealth transfers fail because heirs have not been sufficiently informed and prepared. While discussions about end-of-life are never fun, they’re important to have with loved ones – whether you are terminally ill or not. It is important to share with your loved ones the deep, heartfelt things; don’t leave things unsaid. It is also important to share with them the practical things that will make their lives easier. Many families get torn apart in disputes over inheritances – especially if there are surprises in one’s estate documents. It will help your loved ones if you clearly communicate to them what your wishes are, financially and physically. It is also important to let the right people know where they can find important documents, valuables, passwords, or keys.
  2. Organize important documents. Organize and make sure the following items are available for whomever may need them: birth certificates, marriage certificate, divorce decree, Social Security card, estate documents, and similar items. It’s also helpful to have a complete record of your assets and debts and where they are held. Make sure that your spouse or executor is familiar with it and answer any questions that they have.
  3. Spend down HSA funds. If you have an HSA, it’s time to start using it – particularly if you don’t have a spouse. Once you pass away, the full HSA balance becomes taxable income for any non-spouse HSA beneficiary.


Other non-financial action items to consider:

  1. Consider how you would like to spend your time going forward and plan for that to happen. You may want to continue life as usual while you still can, or you may want to have new experiences while you can. Your top priority might be spending as much time as possible with loved ones; if so, communicate that to them and plan arrangements for it to happen.
  2. Make a list of contacts for your spouse, children, or a friend to reach out to with updates.
  3. Write letters to your loved ones to share with them your thoughts, advice, and hopes for them. I promise you; they will be so thankful that you did. If you are comfortable with it, you could also ask them to write a letter to you; this may give them the opportunity to share thoughts or feelings that they may not be able to express to you out loud. My father, while terminally ill, requested that his children do this, and while difficult, I’m incredibly thankful that he did.
  4. Write down and share any desires for your funeral and burial.
  5. If you are physically able and looking for productive ways to spend your time, organize your things. Sell items that you no longer want or need and donate where possible. It will make your space more relaxing. There are also companies that can be hired to help with this.

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