Professional Documents
Culture Documents
Death and Dying Workbook
Death and Dying Workbook
Current Residence
______________________________________________________________________________
Street
Apt. #
______________________________________________________________________________
City/Town
State
Zip
________________________________________________________________________
Name
Type of Animal
________________________________________________________________________
Name
Type of Animal
Education
High school: _________________________________________ Graduated: ________________
College: ____________________________________________ Graduated: ________________
College: ____________________________________________ Graduated: ________________
Degree(s): _____________________________________________________________________
Organization Memberships: _______________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Hobbies and Interests: ___________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Some of my favorite things in life are:_______________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
FINANCIAL DATA
I.
Bank Accounts
__________________________________
Institution
__________________________________
Institution
II.
III.
Loans
__________________________________
Institution
__________________________________
Institution
__________________________________
Institution
__________________________________
Institution
__________________________________
Institution
IV.
Titles (List all vehicles for which you possess the title): _________________________________
______________________________________________________________________________
______________________________________________________________________________
Deeds (List all property for which you possess the deed):________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
V.
Insurance Policies
Insurance Companies (List each company and policy number and the corresponding home,
automobile, or other property:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
VI.
Burial Plot
Before writing a will, there are seven elements that must be present:
You must be of legal age to make a will, which in Maine is 18.
You must be of sound mind.
You must state your intent that this will is your final word regarding your
property.
You must be able to sign the will voluntarily and in a valid way.
You should have the will written and witnessed.
Your will should follow state standards for formal wills.
Your will should have a statement at the end that says that this is your will, with
your signature, the date, and the witness signature.
II.
Types of Wills
There are several types of wills. You need to identify which will best suits your situation:
Typed, witnessed wills (highly suggested, discussed further in this Guide);
Holographic (oral) wills: not recognized in all states;
Handwritten, non-witnessed wills: not recognized in Maine;
Soldiers and seamens wills: available in Maine;
Statutory wills: available in Maine.
III.
There are several types of legal services to help you prepare your will. You need to identify
which best suits you:
Group legal service: plans available to members of certain organizations (like
AARP, the military, or a union);
Legal clinics: a low-cost alternative that is primarily done through legal assistants
under a lawyers guidance;
Private lawyer: suggested if you own your own business, your estate exceeds $1
million, or if you anticipate any problems.
IV.
Funeral expenses and payments of debts: Remember, your debts dont die with
you! This is where you place pertinent information regarding how your funeral
expenses and other debts will be paid through your estate. This is also where you
can forgive any debts someone owes you.
Gifts of personal property: This is where you state how you would like your
material possessions divided. It is easiest to leave your property to people in
V.
broad but specific categories like furniture. However, if you want to leave
specific items such a Persian rug or an antique diamond ring, then this is where
you would clearly state who should receive it.
Gifts of real estate: This is where you state your division of real estate.
Residuary clause: This is a crucial part of your will, which will cover all assets
not specifically disposed of by the will. This clause distributes assets that you
might not have anticipated owning.
Testamentary trusts: This clause directs funds from your estate into a trust you
had previously established. (See Section V for more information on trusts)
Naming a Guardian (or Conservator): If a guardian is needed for any child of
mine (under 18 years of age), then this is where you would nominate the person to
serve as Guardian of that child.
Naming an Executor (or Personal Representative): This is where you would name
a person to be your Executor, who will take charge of my personal property after
you die.
Testamentary Trusts
A trust is for anyone who wants to make sure his or her assets are protected and managed
according to his or her specific wishes.
A trust is basically a legal relationship in which one person (trustee) holds property for the
benefit of another person (beneficiary). The property can be real estate, stocks, bonds,
personal possessions, automobiles, etc.
A testamentary trust is a trust set up to take affect at your death. Now, the property doesnt
physically change hands, but legally, upon your death, the property becomes controlled by the
trustee.
Trusts can be revocable or not, depending on how they are established. They can be simple or
complex, depending on the wishes of the person who established the trust (grantor). There are
different restrictions the grantor can place on the trust to ensure that the assets are spent
according to the wishes of the grantor. There are many different avenues to set up trusts.
Trusts can be used for many different purposes, but the most common being trusts set-up for
children of the deceased for educational purposes. There are many philosophies regarding the
necessity of trusts, so this is something that you will have to decide on yourself.
YOUR HEALTH
I.
I name the following physician or health care provider to provide my medical care, in
consultation with my Agent (named in Part II).
Name of doctor or health care provider:______________________________________________
Address:______________________________________________________________________
Phone: (
II.
)____________________________ Fax: (
)__________________________
Naming an Agent
I have assigned the following person as my agent to make health care decisions for me, in the
event that I can no longer make decisions for myself.
Name:________________________________________________________________________
Title or Relationship:____________________________________________________________
Address:______________________________________________________________________
Home Phone: (
)_______________________
)______________________
When my primary doctor or judge decides that I am not able to make my own
health care decisions.
Right away, but this does not mean I have given up my right to make up my own
decisions if I am still aware.
III.
I have made the following choices about my wishes regarding being kept alive: (Choose one)
I have checked below my choice about the tube feeding or having water and nutrition fed into
my body through an IV or tube: (Choose one)
Artificial nutrition and hydration must be given, not given, or stopped based on
the choice I made about keeping me alive.
Artificial nutrition and hydration must be given regardless of my condition and
regardless of the choice I made above about keeping me alive.
I have made the following choices about pain relief: (Choose one)
I want treatment for relief of pain or discomfort to be given at all times, even if it
shortens the time until my death or makes me drowsy, unconscious, or unable to
do other things.
I do NOT want pain relief medications if it shortens the time until my death or
makes me drowsy, unconscious, or unable to do other things.
IV.
I have made the following decision regarding autopsy for diagnostic and research purposes:
(Choose one)
I have made the following decision about organ donation: (Choose one)
I wish to donate my organs, tissues, or parts for transplant or therapy for another
person, to be chosen based on generally accepted health care standards
I give any needed organs, tissues, or parts, OR
I give the following organs, tissues, or parts only:
________________________________________
I wish to donate all my organs, tissues, or parts for research and education.
I give any needed organs, tissues, or parts, OR
I give the following organs, tissues, or parts only:
________________________________________
My preference for organ donation is to give my organs to the following
hospital, medical school, or doctor:
Name_______________________________________________________
Address_____________________________________________________
POSTMORTEM
I.
People to Notify
Personal Physician:______________________________________________________________
Funeral Director:________________________________________________________________
Medical Examiner:______________________________________________________________
Family and Friends:_____________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Address book is located:__________________________________________________________
Call 911 if death was expected: Yes
No
Funeral home_____________________________
Family member___________________________
Friend___________________________________
Funeral Committee_________________________
Phone: (
Phone: (
Phone: (
Phone: (
)___________
)___________
)___________
)___________
II.
Burial Options
Burial
I prefer:
Embalming
Viewing
Visitation
Cremation
Yes No
Yes No
Yes No
Burial at sea
Memorial service
Graveside service
Funeral service
Pine casket
Willow casket
Metal casket
Other casket
Yes No
Yes No
Yes No
Cardboard casket
Papier Mache casket
Fiberglass casket
Shroud
Yes No
Prearrangements:
Yes No
Yes No
Disposition of cremains:
Scatter (where)_____________________________________________________
Burial (where)______________________________________________________
Urn preference:
Plant
Statue
Bench
Birdbath
Natural stone
Yes No
Other
MEMORIAL SERVICES
Here is some basic information about the most common types of memorial services.
Viewing This is an opportunity for family and friends to view your body or to sit with you
after you've died. A viewing is commonly held in a small room of a funeral home or
mortuary, but you are free to choose another place -- for example, your home, a
community hall, or a church.
Wake Traditionally, a wake is a gathering to celebrate and remember the life of the person
who has died. Often characterized by both sadness and gaiety, this gathering can be an
important part of the grieving process, allowing family and friends the opportunity to
come together and comfort each other. A wake is often held at a family home or a
mortuary that offers wake services.
Funeral A funeral is a traditional memorial ceremony, usually held in a funeral home or a
church. The body is often present, in either an open or closed casket. Beyond that, there
are no absolutes or requirements about what constitutes a funeral. If the deceased person
was religious, the funeral often includes a brief mass, blessing, or prayer service.
Veterans may choose a military funeral, and members of many organizations (such as
fraternal or 12-step groups) can choose a service that reflects the values of the
organization.
Memorial ceremony A memorial ceremony is a less formal ceremony held to remember
the life of someone who has died. It often takes place some time after the burial or
cremation, so the body is not usually present. Memorial ceremonies may be held
anywhere -- for example, a mortuary, religious building, home, outdoors, or even a
favorite restaurant.
Memorial ceremonies are more often the choice of those who wish to have an economic,
simple after-death commemoration. While funeral directors, grief counselors, or clergy
members may be involved in memorial ceremonies, they are not necessarily the people to
consult for objective advice. Many will advocate that traditional funerals -- often more
costly and less-personalized -- are most effective in helping survivors through the
mourning process. The truth is that most survivors take the greatest comfort from a
ceremony that reflects the wishes and personality of the deceased person.
I want the following type(s) of memorial service(s): Circle one: Public Private
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
My preference for the location of the service is: _________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
I would like the following people invited: ______________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Yes
No
________________________________________________________________________
________________________________________________________________________
OBITUARY WORKSHEET
Full Name_____________________________________________________________________
Announcement
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Biographical Information
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Schedule Ceremonies and/or Gathering of Remembrance
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Survivor Information
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Listing of Newspapers for Placement
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
FINAL FAREWELL
When we experience loss we often regret not having expressed something to our loved ones.
This concluding section is simply an encouragement for you to write letters to your loved ones
that can be shared after you have passed on. This is our final gift to all those in our life that have
made it what it is. We strongly encourage you to review this notebook each year, adding letters
to it or replacing ones that no longer accurately express what you wish to say.
This section needn't be limited to just letter writing. Feel free to be creative, placing photos,
newspaper clips, poems, cartoons; whatever you wish to share as a final statement and/or
goodbye. This notebook can be a strong piece of history that is passed on for generations. Let it
be infused with your personality, a statement of your life and all that you wish for people to
remember. Let it be a gift to your progeny. Fill it with your memories.
This section is also an opportunity to express things other than gratitude. It may be a place
where, for the first time in your life, you are able to say what you have always wanted to say
without filters. You have done a lot of work in life and in preparation for your own passing. This
is the place to complete that work with strength and conviction.
Hospice: A facility or program designed to provide a caring environment for supplying the
physical and emotional needs of the terminally ill.
Irrevocable Trust: A trust that cannot be altered after it has been executed.
Living Trust: A trust established while you are still alive and can be dissolved or changed
before you die.
Living Will (see Advance Directive)
Medical Directive (see Advance Directive)
Mental Health Directive: This document allows you to choose what treatment you want if you
become very mentally ill and are unable to make health care decisions.
Notary Public: A public officer who attests or certifies writings to make them.
Organ Donation: The act of donating a deceased persons organs to an institution for medical
research or transplantation.
Palliative Care (also known as Comfort Care): A type of care program to moderate the intensity
of pain and suffering of a terminally ill person.
Personal Representative (see Executor)
Power of Attorney: A document that lets an individual appoint another person to act on his or
her behalf regarding the control of money and property.
Probate: The legal process of settling an estate, which includes verifying the authenticity of the
will, creating an inventory of the deceaseds assets and liabilities, paying off debts and taxes,
identifying heirs, and distributing property.
Trust: A legal arrangement that allows you to transfer property to a trustee for the benefit of
your beneficiaries, without court involvement.
Testamentary Trust: Created by a will, this trust becomes effective only upon the death of the
person named.
Trustee: The person, persons, or institution responsible for managing the assets placed into a
trust and/or transferring property to beneficiaries or heirs.
Will: The cornerstone of any estate plan, a will specifies how you want your assets distributed
when you die and names an executor for your estate as well as a guardian for your minor
children.
GRIEF SUPPORT
The Growth House
http://www.growthhouse.org/
Griefnet.Org
http://www.griefnet.org/
Good Endings.Net
http://www.goodendings.net/
Dying Well
http://www.dyingwell.org/
Beyond Indigo
http://www.beyondindigo.com/
Compassionate Friends
http://www.compassionatefriends.org/
Becker, Marilyn R. Last Touch: Preparing for a Parents Death
ORGAN DONATIONS
New England Organ Bank
http://www.neob.org/
Wednesday, September 7, 2005
American Bar Associations Commission on Law and Aging
Consumers Tool Kit for Health Care Advance Planning
http://www.abanet.org/aging/toolkit/home.html
University of New England Body Donor Program
http://www.une.edu/com/bodydonor.asp
MEDIA PROGRAMS/SPECIALS
NPR Program
The End of Life
http://www.npr.org/programs/death/
PBS Series
End of Life Tools
http://www.thirteen.org/onourownterms/tools/
PBS
Before I Die
http://www.thirteen.org/bid/
JOURNALS/MAGAZINES
Bereavement Magazine
http://www.bereavementmag.com/
RITES OF PASSING
Fortune, Dion. Book of the Dead. (Formerly printed as: Through the Gates of Death.)
OGaea, Ashleen. In The Service of Life: A Wiccan Perspective on Death.
Starhawk. The Pagan Book of Living and Dying.
Druid rites of passing, issues surrounding death
http://www.druidnetwork.org/rites/passage/passing/index.html