A terminal diagnosis changes everything — and one of the first impulses many people feel is the urgency to get their affairs in order. That instinct is right. Planning now, even with a difficult prognosis, puts you in control of what matters most: your medical care, your legacy, and the experience of the people you love.
This guide is written with compassion for where you are. It's practical — because practical steps provide relief — but it recognizes that this is also an emotional and deeply personal time.
Start with What's Most Urgent
If you have a limited timeline, prioritize the documents that protect your wishes immediately:
Healthcare Advance Directive
An advance directive is the most time-sensitive document. It tells medical providers what treatments you do and don't want as your illness progresses. Without it, decisions may be made by providers following standard protocols rather than your personal values.
Discuss your directive with your physician and ask about a POLST form (Physician Orders for Life-Sustaining Treatment) — unlike a living will, a POLST travels with you to any care setting and is immediately actionable by medical staff.
Healthcare Proxy
Designate a healthcare proxy who will speak for you if you can't communicate. Choose someone who truly understands your values — not just your wishes — so they can make decisions about situations your directive may not anticipate. Have a detailed conversation with this person about what matters most to you.
Financial Power of Attorney
A durable financial power of attorney becomes important before death — it allows a trusted person to manage your accounts, pay bills, and handle financial matters if you're too ill to do so yourself.
Update Your Will and Beneficiary Designations
If you have a will, review it now. Does it reflect your current wishes? Are the people you've named still the right choices? If you don't have a will, creating one — even a simple one — is essential. See our complete guide to wills and estate planning.
Also check beneficiary designations on retirement accounts and life insurance. These override your will and take effect immediately at death.
Understand Your Care Options
Ask your medical team about hospice and palliative care options. Many people wait too long to access hospice — which focuses on comfort, dignity, and quality of life rather than curative treatment. Understanding your options now helps you make intentional choices rather than defaulting to aggressive intervention.
Preserve What Matters Most
Planning for death is also an opportunity to leave something lasting. Many people facing a terminal diagnosis find this dimension of planning to be the most meaningful.
Consider recording video or voice messages for the people you love — for future milestones, or simply to share your love and wisdom. Our guide to recording video messages offers practical guidance. You might also write letters to your children or grandchildren for occasions you may not be present for. See our guide to writing letters for future milestones.
Preserving your life story is another profound gift. Your memories, values, and experiences are irreplaceable. Our guide to preserving memories walks through many ways to capture them.
Tell the People You Love
End-of-life planning isn't just documentation — it's also conversation. Your family needs to know where your documents are, what your wishes are, and how you want your final time to be spent. These conversations are difficult, but they relieve your loved ones of an enormous guessing burden. Our guide to talking with your family can help.
Get Help
You don't have to navigate this alone. An estate attorney can help you complete legal documents efficiently. A social worker or patient navigator from your care team can connect you with community resources. And organizations like the Conversation Project offer free tools for advance care planning conversations.
For a full overview of everything involved, see our complete guide to end-of-life planning.