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There are some practical issues that it may be helpful to consider when you have been told that your cancer can’t be cured.
It’s normal to want to think about what will happen to your possessions after your death. Making a will ensures that you have control over what happens to your property. It makes sure that your loved ones and people or issues you care about are looked after and that your wishes are carried out. Sometimes, putting your affairs in order can clear your mind of little worries, leaving you free to enjoy the present time.
Making a will is not as expensive or difficult as you might think, but it’s a legal document and must be properly prepared. We have more information on making a will|.
Age UK| produce a fact sheet about making a will, aimed at people aged 60 and over who are living in England. You can get a copy by contacting them directly. If you live in Scotland, Wales or Northern Ireland, you should contact the specific Age UK organisation for the country because different rules for making a will may apply.
You may find it helpful to make a list of the documents which may be needed to register your death:
Include on the list where to find this information and make sure that your partner or the executor of your will knows where it is kept.
A serious and long illness will often put a strain on your finances, as you may no longer have your wages or other income.
You may qualify for Disability Living Allowance if you are under 65 or for Attendance Allowance if you are over 65. You can download the claim forms from direct.gov.uk| There is a fast-track claim for people who may not live longer than six months. People who are claiming under this ‘special rule’ need to get their doctor to complete a form for either benefit. Your district nurse or palliative care nurse specialist can tell you more about these allowances and whether you can apply for them.
The benefits agency has two booklets called IB1 and SD1, which outline these and other benefits you may be entitled to. You can get a copy from your local Citizens Advice Bureau, where staff will also be able to advise you about the benefits you can claim. You can also get information from the Benefit Enquiry Line on 0800 882 200 or the Department for Work and Pensions| website.
For more information about benefits and financial support, you can also contact Macmillan|.
You may also find our information on help with the cost of cancer| useful.
We give grants and benefits advice to people with cancer. You may also be able to claim grants from other organisations or charities. The social worker or benefits adviser at the hospital or hospice can give you advice on where to get financial help.
A Guide to Grants for Individuals in Need gives details of all the trusts and organisations that provide financial support. It’s available from bookshops or local libraries.
We have more information about financial issues| and sources of financial support|.
Bank accounts are frozen at the time of death and cannot be used, so you may want to consider putting bank accounts into joint names.
Some private or occupational pension schemes will not pay out any benefits to partners if the owner of the pension scheme was not married. This means that the pension fund is lost. Sometimes people in this situation can transfer their money to a personal arrangement to give them immediate access to their money, or to their partner’s money later. An independent financial adviser can advise you on how to do this. You can contact a financial adviser through the Personal Finance Society or Independent Financial Advisers Promotion.
You may need to make important choices in the later stages of your illness. Usually you can talk about your healthcare with the doctors and nurses looking after you. However, there may come a time when you can’t make decisions or communicate easily.
The Mental Capacity Act| 2005 came into force in 2007 and applies to people aged 16 and over in England and Wales. It aims to protect people who cannot make a decision for themselves. This means that a person can plan ahead for a time when they may not be able to make decisions on their own behalf. It makes it clear who can take decisions in which situations, and how they should go about this. There are many parts to this act including parts on Lasting Power of Attorney and advance decisions. The Adults with Incapacity Act (2000) relates to people in Scotland.
A Lasting Power of Attorney| is where you put in writing the name of someone you trust to make decisions or manage your financial, legal or health affairs on your behalf in the future if you are no longer able to do so.
If you’re unable to make a decision about your medical treatment and have no family or friends to represent your views‚ the medical staff are required to appoint an Independent Mental Capacity Advocate (IMCA) to represent your interests.
Normally you will discuss with your doctor or other healthcare professionals about how you would like to be treated and which treatments you don’t want to have. Some people write down their choices in advance so that, if they become unable to discuss things with their doctors or make any decisions, the doctors will still know what their wishes are.
Instructions about the treatments you do or don’t want are called advance statements| and advance decisions|. They are sometimes known as living wills.
An advance statement is a general statement of your views and wishes. It can indicate the treatment you would prefer and can include non-medical things, such as your food likes and dislikes or religious beliefs. An advance statement can include who you would like to be consulted about your care, if you’re unable to make those decisions yourself. If you want to give these people the power to make decisions on your behalf, you will need to create a Lasting Power of Attorney (LPA). The LPA can include your advance statement so that the people named in the LPA take your wishes into account when deciding what is best for you.
An advance decision to refuse treatment is simply a decision to refuse treatment. For example, you may decide that if your condition suddenly worsens and your breathing stops, you don’t want people to try to bring you round (resuscitate| you). Or that if you are very ill and have an infection, you don’t want to be given antibiotics.
You can change your mind and rewrite your advance decision at any time. A copy of your advance decision to refuse treatment can be kept in your medical and nursing notes. It’s also helpful if you provide your GP with a copy. You may also be advised to provide further copies for the ambulance service, out-of-hours doctor, and district nursing and palliative care services. This ensures your wishes and preferences are known to the teams that you may need to contact, day or night.
Advance statements and advance decisions to refuse treatment can also let your family know your wishes, so that they too can do what you would want.
In Northern Ireland there is currently no legislation covering the use of advance decisions to refuse treatment, advance statements or living wills.
You can get information about advance statements and advance decisions to refuse treatment from a social worker or from some of the organisations in our list of helpful organisations|, such as Age UK. You may find it helpful to read the leaflet Planning for your future care: A guide, which has been produced by The NHS National End of Life Care Programme. You can ask for a copy from your GP or at your local hospital information centre.
It’s important to discuss your wishes with a medical professional such as your GP or consultant and your nurse, family and friends. Remember that your family and friends may see things differently to you. For example, they may treasure every possible minute of your life, even though you may be in a coma or unable to respond to them. If possible, it’s good to have an honest and open discussion with your partner, relatives or closest friend in advance, so that they understand your wishes.
It can be difficult to discuss these issues and you may want support from someone who knows you and who you can trust. You can also talk to some of the organisations in our directory|.
Currently under UK law any action that speeds up a person’s death is illegal. Although your doctor and nurses can make sure that you have enough painkillers to keep you comfortable, it is illegal for them to give you more than you need with the intention of ending your life more quickly.
Some people may want to donate their body for medical research. You can find out more about donating your body by contacting the Human Tissue Authority|.
If you’re thinking about donating your body, it’s important to discuss this with your GP, hospital or palliative care team, and your family or friends closest to you. As part of the donation process, you and your next of kin will be asked to sign a consent form. You can get this from your local medical school. A copy should be kept with your will.
If you want your tissue to be used for a specific type of research, you will need to let the healthcare professional who is dealing with the consent form know. Your wishes will need to be in writing on the consent form.
Not everyone who wishes to donate their body will be able to do so.
Content last reviewed: 1 February 2011
Next planned review: 2013
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
Our cancer information team have written a blog about approaching the end of life. Team member Debbie talks about her own experiences, and discusses sensitive topics such as choosing where to die and making advance decisions about your care.
If you have any questions about Macmillan we would love to hear from you| .
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© Macmillan Cancer Support 2013
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