20 min read

What to do when a loved one is dying, or has died

Some practical tips for managing the death of someone you love.
What to do when a loved one is dying, or has died

My loves, this one's going to be heavy. I really hope that this isn't a relevant topic to most of you right now, and if it's not, please just skip on over to the end where I'm going to talk about a couple of things you can do now, while you're healthy, to make life easier for the people who will have to deal with your death someday.

But this one is for those of you who are walking through the dark place right now, alone, and who have questions about what's up ahead. The emotional journey is one that no-one can prepare you for, because it's different for everybody. But at least I can tell you about the admin (and better believe it, there's a LOT of admin). I'm sure a mountain of admin is JUST what you feel like right now, hey? 😂😭

There's no guidebook for this, not really. Each death is different, and every family has its own complications they'll need to sort through. But I'm going to cover some of the major things that you'll need to deal with, in four main sections:

  1. What to do when someone is very ill and might die.
  2. What to do once someone has died.
  3. Some notes on grief.
  4. What you can do now, while you're healthy, to make your own death easier on the people you love.

What to do when someone is very ill and might die

In many ways, this is the hardest part: this endless limbo; this panic every time the phone rings; this complete isolation; this terrible powerlessness in the face of hospital administrators and doctors who won't tell you what's going on; these moments of hope and then dread; this daily uncertainty.

In no particular order, here are some tips and resources that you might find helpful.

Ask your loved one if they will grant you power of attorney so that you are authorized to make health, care and financial decision on their behalf. This will make it easier for you to manage their admin if they are in hospital or incapacitated. You can download a power of attorney document online, complete it and print it. You'll need to find the right document for your own country. Here's one for the UK. Here's one for South Africa. Depending on where you are, you may need to sign it in front of witnesses, or get it stamped by a commissioner oaths. Your loved one needs to be of sound mind when they sign this document, so consider putting this in place sooner rather than later. You should also get a few certified copies of their ID made.

If it's possible and your loved one is up for it, help them to put their paperwork in order (see the section below). Make sure they have a will in place. Obviously, you might not have the emotional energy for all of this, and that's okay. Recruit other family members to help you, if you can.

If you have the emotional space for it, I highly recommend reading the book Being Mortal by Atul Gawande (prepare to sob your heart out). Gawande is a surgeon who discovered, as his own father was dying, exactly how ill-equipped the modern healthcare system is for dealing with the end of life. Doctors are trained to extend life. The difficult thing you may discover, when you are watching a loved one die, is that sometimes the things doctors will do to extend life come at too high a cost for the quality of the little life that remains. At some point, you may need to decide to stop trying to save someone's life and rather focus on helping them to die peacefully. This book will equip you to have conversations with your loved ones that will help you to guide these impossible decisions. Here's a summary of the 5 questions he suggests you ask, but read the whole book if you can.

A living will/advanced decision is a legally binding document that lays out what a person wants in regards to medical care. It includes the right to refuse life-extending medical treatment in certain circumstances, like if they're brain-dead. If your loved one has an old living will, it's worth updating it. As a friend of mine said:

Relevant to Corona: for those who do not wish to be put onto ventilators, should fill in a ‘living will’. If you have an old living will, it's a good idea to make a new one (here's a template). It’s good to freshen your living will from time to time, because doctors are far more likely to take a fresh one seriously, knowing that this is your ‘current’ line of thinking. In light of Corona, my parents have both updated their living wills and added specific wording to the effect that they may not be ventilated.

An alternative living will template.

While we're on the topic of doctors: record any conversations you have with a doctor (with their permission). You will be so overwhelmed with information that you may find you forget everything you just heard, immediately. And getting the damn doctors to talk to you in the first place can be extremely difficult, in both public and private hospitals (they're busy saving lives, after all), so you really need to use your time with them efficiently. I also suggest that you write down any questions you have before you talk to the doctor, so you don't forget to ask them.

Pack a go-bag, for both you and your loved one (if they're at home) so that you can leave at a moment's notice. This bag should include essential paperwork (like the ID copies you made), a warm jersey, hand sanitizer, cash, some snacks, and 2 day's worth of any medications.

You should also keep a list on your phone of all the medication your loved one normally takes, in what dosage, and information about any other underlying medical problems that might be relevant. Add the names and contact numbers of any doctors you are dealing with, and the hospital's phone numbers. Add other essential information as you get it: bed numbers in the ward, the name of the nurse on duty, etc. We found it helpful to keep this in a Google Doc with the link in the description of our family emergency WhatsApp group, so anyone could access it easily.

Accept help. When people say, "let me know if there's anything I can do..." take them up on this. Good tasks to delegate include: communicating with the wider network of friends and family, doing research and running errands. People want to help you. Let them.

Find out what your various medical aids and insurances will cover. One of our readers had to navigate a real minefield around paying for end of life care:

End of life care may or may not be covered by medical aid depending on the illness. Critical to have critical illness cover here especially the big C. Also varies for different types of cancer. Any potential shortfalls should be covered with gap cover. It's worth it. I didn't have gap cover but luckily paid for everything. Including 24h nursing at home. Make sure to know the medical aids procedures. Discovery didn't make it obvious that I needed additional approval for meds which led to a lot of out of pocket charges for me which they reimbursed. Best to have some cash stashed away because this will happen. Or know your loved ones pin, or be able to access their banking app to you can transfer money on their behalf to pay for any not covered.

Take a break sometimes. It's okay to leave your phone with someone who knows where to reach you in an emergency, and to go off and do something joyful for a bit (in fact, it's essential to top up your own emotional tank). If you're struggling, reach out to someone. In South Africa, try the SADAG helpline. Try one of these helplines in the UK. The hospital or hospice will likely have staff counsellors you can talk to, too.

The website LoveLegacyDignity is filled with excellent South African resources for approaching the end of life.

What happens when someone has died

No, I don't mean "is there a heaven where they frolic around with Labrador retrievers under an ice-cream fountain for all eternity" - I hope there is, but I honestly have no idea. I mean, what happens to their status as a legal person, and all the stuff they owned. Before we chat about all the things you can do to plan and prepare, it helps to have a rough understanding of what the process looks like. A map of the terrain.

Depending on where or how someone dies, their body will be taken by an ambulance or a funeral director to a mortuary. There are mortuaries in hospitals and funeral homes. The cause of death needs to be established by a doctor. Sometimes this will be clear and obvious, and it's as simple as a doctor issuing a medical certificate/death notice detailing what happened. If it's not obvious (the person died suddenly or violently) someone called a coroner (a person responsible for investigating a death) will order an autopsy or post-mortem examination where a doctor will examine the body to determine exactly what happened.

All of this stuff happens quite quickly and automatically as soon as you alert an ambulance or the police. If someone dies in a hospital, the hospital will be able to guide you through these steps. You don't need to do too much planning for any of this.

In fact, don't feel rushed to do anything on that first day except be with your family, and grieve. Muslim readers who need the burial to happen quickly, you'll have the support of your community in doing this.

The body, funerals and memorials

Once the medical certificate has been issued, the family can make arrangements to dispose of the body and hold a funeral. You will probably engage a funeral home and/or religious institution for their help at this point.

Funeral homes can help you both disposing of the body respectfully (and taking you through the bureaucratic stuff like applying for the certificates), and arranging a funeral/memorial service. But you don't have to use them for both things. When my dad died, we chose what's called a silent cremation which means that the body is cremated without anyone being present. Doves, the funeral home we used, helped us to do this efficiently and kindly, and it wasn't that expensive (if memory serves me correctly, about R4,000). But we chose to arrange our own memorial.

Look, it's weird to sit at a funeral home the day after someone you love just died and have a conversation where they're trying to upsell you on things, but you really can just say no to almost everything. These decisions are very personal and cultural and you should do whatever feels right to you, and not feel pressured into doing anything else. My gran was insistent that no-one was allowed to be sad when she died (this was a strict order), so we also had a silent cremation for her and then a small boozy family lunch at a restaurant in her honour. With my dad, we had a big funeral at the church he worked at and it felt a bit like organising a wedding in its complexity, but that felt right for him. Just trust your gut. There are no rules, and anything you choose is okay.

Funerals and memorials are a great place, again, to accept help that is offered. Delegate tasks like finding a venue or food or decor. They're all very delegatable things! This is also something you can plan in advance before someone dies: just book a meeting with a funeral director and make some of the choices before you're in the thick of grieving.

A quick checklist of stuff you need to think of when arranging a funeral/memorial:

  • Venue
  • Food/drink
  • Invitations (including a list of who needs to be contacted)
  • Speeches/eulogies/religious service/music
  • Decor/programmes

If you change your mind at any point, that's fine! This reader had a great tip:

Compare prices from one funeral director to another and decline offers to meet at your home unless they have to come to your home to fetch the body. If you wish to change funeral directors after the body has been collected, this is okay, the industry has a set fee for collection, so you won’t be charged extra. Be as good a consumer in funerals as you are with any other purchase.

You may be able to choose whether or not to see the body of your loved one. This is very personal and, again, let your instincts guide you. My grandmother died at home when I was a teenager, and my uncle and I washed and dressed her body. She was quite stiff, and difficult to manoeuvre, and when we lifted her arms above her head to get her nightdress off there was a terrible crack, like we'd broken her ribs. There was a horrible moment where both my uncle and I started apologising to her for hurting her, and then a moment of great peace where we both realised, completely, that she wasn't there, and this was just a body, and we couldn't hurt her. It was ultimately healing, and I'm grateful for that experience. So when my uncle, grandfather and father died, I felt like I didn't need to see their bodies, because I already understood that they weren't in them any more.

The final step that happens is that the death is registered with the government and a death certificate is issued. This must happen within a few days of the death. If you're using a funeral home, they will help you with this.

Another tip from a friend:

Oh my god, when they ask how many copies of the death certificate you want, get as many as you can pay for. Ten is not too many. Astonishing how many people/companies/service want the originals and won’t return them.

The money stuff

Once the death certificate has been issued, they are no longer a legal person. They can no longer enter into legal agreements or be required to fulfil contracts (uh, obviously) and everything they owned is now frozen until their estate is wrapped up (an "estate" here just means "everything the person owned", including their house, furniture, money, investments etc.). The person or company responsible for wrapping up the estate is called an executor. The executor is appointed in the will if there is one, or by the courts if there isn't.

If you had a power of attorney, it now ends. All authority now passes to the executor.

Wrapping up the estate means that there's a period of time where the death of the person is made public. Anyone the person owed money to is allowed to come forward and make a claim against the estate. The executor works out how much money must be paid from the estate in taxes. The executor also tracks down and compiles a list of all of the things of value that the person owned.

If you were named the executor and have no idea what to do, here's a good South African guide, and a good UK guide. If you're feeling overwhelmed or the estate is complex, you can delegate your duties to a company that does this regularly. Know that this can be expensive (usually 2.5 - 3.5% of the estate's value) but it can be worth it. This was especially true for a friend of mine who was living in the UK when his father died in South Africa:

Being out of the country having my father's financial adviser as the executor of the estate was life saver. I literally don’t know how I would have dealt with it otherwise. Though that was mostly thanks to my fathers forethought rather than anything I did.

While the estate is being wrapped up, the heirs generally cannot move or access these assets. For instance, it's difficult for heirs to sell a house during this time.

This is an important point: you cannot inherit a debt. If your parent dies and owes a big personal loan, that creditor cannot approach you and ask you to pay up. Instead, the creditor makes a claim against the estate, and if their claim is found to be valid, then they get their money back first, and the heirs get whatever is left in the estate after all the debts have been paid. If the estate includes a house, it's possible that the house will be sold to pay back any debt claims (or, the heirs can agree to pay cash to settle the debts, to prevent the house from being sold). If there's not enough in the estate to pay everybody back, even after selling any assets, then those debts are written off, they're not passed on.

Of course, if you're married in community of property, and your spouse dies, this is all a little more complicated, and you should get detailed advice about this.

Only once all of the claims have been taken into account (including taxes, and the executor fees are paid) then what's left is divided up to the beneficiaries (the people who inherit the estate). If there's a valid will, that will say how the estate should be divvied up. If there isn't a will, then the person is said to have died intestate and there is a set of rules in every country about how the estate is divided.

Once a judge has approved all of this, the estate is finalised, and the money is actually handed over to the beneficiaries. Now here's the rub: it takes a very, very long time for an estate to be wrapped up. In the UK, expect 6-18 months. In South Africa, expect up to 3 years (unless the estate was worth less than R250,000, in which case the process is sped up). That means that one of the most important things to think about is how you'll support that person's financial dependents during this period.

It's awful and unfair and unjust that it can take so long, and we need to reform these processes. But on a personal level, you need a plan for yourself or your family that makes sure they're looked after in that period.

That's where insurance comes in. Life insurance and funeral insurance aren't a part of the estate: they're paid out as soon as someone dies, usually very quickly after you have a death certificate. Life insurance can fill a crucial gap between when you die, and when your dependents will get their inheritance. If your loved one had life or funeral insurance, you should apply for these as soon as possible.

Pensions and retirement annuities are another helpful exception: they're not part of the estate. Rather, they are paid out directly to your dependents, or sometimes, to a nominated beneficiary. It can take a few months for this to happen, but it is unlikely to take as long as wrapping up the rest of the estate. You should initiate this process by directly contacting the advisor or fund.

Seriously consider withdrawing all of the cash from their bank and savings accounts before you register for their death certificate and close these accounts, to use for paying the funeral and supporting financial dependents while the estate is wrapped up. If you choose to do this:

  1. Do it as soon as possible after the death.
  2. Keep clear records of the withdrawals and who the money went to.
  3. Make sure that all heirs know about this plan and are okay with it.
  4. As far as possible, make sure that you're splitting this money along the same lines as the will or intestate rules specify, so it's going to its ultimate beneficiaries anyway.

Here's the thing: withdrawing money after someone has died is illegal. It could be challenged in court later if someone who was owed money (as a creditor or an heir) feels they were entitled to what you withdrew. It could delay the estate being wrapped up. I know one family where one son did this, and it lead to the siblings no longer speaking to each other. Do tread carefully.

So ja okes, I'm literally telling you to consider breaking the law here. But in my defence, so is this actual lawyer:

And doing this was a lifesaver for this reader's family:

There are a few hours between time of death and when the banks freeze all accounts so if they have access to the bank cards and pin codes that is something they would need to consider as policies can take a while to pay out, if any are available. When my Dad died, my Mother relied heavily on the cash we were able to withdraw from his accounts before they were frozen as there was an issue with his death certificate and it took longer for his policies to pay out.

In South Africa, you can also apply for the UIF dependents benefit. You must start this process soon after death because there's a 6 month window. In other countries, there might be other grants or benefits you're entitled to, and you should research this.

One last thing about estates: if you are the executor and you're dealing with a biggish or complicated estate, get a tax consultant involved.

Miscellaneous death admin

Once you've got a death certificate and initiated the process of the estate being wrapped up, there's some miscellaneous admin you need to get through. You should make a list of subscriptions and accounts the person had (it's helpful to go through their bank statement), stuff like cellphone contracts, medical aid etc. Email each of these providers with a copy of the death certificate so that they can close these accounts, or transfer them into the name of a surviving spouse. Legally, death terminates most contracts like this, but you need to let everyone know. If anyone starts coming at you wanting to talk about outstanding bills, don't be bullied into paying, just email them the contact information of the estate executor and tell them to make a claim with them.

The good news is, some of the accounts you discover, when you go through this process, might have credit life insurance or other benefits that pay up debts in the event of death. As this reader suggests:

Check if their accounts have clauses making them paid up on death, some even have cash backs in the event of death. Systematically go through all info that you have. Including the fine print.

If your loved one owned a firearm, and the heirs don't want it, dispose of it safely by surrendering it to the police. If there's uncertainty about it, declare the weapon to the executor. They can usually apply for a temporary license for it. Find a way to store it safely (at last resort, contact a local gun shop).

If there was a SASSA account, these payments will stop automatically, because Home Affairs will alert them.

If you or other dependents are at a loss, find a fee-based financial advisor and ask for their advice about what to do next.

A general tip for this whole process: keep all of your information organised. Find a secure way to store all of the relevant passwords, account numbers and documents you'll start to accumulate. I have a physical folder stored in a secure place, with some certified copies of these documents stored elsewhere, and a secure note in my password manager (1Password) with all of the passwords and other information. I also keep digital scans of everything as an additional backup.

So basically, here's a rundown of the major steps of death admin, and how many days after the death you can expect these things to happen:

  1. Establish the cause of death and issue a death notice (1 day).
  2. Register the death and issue a death certificate (1 - 5 days).
  3. Bury or cremate the body. Hold a funeral or memorial service if you want to (1 - 7 days).
  4. Cash out insurance policies (3 - 30 days).
  5. Close accounts, wrap up other miscellaneous admin (7 - 30 days).
  6. Transfer benefits from retirement funds (1 - 3 months).
  7. Wrap up the estate (6 months - 3 years).

Some notes on grief

The death of a loved one will hit everyone in different ways. Expect the unexpected, even from close family members you have known your whole life. (Sometimes the unexpected will be pleasant though.)

When someone you love dies, you discover that there is a secret society of the grieving. You will suddenly become aware of which of your friends have lost someone too. They will be the people who understand what you're going through, the ones who won't shy away from hearing about your worst stories, because they've been carrying their own. There are things we can't tell anyone else, because they're too terrible to say to those who don't understand. The awful indignities of the failing body. The moments when we were not at our best and did not behave nobly. The times the person dying was tired and in pain and cruel. The moments of comedy, too, because death is utterly absurd and occasionally hilarious.

There is a secret sorority of grief. And there will be other people who do understand, and you can be honest with. You will be alone in your grieving, because the love you have for the dead is perfectly unique. But you won't be completely alone.

You will grow around your grief like a tree grows around a fence. It will never lessen. It will be a part of you always. But you will become bigger than it.

You will keep loving them always.

A tree growing around a fence
Photo by Nic Price

On days when it's hard, remind yourself that there is joy in your future. There is meaning and love and goodness in your future. You will not always feel this terrible. Talk to someone.

How you can plan for your own death

Friends, this has been a loooooong post. Because there really is endless endless endless admin around death. This is what adulthood is, being able to do this work so that others don't have to. There will be times you find yourself looking around for an adultier adult! But doing this work, carrying this load, this work is your love made visible.

It is a great gift that you can give the people you love, to do as much of this admin for them, so that they don't have to do it in the midst of their grieving. To sort these things out now, while it's easy.

There are three main things you need to do, to offer your loved ones this gift:

  1. Have a will in place.
  2. Keep your records neat and make sure they're easy to find.
  3. If you have dependents, make sure you have a financial and custodial plan for them if you die.

First, make a damn will. Even if you're happy with the rules of intestate succession, you should have a will anyway, so that you can appoint an executor and agree on the fees they'll take upfront. You can download free will templates online (here's one for SA) but make SURE that you're following the instructions about exactly how they must be signed and witnessed.

If your life is even slightly complicated it's better to get a professional to draft a will for you. South Africa has a Will's Week every September where lawyers will help you draft a will for free/very little. You could also try Capital Legacy. Negotiate your executorship fees upfront. The maximum in South Africa is 3.5% + VAT (3.99% effectively). Try to negotiate this down to at least 2.5%.

I'd avoid using the bank, personally, but it's not a terrible option if you can't find anyone else.

Make sure your will is kept somewhere safe, and your family knows it exists and how to find it.

If you employ a domestic worker, please also give consideration to leaving something for them, especially if you can't enrol them for UIF.

Then, keep your records neat. You'll make life so much simpler for people who have to deal with your admin if you get sick or die if it's all organised. My strategy for this is that I keep all of my most important records and passwords in a password manager, and two of my most trusted friends each know half of the master password. Hypothetically, those two could collaborate and rob me of everything I own, but it does mean that if something happens to me, they have the "master key" that unlocks everything in my life. There's also a secure note in there that details some extra stuff they need to know (i.e. the treasure map to my buried gold... just kidding). There are other ways you can solve this problem, like keeping hard copies of this information in a safety deposit box, but however you do it, find a solution.

If you have dependents, read what I said above about how long it takes for an estate to be wrapped up, and make sure you have a plan in place to support them financially. This might mean getting life insurance, or transferring some assets to a spouse, or listing beneficiaries on a retirement fund, or something else, but give this some thought. If you're responsible for the care of children or other dependents, think about their care, too.

Once you've handled those three crucial things, there's some additional stuff you might want to think about:

  • Write a letter of wishes detailing other stuff like how you want your body to be disposed of, what kind of funeral you want etc. so that your family doesn't have to make those decisions for you. If you want something big/expensive, think about how you'll finance this (e.g. research funeral insurance or pre-paying for your own funeral, which is a thing you can do).
  • Work through this excellent checklist to put together a resource of everything your loved ones will need to know if you're incapacitated or die. Keep this safely with your other documents.
  • If your estate is large or complex, talk to an estate planning specialist who can advise you on how to structure your financial life in the best way for your heirs.

Writing a will, having your stuff sorted, is one of the kindest gifts you can give the people you love. Grief is a terrible time to be stressing about money or worrying about admin. You're going to die someday. Someone is going to have to do all of this nonsense. Make sure it's you, not them.

Special thanks for this piece to Marcia Joubert, Jodi Allemeier, Peter Cardwell-Gardner, Sam Humphries, Helen Moffett, Lize Eloff, and Melissa Attree, who contributed resources to this piece, as well as all of you who gave me helpful suggestions on Twitter and Facebook.