END-OF-LIFE

PLANNING GUIDE:
A Resource for WCBR
Residents and Their Families

Produced by the WCBR

Chaplain’s Support Committee
January 2019
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Directory
Director of Resident Services 434-972-3138 OR x3138
Administrative Assistance for Resident Services 434-972-3168 OR x3168
Independent Living Social Worker 434-972-2336 OR x2336
Catered Living Social Services 434-972-2663 OR x2663
Health Care Social Worker 434-972-3154 OR x3154
Chaplain 434-972-2560 OR x2560
Chaplain Intern 434-972-2529 OR x2529
Front Desk 434-972-3100 OR x3100
Development Office 434-972-3281 OR x3281
Environmental Services 434-972-2732 OR x2732
IT Help Desk 434-972-4500 OR x4500
Facilities Services 434-972-3160 OR x3160
Independent Living Activities Coordinator 434-972-3248 OR x3248
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Contents

Pre-Planning for End-of-Life ............................................................................................ 3

Advance Directives and Durable Medical Power of Attorney ............................. 3
Five Wishes ......................................................................................................................... 4
Pre-Planning My Funeral, Memorial Service and/or Obituary .......................... 5
Pre-Planning What I Want to Be Done With My Body ......................................... 7
Care and Disposition of Your Pet(s) ........................................................................... 8
Gathering Legal Papers and Important Information ............................................. 9

During End-Of-Life........................................................................................................... 10
Emotional And Spiritual Support ............................................................................... 10
Resources for your Family and Friends ................................................................... 13

After Death ........................................................................................................................... 14

Memorial Notifications ................................................................................................. 14
Annual Service of Remembrance ............................................................................... 15
Executor Responsibilities ............................................................................................. 16
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Pre-Planning for End-of-Life

Pre-Planning: Advance Directives and Durable Medical

Power of Attorney
1. What is an Advance Directive?

An Advance Directive (sometimes called a Living Will) lets you decide which,
if any, life-extending treatments you would like to receive.

2. What kinds of things can I include in my Advance Directive?

The primary question on your Advance Directive will be along the lines of, “If
you are in an irreversible coma and have a terminal diagnosis, do you want to
delay the moment of death with life-extending treatments?”
There are several life-extending treatments that are covered in this document:
- Ventilator: This is a machine that helps you breathe by pushing air in
and out of your lungs for you.
- Feeding Tube: This is a tube that is threaded down your throat in
order to allow food to be fed directly into your stomach.
- Dialysis: This is a method to filter your blood when your kidneys can
no longer function properly.
- IV Administration: This is a tube inserted into a vein in order to
administer medications and fluids.

3. Can I include a DNR or POST with my Advance Directive?

No. Both a DNR (Do Not Resuscitate) and POST (Physician Order for Scope
of Treatment) are Physician Orders and can only be issued by your Physician.
Other Orders that you can request are a DNI (Do Not Intubate) and DNH
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(Do Not Hospitalize). All physician Orders are treated as binding by

Emergency Medical Technicians who might respond to an emergency call.
However, if they are not notified of your Physician Orders by a bracelet, a card
on your person, or a notice in a visible place in your home, EMTs will act on
good faith and provide life-saving treatment, until your Physician Orders are
brought to their attention. Any of these Physician Orders can be revoked at
any time (by your or by your health care agent, if you are unable to make
decisions for yourself).
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Pre-Planning: Five Wishes

1. What is Five Wishes?

Five Wishes is a legal document that allows you to address five different
wishes for your end-of-life. It combines your Advance Directive, your Durable
Medical Power of Attorney and your Funeral/Memorial service pre-planning
in one document.
2. What are the “Five” wishes?

- My wish for the person I want to make care decisions for me when I
can’t (Durable Medical Power of Attorney)
- My wish for the kind of medical treatment I want or don’t want
(Advance Directive)
- My wish for how comfortable I want to be
- My wish for how I want people to treat me
- My wish for what I want my loved ones to know (Funeral Pre-
Planning)

3. How do I fill out a Five Wishes document?

These documents are provided by the WCBR Chaplain. If you would like to
fill one out, you can make an appointment with the WCBR Chaplain. You may
fill this form out on your own or with the assistance of the WCBR Chaplain or
Social Worker. However, if you fill it out on your own, be sure to leave the last
two pages blank until you are in the presence of two witnesses or a notary
public. The WCBR Chaplain can help you locate legal witnesses.
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Pre-Planning: My Funeral, Memorial Service and/or

Obituary

1. Does WCBR Offer Pre-Planning Resources?

Yes. The WCBR Chaplain is happy to speak with you and your family at any
time to pre-plan your funeral or memorial service. This resource is available
whether you plan to have a service at WCBR or not.
2. What kinds of things do I need to think about when pre-planning my
funeral or Memorial Service?

- Where: Where do you want your service to take place? Here at

WCBR; At your local church; Where your family lives; Somewhere
else?
- When: Do you want your service to take place immediately after your
death or do you want it to take place some months later?
- Who: Who do you want to participate in your service? Do you want
various family members and friends to do readings, sing a solo, give a
eulogy, etc?
- What: Are there special readings, music, or other liturgical elements
that you want included in your service?

3. What about pre-planning my obituary?

Sometimes it can be difficult for your family to write an obituary immediately

after your death. Emotions can be overwhelming. If you wish to relieve your
family of this responsibility, you can write your own obituary. It is a wonderful
way to think about how you would like to be remembered. The WCBR
Chaplain is available to assist you with this task as well.
If you or your family wish to have people make a memorial gift in lieu of
flowers, it is good to mention it in your obituary. Places to consider for a
memorial gift could include charities that are close to your heart, non-profit
organizations you are affiliated with, the WCBR foundation, and many more.
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Pre-Planning: What I Want to Be Done With My Body

1. What are my options?

- Burial
- Cremation
- Donation

2. What do I need to know about burial?

If you decide to have your body buried after you die, you will need to select a
funeral home to move forward with this plan. There are two options. First, you
can select only the funeral home and leave further plans up to your family after
you die. Second, you can pre-plan and pre-pay for your wishes with the funeral
home. These plans could include selecting your coffin, selecting where you
would like be buried, selecting your headstone, and more.
As you are looking at funeral homes, make sure to ask for a comprehensive
price list. If the funeral home refuses, they are violating federal law and it is
better to choose another funeral home.

3. What Do I need to know about Cremation?

Cremation is the process in which your body is burned after you die. This is
often a cheaper option. It is also a good option if your family or ancestors are
laid to rest in a Columbarium or that is the tradition at your faith community.
It can also be a good choice if your family is spread out over a large geographic
area. Each of your family members would be able to keep a part of your
remains in a special urn to remember you by, rather than having to travel long
distances to visit a grave site.

Many funeral homes will perform cremation, but not all. The Virginia
Cremation Society is another organization that can offer cremation. When
speaking with either a funeral home or other cremation organization, make
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sure to ask if the price quoted includes the full cost of the actual cremation, the
urn or container in which you want your cremains to be placed, any
transportation necessary, and any necessary medical examiner’s fees.

4. What do I need to know about donation?

There are two types of donation to consider: organ, eye, and tissue donation or
whole body donation. Organ, eye, and tissue donation can be an opportunity
to provide life or increased functioning to another person after you die. When
you donate your organs, it takes place soon after you die and your body will be
presentable even for an open casket. Donating eyes or even skin is not visible
to loved ones.

An intention to donate your organs can be indicated on your Virginia Driver’s

license. This can be accomplished at the Department of Motor Vehicles.
Another way to mark your intention to be an organ donor is through
DontateLifeVirginia.org. You can also call Donate Life Virginia at 1-866-823-
6667 if you have any questions about organ, eye, or tissue donation or if you
want to see if you are already registered as an organ donor.

Donate Life Virginia

1-866-823-6667
https://www.donatelifevirginia.org

The second type of donation is whole body donation. You cannot donate your
organs, eyes, or tissue AND do whole body donation. It is either one or the
other. Whole body donation allows your body to be used for teaching anatomy
and surgery to health professionals or can contribute to scientific research.
Whole body donation precludes an immediate burial. Families may request the
return of your remains once your body is no longer needed. However, this
requires that they fill out a form requesting it at the time of your death. See
next page for contact information.
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State Anatomical Program

1-800-447-1706
OCME.Anatomical@vdh.virginia.gov
http://www.vdh.virginia.gov/stateanatomicalprogram/

5. What do I need to know if I want my body or remains shipped to

another location?

This service can often be provided by your funeral home. The fees for this
usually include pick-up at place of death, embalming, filing of documents,
providing a shipping unit, and delivery to the departure airport. NOTE: You
will need to contract the services of a funeral home at your destination to pick
your body up at the airport there and to arrange the funeral locally.

You can also visit US-Funerals.com for advice about shipping your body or
any other funeral related information.
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Care and Disposition of Your Pet(s)

1. What do I need to do in order to make sure my pet is cared for after my

death?
Your pet(s) are very important to you. We want to make sure that they are well
cared for in a timely manner after you die. In order to do so, immediately upon
moving or upon obtaining a pet, you must give Resident Services the
following information:
- Type of Pet
- Pet’s Name
- Name and Contact Information for the person who will assume
custody of your pet
- Care Instructions
- Name and Contact Information for a local Temporary Guardian (if
needed)
If you have any questions, you can contact the Director of Resident Services at
434-972-3138.
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Gathering Legal Papers and Important Information

1. What kind of documents and information do you mean?

The kind of documents and information will vary for each person. However, it
would include your Last Will and Testament, your Advance Directive, your
medical and legal powers of attorney, the location of your safety deposit boxes,
birth certificate, social security card, deeds, financial account information,
account logins/passwords, and much more.
2. Where can I find resources to help with this?
You can speak to the WCBR Social Services professionals in Independent
Living or in any of the Care Areas. You may also speak with the Chaplain or
the Director of Resident Services. Phone numbers for each of these people are
in the directory at the front of this booklet.

3. To whom should I provide a copy of this information?

Make sure any people named in your legal documents get a copy. You can also
create a list of the documents you have collected and where they stored so that
your family or executor can find them after you die. This list should be given
to anyone name in your legal documents as well. WCBR can also keep a copy
of this list in your resident file.
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During End-Of-Life

Emotional And Spiritual Support

1. What kind of emotional and spiritual support is available at the end-of-

life?

The end of our life can be a very emotional and difficult time. WCBR offers
support from the WCBR Social Worker and the WCBR Chaplain to both our
residents and their friends and family at any time, but especially during the
end-of-life. However, if you prefer support from outside WCBR, the WCBR
Chaplain is available to contact your spiritual or religious community leader
and arrange for them to visit at you and/or your family’s convenience.

There is also a Sanctuary Space on the first floor of the Health Center, across
from the Transportation desk. This room is open 24/7 for residents, visitors,
and staff to use. It is a quiet space if you just need some time to yourself.
However, it also has resources from many different faith traditions.

2. What if I am on hospice?

Hospice is a palliative care service that focuses on keeping you comfortable

rather that helping you get better as you near the end of your life. In order to
enroll in Hospice, you will need an order from a Physician. Once enrolled in
hospice, you and your family will be able to receive care from the Hospice
team, which includes medical personnel, a social worker, a chaplain, and
various volunteers. WCBR encourages you to make use of hospice if and when
the time is right and we always work together with the hospice team to make
sure you get the best care possible. Hospice is covered by Medicare Part A if
you have been given a diagnosis that anticipates your death within 6 months.
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Resources for your Family and Friends

1. I have a family member or friend who is coming from out of town to be

with me during the end of my life. Where can they stay?

- WCBR Guest Room: WCBR has two guest rooms available. It can
accommodate 2-3 people. Resident services can assist in making a
reservation. To do so, please call 434-972-3168 or 434-972-3138.
- Hilton Garden Inn: This is directly across the street from WCBR,
behind Shadwell’s at 1793 Richmond Rd. You can contact them for
reservations at 434-979-4442.
- The Comfort Inn: This is located just off I-64 as you exit to visit
WCBR at 2097 Inn Drive (1/4 mile east of the WCBR entrance on
250 East). You can contact them for reservations at 434-977-3300.
Both of the above hotels offer discounts to people associated with WCBR.
When your family or friends make a reservation, be sure to mention your
connection to WCBR.

2. Where should my family member or friend call if they have further

questions?

Depending on the question, it would be appropriate to contact different

members of the WCBR team. There is a directory at the front of this booklet
that might help you figure out who to call. If you are unsure, you can always
contact the Director of Resident Services at 434-972-3138. They will be able to
connect you to the correct person.
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After Death

Memorial Notifications

1. How are the other WCBR residents notified of my death?

An “In Memoriam” notice will be placed in the Resident Information Center

(RIC) and a white rose will be placed in the Chapel with your name, birth date,
and date of death listed. If you lived in Health Care, Catered Living, or Vista at
the time of your death, a white rose will be placed there as well. Information
about your funeral or memorial service is posted in the Mail Room as well as in
whichever care area you lived in.

2. What if I do not want this information shared with the entire WCBR
community?

If you or your family does not want information about your death and/or your
memorial service distributed in the way mentioned above, please inform
Resident Services at 434-972-3138 or 434-972-3168. We will respect your
wishes.
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Annual Service of Remembrance

1. What is the Annual Service of Remembrance?

The annual service of remembrance is a time for the entire WCBR community
– residents, staff, and family members – to remember all those who have died
in the last year. This does not replace an individual memorial service for your
loved one. You may contact the Chaplain at 434-972-2560 to help plan an
individual memorial service at WCBR and you may contact the Independent
Living Activities Coordinator at 434-972-3248 to help schedule that service.

2. When is the Annual Service of Remembrance?

The Annual Service of Remembrance is on the first Saturday of November

every year. We celebrate those who have died between October 1 of the
previous year and October 1 of the current year.
3. How can my family participate in this service?

Each year, the WCBR Chaplain will send out invitations to this service. At that
time, Family Members are invited to request readings, music, or other elements
of the service that remind them of you. They are also invited to participate in
the service by reading or praying. Each family also has the opportunity to
select someone to accept a rose on your behalf and place it in a memorial vase.
However, all residents are invited to this service, whether they are family to
anyone who died or not.
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Executor Responsibilities

NOTE: It is very important for you to let WCBR know who your executor
and power of attorney are in advance and to also keep them updated
should you make any changes.
Often the executor or co-executor is also the person who holds the power-of-
attorney to act for the resident. However, sometimes the executors or co-
executors are not the individuals who hold the power-of-attorney. It is
imperative that WCBR Resident Services know, in advance, who the executors
are, and who holds power of attorney.
Resident Services office phone numbers are 434-972-3138 or 434-972-3168.
1. If I live in Independent Living at the time of my death, how can my
family or executor access my apartment or cottage?

Upon the death of a resident, to safeguard the privacy and belongings of the
deceased resident, Resident Services will have the key fob lock deactivated on
the deceased resident's apartment or cottage unless their spouse is present.
The spouse may stay in the apartment or cottage, however all other persons
must vacate the apartment. This includes your children and caregivers.

No one except your spouse is allowed access to the unit until the executor
presents a copy of the page of the will to Resident Services that specifies that
they are the executor. The executor must designate in writing any other
person or persons (i.e., family members) to be allowed entrance. This
information can be provided via email if necessary.

You may designate, in advance, persons to be allowed entrance to your

apartment or cottage, by drawing up a statement with the executor of the
estate.
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2. What other responsibilities will my executor have?

WCBR cannot advise you or your executor directly about all the
responsibilities an executor might have. It is important to talk to your attorney
and/or financial advisor to make a full list. The following are some items you
might want to bring up during that conversation:

- File will with probate court

- Notify banks, credit card companies, and government agencies of
your death
- Set up bank account for incoming funds and pay any ongoing bills
- File inventory of estate’s assets with the court
- Determine probate
- Maintain property until it can be distributed or sold
- Pay estate’s debts and taxes
- Distribute assets
- Dispose of other property
Your executor will also need to work with the Director of Resident Services to
clear out your apartment or cottage in a timely manner.