Death is a natural part of the cycle of life. End of Life care is the term used to describe the support and medical care given during the time surrounding death, whether from a sudden illness, a life-ending disease or old age.

Most Americans say they prefer to die at home. However, 70% of deaths occur in a hospital, nursing home or long term care facility.

As with so many other older adult issues, planning ahead and sharing those plans with family and medical and legal professionals can ensure that one’s wishes are followed. This can be a true gift to family members, sparing them decisions in a time of crisis.


Below are a few considerations should you be faced with a life limiting illness or injury:

Designated Decision Maker

Who should make decisions for you regarding medical interventions, including, but not limited to the use of technology to sustain breathing and heart functions, feeding tubes, I.V. fluids, use of antibiotics, or pain medication? Do you want medical professionals to make these decisions or have you identified someone to act as your Power of Attorney for medical concerns?

A Planned Home going

Where would you want to be at the end of life? A medical facility, home,or other environment? Who would you want with you at the end? Family, friends, clergy, pets, or other?

Medical Interventions

Would you want medical interventions provided to sustain life at all costs if the interventions will not change the outcome?


What is hospice? At any time during a life-limiting illness, it’s appropriate to discuss all of a patient’s care options, including hospice. By law the decision belongs to the patient. Most hospices accept patients who have a life-expectancy of six months or less and who are referred by their personal physician. When I use hospice does this mean I won’t receive any medical treatment? Many communities have more than one hospice. Medicare requires certified hospices provide a basic level of care but the quantity and quality of all services can vary significantly from one hospice to another. To find the best hospice for your needs, ask your doctor, healthcare professionals, clergy, social workers or friends who have received care for a family member. Hospice patients are cared for by a team consisting of a physician, a nurse, social workers, counselors, home health aides, clergy, therapists, and volunteers. Each one provides assistance based on his or her own area of expertise. In addition, hospices provide medications, supplies, equipment, and other services related to the terminal illness. Does accepting hospice service create conflict with my faith? While some churches and religious groups have started hospices (sometimes in connection with their hospitals), these hospices serve a broad community and do not require patients to adhere to any particular set of beliefs.

Leaving a Legacy/Wills

What are your priorities for your legacy? Have you prepared a will and assigned an Estate Executor? Do I need these? When did you last review your will? Have your circumstances changed since the will was executed?

Advance Directives

Have you prepared an Advance Directives form? Is this the same as a DNR?

Additional Resources

Preparing and Planning for Life’s Final Chapter© can help answer these questions and is a guide to end of life care planning with practical considerations about end of life care options, clarification about important documents, and guidance on communicating decisions with friends, family, and medical professionals.

This is a free resource to seniors and their caregivers.

It is available to read by clicking  on the link below, visit our office for a printed copy, or have a copy mailed to you for a postage fee of $4 (send a check payable to COA to 95 White Bridge Road, Suite 114, Nashville, TN 37205 with the title of the publication you are requesting and your mailing address).

There are many resources listed in The Directory of Services for Seniors© that can be of great assistance for planning for this phase of life including hospice agencies and elder law attorneys  and more.

This is a free resource to seniors and their caregivers.

Advance Directive Forms


The following forms may be downloaded for personal use:

Advance Care Plan Form (Includes end of life wishes and appointment of health care agent)

Physician’s Orders Form (also known as POST form)

Health Care Agent Form (if you do not wish to designate end of life care-only appoints health care agent)

Appointment of Surrogate Form (appropriate when someone lacks the mental capacity to appoint a health care agent)

All forms are approved by the Tennessee Department of Health, Board for Licensing Health Care Facilities.

Informative Videos

NPT’s Aging Matters: End of Life weaves personal stories of families alongside interviews with scholars, doctors, and medical ethicists to explore the complicated experience of dying, and why so few live the death they say they want. The program explores how the culture of death and dying in America has been radically transformed by medical science, how the medical system reinforces our culture-wide unwillingness to face death, as well as efforts to change how Americans understand and talk about dying.

End of Life | Aging Matters | NPT Reports

"NPT Reports: Aging Matters: End of Life" weaves personal stories of families alongside interviews with scholars, doctors, and medical ethicists to explore the complicated experience of dying, and why so few live the death they say they wan

Tennessee's Living Will | Aging Matters | NPT Reports

Tennessee's legal document acknowledging a person's end-of-life decisions is called an Advance Care Plan. Tennessee's Advance Care Plan also provides a way to design a health care agent. The health care agent is the person you would want to speak for you in the case that you can no longer make decisions for yourself.

Palliative Care and Hospice | Aging Matters | NPT Reports

Over the last 50 years, care at the end of life has evolved into a highly specialized medical field called hospice care. Most hospice care is delivered at home. In recent years, innovations adapted from hospice care are being expanded to benefit patients suffering from a chronic condition who may live for any number of years. This emerging field is called palliative care.

Advanced Care Conversation | Aging Matters | NPT Reports

Why it's important to not only fill out advanced care directives but to talk to family about your choices.

Helpful Links

Council on Aging of Greater Nashville’s Directory of Services for Seniors©. For a listing of local hospice agencies, view our the End of Life Issues Chapter on our online directory.

For a listing of local hospice agencies, view our the End of Life Issues Chapter on our online directory.

Legal Aid Society of Middle Tennessee’s Advance Health Care Plan Guide & Documents (Click on Living Will/Advance Care Plan)

www.las.org/booklets/health_problems/ (Click on Living Will/Advance Care Plan)

Aging with Dignity’s Five Wishes


AARP-End of Life Care


Put It in Writing Campaign


Caring Connections


Consumer’s Tool Kit for Health Care Advance Planning


The Conversation Project


National Institute on Aging-End of Life Helping with Comfort and Care (order this book free of charge)