SERVING EASTERN CONNECTICUT - SINCE 1985

Patients

Advance Care Plan

Advance Care Plan

A kit with everything you need

The end of life requires decisions. Center for Hospice Care recommends the use of a planning kit available through The State of Connecticut Department of Social Services. It’s called Advance Directives: Planning for Future Health Care Decisions, and it enables patients and families to know that their plans and intentions will be documented.

This packet includes:

  • A summary of Connecticut Law and Frequently Asked Questions regarding end of life decisions
  • Directions on how to complete the Health Care Instructions and Advance Directives Form
  • The form Consolidated Health Care Instructions and Advance Directives
  • A form to appoint a Health Care Representative
  • A form for Living Will and Health Care Instructions
  • A form to Give Anatomical Gift (organs or other bodily parts)
  • A form for Designation of a Conservator of the Person for My Future Incapacity
  • A form for Witnesses’ Statements (2 needed)
  • An optional form for Witnesses’ Affidavits that can be witnessed and subscribed by a Notary Public

Additional planning discussion points

Burial and/or cremation services, funeral arrangements, and memorial services are choices best made in advance of death.

These decisions are surrounded by other questions that are influenced by beliefs and traditions. Each one deserves consideration by the patient and the family. Here are the discussion points recommended by Center for Hospice Care.

Organ donation. Determine the patient’s preferences.

Embalmment. Part of the discussion regarding funeral planning.

Cremation. An option for discussion, along with where the decedent’s ashes will reside or be cast.

Obituary. If desired, information will need to be collected for local media.

Contributions to charity in lieu of flowers. This course of action needs to be determined so that the directive can accompany notification of the person’s passing.

Visitation. Eligible persons, hours and logistics should be discussed.

Wake. Planning for this event should accompany the discussion of funeral services.

Religious or memorial services. According to the patient’s and/or family’s faith and in conjunction with a designated church.

Burial site. Selection and logistics should be anticipated.

Veteran support. Deceased veterans are often honored by surviving fellow servicemen and women.

Planning Resources

These websites may be helpful with planning:

The AARP offers this planning guide for when a loved one dies.
www.aarp.org/home-family/friends-family/info-06-2012/when-loved-one-dies-checklist.html

This site offers an index of cemeteries in New London County, CT
www.ctgenweb.org/county/conewlondon/cemeteries/index.html

This site provides a list of funeral homes in New London County, CT
www.funeralhomesguide.com/county/CT/NewLondonCounty.html

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