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My Toolkit

Physical Death

My Intentions for the Time Surrounding Physical Death

This Section encourages you to consider death as a physical event that typically lasts minutes, hours or days. Often, it is hours or days and can be predicted by healthcare and/or hospice providers. In these instances, documenting your wishes will make physical death a calmer experience for you and your loved ones.


My Intentions For Death Form

Excerpted questions with sample responses (actual forms do not include responses).

Item/Issue/Possibility Questions Answers Notes
People present When death is imminent, who would you like in the room with you? My children  
  When death is imminent, who would you like in the house or hospice/hospital waiting room? My siblings and their spouses, the rabbi, Milly and Jim (my best friends) Consider who you might want to have nearby for support, but you do not want in the room with you.


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