End-of-Life Planning: The Essential and the Absurd

In PSP support groups, one question pops up daily: “What do I need to know?” The answers are empathetic, but one action stands out as non-negotiable: end-of-life planning. Do it early, and the relief starts immediately.
Planning for the end feels surreal—especially at 50. That absurdity often sparks dry humor, but here’s the truth: you can’t ignore it. The window to express your wishes is narrow. Miss it, and loved ones are left guessing—under stress, with conflicting opinions and heated arguments like “they would have wanted X.” Imagine being unable to speak, hearing those debates without a voice. Heartbreaking.
Some believe planning tempts fate. I disagree. My faith doesn’t teach us to plan on miracles. The statistics are harsh, and while I hope to beat them, I believe every parent or spouse owes it to loved ones to have these conversations. For me, that meant finding a trusted friend—a Rabbi—and a financial planner. Together with my spouse, we tackled health, wealth, and mental well-being. Yes, the control freak in me went into detail about things I won’t even be around for.

Health Decisions: Start Here
What treatments do you want—or not want? Where should care happen: home, hospice, or hospital? Do you want a caregiver, and if so, what type and when? Who will decide if you can’t?
In many countries, you can file advance directives, appoint a power of attorney, and document your wishes. In Israel, for example, you can submit an End-of-Life form to the Ministry of Health. If you have religious or cultural requirements, include them. It’s not fun, but the relief afterward is real. For a universal starting point, resources like the U.S.-based AARP Advance Directive Toolkit (adaptable internationally) can help.

Finances: Navigating the Minefield
Where are the accounts, passwords, and key documents? Who handles what if you’re gone? PSP brings financial shocks—loss of income, home modifications, caregivers, equipment. Funding exists, but it’s often means-tested and bureaucratic. I retired at 50. It was abrupt and stressful. Planning helps. Update wills, keep life insurance current, and create a household budget to weather the storm.

The Emotional Toll: Don’t Go It Alone
The change is dramatic and impacts everyone differently. Friends often don’t know what to say. Professional help is often essential. Most countries offer counseling, charities, and support groups for patients and caregivers. Some people make videos for future generations—do what feels right for you.
Yet amid the planning, remember: life is for living. Don’t let logistics eclipse quality time with loved ones. Lean on local experts and support groups so you can wrap this up efficiently—then set it aside.

Beyond the Basics: Digital and Legacy Details
What happens to your online accounts, social media, and digital assets? Document funeral and burial preferences, along with any religious or cultural requirements.

Before the End of Life
I’ve been thinking about the time before all this—when I might not be able to express my wishes—and a friend had a great idea: make a list of things you want to do. I, for example, want to watch Friends and The West Wing over and over, plus reruns of the British Office and, oddly, Air Crash Investigations on National Geographic, along with spiritual items like specific audiobooks. It’s worth considering.

Sharing the Load: Family Conversations
Finally, how and when do you share your plans with family? These conversations are hard, but they prevent confusion and conflict later. I’ve had discussions with my family—especially about power of attorney—and still have work to do on finances (though they have the spreadsheet).
As a self-admitted control freak, relinquishing the reins stings—but with PSP, choice isn’t an illusion; it’s a necessity. Planning early means less stress later. Find trusted advisors—lawyers, financial planners—and don’t delay.
I hope these discussions stay on ice for a long time, but knowing they’re largely behind us brings peace.

There is so much to say on this topic in terms of the spiritual side of life but we all have our different belief sets and I am leaving that for a diifferent time and place.