What to do after a terminal diagnosis: what matters first, and what can wait
What to do after a terminal diagnosis, gently: what matters first, what can wait, getting affairs in order (will, power of attorney), and the letters and talks.
10 min readBy The Sealkept team
In this guide
After a terminal diagnosis, nothing has to be done today. The first things that matter are support for you and the people around you, and making sure someone you trust can speak for you if you can't. Getting your affairs in order, a will, a power of attorney, a list of accounts, can follow over the coming weeks, at a pace you choose.
We're sorry you're reading this. This guide is written to be gentle and practical at the same time. Take what helps and leave the rest. It's general information, not medical or legal advice, and your own care team will know far more about your situation than we can.
What matters first?
In the first days, the only real task is to look after yourself. Shock, numbness, anger and strange calm are all common. You don't need to make plans while the news is still landing.
When you're ready, three things tend to matter most early on.
Support. Ask your doctor, consultant or specialist nurse about palliative care. Palliative care is about comfort, symptom control and support for you and your family, and it can begin at diagnosis, alongside any treatment you choose. It isn't only for the last days. Palliative teams also help with practical worries, and many can connect you to counselling, social workers and spiritual care.
Understanding. Some people want every detail about their prognosis; others want very little. Both are fine. It can help to bring someone to appointments to take notes, and to write questions down beforehand. You're allowed to say "I don't want to know that yet."
Who speaks for you. If there's one piece of paperwork to do early, it's this: a legal document that names who can make decisions for you if you become too unwell to make them yourself. More on that below.
What can wait?
More than you might think. Clearing out belongings, deciding who gets which keepsakes, sorting old photos, closing accounts, planning a funeral in detail: all of these can wait, be done slowly, or be done by someone else afterwards. Many people find that once the key documents are in place, a weight lifts and the remaining time can be spent on living.
You also don't owe anyone a plan. Friends may arrive with lists and suggestions. It's fine to say "thank you, I'll come back to that".
How do I get my affairs in order?
Getting affairs in order with a terminal illness usually comes down to four documents and one list. The names and rules differ by country, so choose yours below. In every case, a solicitor, attorney or notary can help, and many will visit you at home, in hospital or in a hospice.
- Healthcare power of attorney (healthcare proxy). Names the person who can make medical decisions if you can't. Forms and names vary by state.
- Living will (advance directive). Records which treatments you would or wouldn't want, for example resuscitation or ventilation. Many states combine this with the healthcare proxy in one advance directive form.
- POLST or similar. In many states, a doctor can complete a portable medical order (often called POLST or MOLST) for people with serious illness, so emergency teams follow your wishes. Ask your doctor whether your state uses one.
- Durable power of attorney for finances. Lets someone you trust manage your money and bills if you can't.
- Will. Says who inherits and who will be executor. Some people also use a living trust to avoid probate; an estate planning attorney can tell you whether that's worth it for you.
Rules vary by state, so check local requirements or ask an attorney.
- Lasting Power of Attorney (England and Wales). There are two kinds: one for property and financial affairs, one for health and welfare. Both must be registered with the Office of the Public Guardian before they can be used, and registration can take weeks, so it's worth starting early. Scotland and Northern Ireland have their own versions.
- Advance decision to refuse treatment. A legally binding record of treatments you don't want in particular situations. It must meet certain requirements, especially for life-sustaining treatment, so ask your doctor or palliative team for help.
- Advance statement. Your wider wishes and preferences, such as where you'd like to be cared for. Not legally binding, but it guides the people caring for you.
- Will. Names your executor and beneficiaries. A solicitor can visit and make sure it's valid, which matters if your circumstances are at all complicated.
Rules differ across England and Wales, Scotland and Northern Ireland, so ask a solicitor if you're unsure.
- Advance directive. Most European countries recognise some form of written treatment wishes, such as the Patientenverfügung in Germany or directives anticipées in France. How binding they are varies.
- Healthcare representative. Many countries let you name a person to speak for you on medical matters. In some, this is part of the advance directive.
- Financial power of attorney. Often needs to be signed before a notary to be widely accepted, especially for property.
- Will. Many countries use notarial wills, and some have forced heirship rules that reserve part of an estate for children or a spouse. If you have property in more than one country, ask about the EU Succession Regulation, which can let you choose the law of your nationality.
Rules vary widely across Europe, so a local notary or lawyer is the right person to ask.
Alongside these, write one simple list: your bank and pension accounts, insurance policies, property, regular bills, and where the important papers are kept. Our guide to organising important documents has a full checklist. For online accounts, a password manager with an emergency access feature is safer than writing passwords down. Name who should look after your phone, email and photos.
Where can I find support?
Support exists for both the medical side and everything around it. Your GP, family doctor or specialist team is the starting point for referrals.
In the UK, the NHS provides palliative and hospice care, often with community nurses who visit at home. Charities such as Macmillan Cancer Support and Marie Curie offer information, support lines and, in some areas, nursing care; Marie Curie supports people with any terminal illness, not only cancer. Many local hospices also offer day services and family support.
In the US, ask about palliative care as early as you like, and about hospice when the focus shifts to comfort. Medicare covers hospice care for people who qualify, and many private insurers and Medicaid programmes do too. Hospice can be provided at home as well as in dedicated facilities.
Elsewhere, ask your doctor what palliative services exist locally. Many disease-specific charities also run helplines that can point you in the right direction.
What about the emotional work?
This is the part no one else can do for you, and the part many people later say mattered most. It doesn't have to be big or formal.
Conversations
Some conversations are easier face to face: telling people you love them, saying sorry, saying thank you, or talking about what you want for the time you have. You don't have to have every conversation. Choose the ones that feel important, and let the rest go.
Letters
A letter lets you say something carefully, and it lets the person keep it. Write one to each person who matters, or one to the whole family. Our guide on what to write in a goodbye letter has a gentle structure: a memory, what they mean to you, a hope, and a farewell. Keep it short if your energy is low. A few true sentences are enough.
I wanted to write while I still could. I'm not going to manage a long letter, so here is what matters. You made my life better every single year. I loved Sunday mornings with you more than you knew. Please don't spend too long being sad. Go to the sea, eat chips on the wall, and think of me. I love you.
— Dad
Recordings
Your voice and face hold things words can't. A five-minute voice note telling a favourite story, or a short video answering a few questions, can be treasured for decades. Our list of legacy video questions has prompts to choose from, and you can record in short sessions on good days. Some palliative teams and hospices also offer help with memory boxes and recordings, so it's worth asking.
Letting yourself off
Some people don't want to write or record anything, and that's completely fine. The time you spend with people now is a legacy in itself.
Where Sealkept fits
If you'd like your letters and recordings to reach particular people after you've died, rather than being found in a drawer, Sealkept can hold them. You can record a voice note or a short video in your browser on a good day, or upload one from your phone, and add photos and documents too. Each message is addressed to one person, and each recipient gets an email with a private link to only their messages, where they can play recordings and download everything.
You check in on a rhythm you choose, weekly, monthly, quarterly or yearly, with one tap. If you can't check in because you're unwell, nothing goes out straight away: there are reminders, optional trusted verifiers who can confirm, a soft alert to recipients with a "they're okay" link, and a grace period you set. Pause mode is there for hospital stays. For a note about finances or anything sensitive, a message can be set to release only when a verifier confirms. Everything is encrypted at rest.
Sealkept isn't a legal will and doesn't replace one. Our page for people facing health challenges explains how verifiers and pause mode work around treatment and hospital stays, and our guide to the dead man's switch covers how the safety layers fit together.
However much time there is, you don't have to fill it with tasks. Do the few things that bring you peace, and give the rest to the people who love you. If writing to them is one of those things, Sealkept can keep your words safe until they're needed.
FAQ
Common questions
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A few minutes tonight. Peace of mind for good.
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