If you're reading this, someone you love is probably nearing the end of their life, or has just died. You may be exhausted, numb, or moving through a fog where even simple decisions feel impossible. That's normal. Almost no one knows what to do the first time, and nobody expects you to.
This guide walks through the whole journey in the order you'll actually live it. It starts earlier than most checklists, at the moment hospice begins, because the weeks before a death are when families have the most power to make everything that follows easier, and the most precious time to spend together. Jump to whatever stage you're in. You don't have to read it all at once, and you don't have to do it all today.
Also on this page: a who-to-call reference table, a printable checklist, and answers to common questions.
What to Do When Someone Enters Hospice
Hospice is not giving up. It's a shift in focus from trying to cure an illness to making the time that's left as comfortable, peaceful, and meaningful as possible. Many families say their only regret about hospice is that they didn't start it sooner.
Understand what hospice provides
In the U.S., hospice is usually covered by Medicare Part A, Medicaid, and most private insurance once a doctor certifies that a person likely has six months or less to live if the illness runs its expected course. The person agrees to comfort care rather than treatment aimed at curing the terminal illness. Care can continue past six months if the doctor keeps recertifying it, and the patient can leave hospice at any time.
Most hospice care happens wherever the person lives: their home, a family member's home, assisted living, or a nursing home. A hospice team typically includes:
- A hospice nurse who manages pain and symptoms and visits regularly. A nurse is also reachable by phone 24 hours a day.
- A hospice physician who oversees the care plan alongside the person's own doctor.
- Home health aides who help with bathing and personal care.
- A social worker who helps with paperwork, family conversations, and planning.
- A chaplain or spiritual care provider, for any faith or none.
- Volunteers who can sit with your loved one so you can rest.
- Bereavement support for the family that continues for about a year after the death.
Hospice also generally covers medical equipment like a hospital bed and medications related to the terminal illness. It usually does not cover room and board in a nursing home or around-the-clock in-home caregivers, so ask early how those costs will be handled. Some families also bring in a death doula, a non-medical companion who helps with emotional support, legacy projects, and planning the final days.
Gather the documents while your loved one can still help
This is the single most valuable thing a family can do before a death. Once someone is gone, finding a will, a life insurance policy, or the password to a bank account can take months. While they're alive and able, it can take an afternoon. Work through these gently together, or with the hospice social worker:
- Advance directive and living will: their wishes about life support, feeding tubes, and resuscitation.
- Healthcare power of attorney: who makes medical decisions if they can't.
- DNR order or POLST/MOLST form: a signed medical order telling emergency responders not to attempt CPR. The name varies by state. Keep it visible at home.
- Financial (durable) power of attorney: who can pay bills and manage accounts now. This authority ends at death, when the executor takes over.
- Will or trust: where the original is and who the executor is.
- Beneficiary designations: life insurance, retirement accounts, and payable-on-death bank accounts pass outside the will, so they need to be current.
- A list of accounts: banks, credit cards, investments, pensions, insurance, loans, utilities, and subscriptions.
- Digital life: phone passcode, email, password manager, social media, and photo storage. Without the phone passcode, families can lose years of photos.
- Key documents: Social Security card, birth and marriage certificates, military discharge papers (DD-214), property deeds, and vehicle titles.
- People to notify: friends, former coworkers, church or club members, and the people only they know how to reach.
- Funeral wishes: burial or cremation, a preferred funeral home, any prepaid (pre-need) plan, music, readings, and where they'd like to rest.
- Donation wishes: whole-body donation to a medical school usually must be arranged in advance, and tissue or eye donation may still be possible after a hospice death even when organ donation isn't.
Keep it all in one secure place
A three-ring binder works. If you'd rather have it on your phone, Life Organizer is an encrypted app for recording accounts, documents, contacts, and final wishes in one private place your family can reach when it matters. It's a one-time purchase, not a subscription.
See Life OrganizerHave the conversations that matter
Paperwork protects the family. Conversations protect the relationship. Ask your loved one what matters most to them now: where they want to be at the end, who they want to see, what music or prayers bring comfort, what they want their service to feel like. Some people want to plan every detail of their own funeral. Others would rather talk about anything else. Follow their lead.
Palliative care physician Ira Byock describes four things people most need to say before a death: Please forgive me. I forgive you. Thank you. I love you. If there's something you need to say, say it now.
Celebrate them while they can still feel it
Too often, the most beautiful words about a person are spoken at their funeral, a few days too late for them to hear. Hospice is a chance to change that. Families are increasingly gathering stories, photos, and messages now, while their loved one can read them, laugh at them, and add their own.
- Record their voice. Even ten minutes of audio telling a favorite story becomes priceless. Our 50 questions to ask your parents are a gentle place to start.
- Invite people to send messages. Friends who can't visit can still say goodbye in writing, and you can read their words aloud at the bedside.
- Collect photos from everyone. Old friends and cousins have pictures you've never seen.
- Consider a living celebration while your loved one can still attend: a small gathering, a video call, or a "memory night."
Start a living tribute that becomes their legacy
A TributeWell page lets family and friends share photos, stories, and messages your loved one can enjoy right now. When the time comes, the same page becomes their memorial, with every memory already in place and nothing to start over.
Create a Living TributeFree trial · No credit card required · No accounts needed for guests
Take care of the caregivers
Caregiving at the end of life is physically and emotionally exhausting, and exhausted caregivers make harder decisions. Accept every offer of help, and be specific: "Can you sit with Mom Tuesday afternoon?" works better than "Let me know if you need anything." Ask the hospice about respite care: Medicare's hospice benefit can cover a short inpatient stay, generally up to five days at a time, so the family caregiver can rest. If you work, ask HR about the Family and Medical Leave Act (FMLA), which allows many employees up to 12 weeks of unpaid, job-protected leave a year to care for a seriously ill spouse, parent, or child.
The Final Days: Signs Death Is Near and How to Be Present
Dying is a natural process, and the body tends to follow a recognizable pattern as it slows down. Knowing what's normal can turn a frightening moment into one you're able to stay calm and present for. Every person is different; some signs appear weeks out and others only in the final hours.
Common signs in the final weeks
- Sleeping much more, and less interest in conversation or visitors.
- Eating and drinking less, then very little. This is the body's natural process, not starvation, and forcing food can cause discomfort.
- Withdrawing inward, sometimes talking about "going home" or a trip, or mentioning people who have already died.
Common signs in the final days and hours
- Breathing changes: long pauses between breaths, or cycles of rapid then slow breathing.
- Noisy, gurgling breathing from secretions in the throat. It sounds distressing but usually doesn't bother the person. The nurse can suggest repositioning or medication.
- Cool hands and feet, and purplish, blotchy (mottled) skin on the knees, feet, and hands.
- Restlessness or confusion, such as picking at sheets. Tell the nurse; it can often be eased.
- Less urine, darker in color.
- A brief rally: sometimes a burst of clarity, energy, or appetite a day or two before death. Treasure it, and use it to say what you want to say.
Call the hospice nurse any time something worries you. That's what the 24-hour line is for, and no question is too small. They can tell you what they're seeing and whether it's time to gather the family.
With hospice, call hospice, not 911
When a person enrolled in hospice has a crisis or dies, call the hospice number. Calling 911 can lead to CPR, ambulance transport, and hospital procedures your loved one chose to avoid, especially if responders can't immediately find a DNR or POLST form. Make sure every relative and visiting caregiver knows this.
How to be present
- Keep talking to them. Hearing is widely believed to be one of the last senses to fade. Tell them who is in the room, share memories, read the messages friends have sent, and say goodbye even if they don't respond.
- Touch gently. Hold their hand, stroke their hair, moisten their lips with a swab.
- Create the atmosphere they'd want: soft light, favorite music, a prayer, the family dog on the bed.
- Give permission. Many hospice nurses notice that people sometimes seem to hold on until they hear it's okay to let go: "We'll be all right. We'll take care of each other."
- Forgive yourself in advance. Many people die in the few minutes when family steps out for coffee or sleep. It's common, and it isn't a failure.
Small things to settle now
- Choose the funeral home if you haven't, so you know who will be called.
- Decide who will call whom. A short phone tree spares one person dozens of calls.
- Ask whether your loved one wants anything specific with them: a rosary, a ring, a favorite blanket, certain clothing.
- Let distant family know, so anyone who wants to come can.
The First Hours After Someone Dies
When death comes, the breathing stops, there's no pulse, the eyes may stay partly open, and the jaw may relax. Even when you've been expecting it, the moment can be overwhelming. There is no emergency now. You don't have to call anyone immediately. Many families sit with their loved one for an hour or more, pray, cry, or simply hold them. Take the time you need.
If they died at home with hospice
Call the hospice nurse line
A nurse will come to confirm the death. Depending on your state's rules, the nurse may pronounce the death or arrange for it to be pronounced. Police generally aren't needed for an expected death under hospice care.
Contact the funeral home
The hospice will help you call. You choose when they come; it's fine to ask them to wait until family arrives. Mention any prepaid arrangements.
Let the nurse handle medications and equipment
The nurse will dispose of remaining medications and arrange pickup of medical equipment over the next few days.
Your loved one is taken into the funeral home's care
The funeral home transports them and sets a time, usually within a day or two, to make arrangements. You don't have to finalize anything on that first call.
If the death happened somewhere else
At home without hospice, or unexpectedly: call 911. Emergency responders will come, and if the death wasn't expected, the police and a medical examiner or coroner may need to be involved. If there's a valid DNR or POLST, show it to responders. This doesn't mean anyone suspects wrongdoing; it's a legal requirement for unattended deaths.
In a hospital, nursing home, or hospice facility: staff will confirm the death and ask which funeral home to call. You can usually stay with your loved one for a while before they're moved.
Away from home or out of state: contact a funeral home near where you want the burial or service. They can coordinate with a funeral home where the death occurred to bring your loved one home.
Before you leave, or soon after
- Tell immediate family personally, before anything goes on social media. A small circle is enough for now.
- Arrange care for children, dependent adults, and pets who relied on your loved one.
- Secure the home and vehicle if they lived alone: locks, lights, perishable food, keys, valuables, medications, and important papers.
- Look for a prepaid funeral plan or written wishes before meeting the funeral home.
- Eat something and sleep if you can. The next few days are full of decisions.
The First Few Days: Arrangements, Notifications, and the Service
Meet with the funeral home
Bring your loved one's full legal name, Social Security number, date and place of birth, parents' names (including mother's maiden name), marital status, education, occupation, military discharge papers if they served, and any prepaid plan. The funeral home uses this to file the death certificate.
The Federal Trade Commission's Funeral Rule gives you important protections. Funeral homes must give you an itemized general price list when you ask about arrangements in person, and must give prices over the phone if you ask. You can choose only the goods and services you want, and you can buy a casket or urn elsewhere without paying a handling fee. Embalming generally isn't required by law, and direct cremation or immediate burial are lower-cost options. It helps to bring a calm friend who isn't grieving as deeply.
Order certified copies of the death certificate
The funeral home usually files the death certificate and can order certified copies for you. You'll need originals, not photocopies, for banks, life insurance, investment accounts, pensions, the DMV, and property transfers. Most families order 5 to 10 or more; count the institutions on your list and add a few. More can be ordered later from your state or county vital records office, but it usually takes longer. If a medical examiner is involved, the cause of death may be pending for days or weeks.
Notify the most time-sensitive people and agencies
- Social Security: the funeral home usually reports the death, but call the Social Security Administration yourself to confirm and ask about survivor benefits. A one-time $255 lump-sum death payment may be available to a surviving spouse or child. Benefits are paid a month behind, so a payment received for the month of death usually must be returned.
- Employer: if your loved one was working, ask about final pay, unused vacation, workplace life insurance, and pension or retirement accounts.
- Veterans Affairs: if they served, they may be eligible for burial in a VA national cemetery, a government headstone or marker, a burial flag, military funeral honors, and in some cases a burial allowance. Tell the funeral home; they can help request these.
- Life insurance companies: start claims with the policy number and a certified death certificate.
Write and share the obituary
An obituary announces the death, shares the story of a life, and gives service details. Our step-by-step obituary guide includes a fill-in template. Most funeral homes will post it on their website, and newspapers charge for print notices. For safety, leave out the exact birth date, the home address, and the mother's maiden name; identity thieves and burglars sometimes watch obituaries, and homes are occasionally targeted during services.
Give everyone one place to gather
In the days after a death, families are flooded with the same questions over and over: When is the service? Where do I send flowers? Is there a livestream? Can I share a photo? One simple page answers all of it at once, and an obituary never has room for everything people want to share.
Create a memorial page on TributeWell
One link for service details, a livestream, and a place where friends and relatives everywhere can post photos, videos, and memories, with no accounts or apps needed. Add a button linking to the official obituary or a fundraiser. Put the link in the obituary and program, and display its QR code at the service so guests can add memories on the spot. If you started a living tribute during hospice, it simply continues as their memorial with every message already there.
Create a Memorial PagePlan the service
A funeral, memorial service, or celebration of life doesn't have to happen within days. Many families now hold a private burial or cremation right away and a celebration weeks later, when people can travel and the family has had time to breathe. Some religious and cultural traditions call for a service within days, and that's fine too. Our celebration of life planning guide walks through venue, speakers, music, readings, and slideshows. Ask a friend to keep a list of who sent food, flowers, and gifts so thank-you notes are easier later.
The Following Weeks: Accounts, Estate, and Paperwork
Once the service is over, the administrative work begins. It's slow and often frustrating, so pace yourself. Most of this falls to the executor (or "personal representative") named in the will, or to a court-appointed administrator if there's no will.
Start the estate process
Find the original will
Along with any trust documents.
Talk with a probate or estate attorney
Even briefly. Rules vary widely by state, and many states have simplified procedures for small estates.
Open probate, if needed
This gives the executor legal authority (often called letters testamentary) that banks and others will ask to see.
Get an EIN and open an estate account
If the estate will receive or pay money, keep its funds separate from your own.
Inventory assets and debts
Real estate, vehicles, accounts, valuables, and everything that's owed.
Don't pay their debts with your own money
Debts are normally paid from the estate. Family members generally aren't personally responsible unless they co-signed, held a joint account, or live in a state with community property or other specific rules. Debt collectors can speak with the executor, but you don't have to agree to pay anything personally. Check with an attorney first.
Protect against identity theft
Send a copy of the death certificate to each of the three credit bureaus (Equifax, Experian, and TransUnion) and ask them to place a deceased flag on the credit file. Cancel credit cards and watch for mail about new accounts. Scammers target grieving families, so be wary of anyone calling about a "debt" or "unclaimed policy" who asks for payment.
Contact, transfer, or close accounts
- Banks and credit unions: joint accounts usually pass to the survivor; payable-on-death accounts go to the named beneficiary.
- Retirement accounts, annuities, and pensions: beneficiaries file claims directly with the plan.
- Health insurance, Medicare, and Medicaid: Social Security typically informs Medicare, but confirm and cancel any supplemental or private plans.
- Mortgage, rent, and property: keep insurance active on an empty home and notify the lender or landlord.
- Utilities, phone, internet, and streaming: transfer or cancel. Check bank statements for recurring subscriptions.
- DMV: cancel the driver's license or state ID and transfer vehicle titles.
- Passport and voter registration: notify the State Department and your local election office.
- Mail: the executor can forward mail through the U.S. Postal Service, which also helps uncover unknown accounts.
- Memberships and loyalty programs: close them, and ask whether airline miles or points can transfer.
Handle their digital life
Facebook and Instagram let you memorialize an account or request removal. Apple and Google both have legacy and inactive-account tools that let designated people access data; without them, recovering photos can be difficult. Download photos and videos before closing anything.
Taxes
A final federal and state income tax return is due for the year of death, filed by the executor or surviving spouse. If the estate earns income while it's being settled (interest, rent, or a sale), it may need its own return (IRS Form 1041). Federal estate tax affects only very large estates, though some states have lower thresholds. A tax professional can save you time and mistakes.
The Months Ahead: Grief, Remembering, and Legacy
The phone calls slow down. The casseroles stop arriving. Everyone else returns to normal, and that's often when grief hits hardest. There's no timeline and no right way to grieve. Waves of sadness, anger, guilt, numbness, and even relief are all normal, and they don't follow neat stages.
Finish the estate
Pay valid debts and final expenses from the estate, file final tax returns, distribute assets according to the will or state law, and close the estate. Simple estates can wrap up in months; complicated ones can take a year or more. That's normal, and it's fine to move slowly. Before clearing out the home, give family a chance to choose keepsakes, and photograph things nobody can keep.
Get support for your grief
- Use the hospice's bereavement program. Hospices offer grief support to families for about a year after a death, often including calls, mailings, and support groups, at no cost. Many families never realize it's available.
- Find a grief group through hospices, hospitals, places of worship, or online communities.
- Get practical help with what's left. Services like Good Grief help families work through the after-loss to-do list so it doesn't all land on one person.
- Talk to a professional if grief isn't easing over time, if you can't function day to day, or if you're having thoughts of harming yourself. In the U.S., you can call or text 988 any time.
Keep their memory alive
The first year is full of hard "firsts": birthdays, holidays, the anniversary of the death. Families who plan something for these days often find them easier than those who try to push through. Light a candle, cook their favorite meal, visit their resting place, or invite people to share a memory.
This is also when a memorial page quietly does its most important work. A year from now, a grandchild will want to hear their voice. A cousin will find a photo nobody else has seen. An old friend will learn of the death and want somewhere to say goodbye. A TributeWell page stays open for exactly that: a place to return on anniversaries, add new memories, and let the family know people are thinking of them.
Who to Call: Quick Reference
| Who | When | Why |
|---|---|---|
| Hospice 24-hour line | Immediately (hospice deaths) | Confirm the death, dispose of medications, call the funeral home |
| 911 | Immediately (unexpected deaths, not in hospice) | Emergency response, pronouncement, medical examiner |
| Funeral home | Within hours | Transport, arrangements, death certificate filing |
| Immediate family | Within hours | Personal notice before social media |
| Employer | First few days | Final pay, workplace life insurance, benefits |
| Social Security | First week | Confirm death report, survivor benefits, $255 payment |
| Life insurance companies | First week | Start claims |
| Veterans Affairs | First week (if they served) | Burial benefits, flag, headstone, honors |
| Probate attorney | First 2–3 weeks | Estate process and state rules |
| Credit bureaus | First 2–4 weeks | Deceased flag to prevent identity theft |
| Banks, investment firms, pensions | Weeks 2–8 | Transfer or close accounts, beneficiary claims |
| Utilities, phone, subscriptions | Weeks 2–8 | Transfer or cancel |
| DMV, passport, voter office | Weeks 2–8 | Cancel IDs, transfer titles |
| Tax professional | Within the year | Final income tax return and any estate return |
Printable Checklist: From Hospice to After
Check items off as you go, or print it and keep it with your loved one's papers.
When hospice begins
In the final days
The first hours
The first week
The following weeks
The months ahead
Common Questions
What is the first thing to do when someone dies?
If the person was in hospice, call the hospice nurse line, not 911. The nurse will come to confirm the death and help contact the funeral home. If the death was unexpected and the person was not in hospice, call 911. If the death happened in a hospital or care facility, staff will guide the next steps. There is usually no need to rush; you can take time to sit with your loved one before anyone is called.
Should I call 911 if someone dies at home under hospice care?
Generally no. When a death is expected and the person is enrolled in hospice, call the hospice's 24-hour number. Calling 911 can lead to resuscitation attempts and a hospital transport the person did not want, especially if a DNR order or POLST form is not immediately visible.
How many copies of the death certificate do I need?
Most families order 5 to 10 or more certified copies. Banks, life insurers, investment firms, pension plans, the DMV, and property transfers often require an original certified copy. Count the institutions you will need to contact and add a few extra; the funeral home usually helps you order them.
Who do I need to notify when someone dies?
Notify close family first, then the funeral home, the person's employer, Social Security, life insurers, banks and credit card companies, the three credit bureaus, and any agency paying benefits, including the VA if they served. An online memorial page helps share news and service details with the wider circle at once.
Am I responsible for a deceased parent's debts?
In most cases, no. Debts are normally paid from the deceased person's estate. Family members are generally not personally responsible unless they co-signed, held a joint account, or live in a state with community property or other specific rules. Talk to a probate attorney before paying any debt with your own money.
What are the signs that death is near in hospice?
Common signs in the final days include sleeping most of the time, little interest in food or drink, confusion or restlessness, changes in breathing such as long pauses or noisy breathing, cool or mottled skin on the hands, feet, and knees, and less urine. Every person is different, and the hospice nurse can tell you what they are seeing.
What should we do while a loved one is still in hospice?
Make sure the key documents exist and can be found: advance directive, healthcare and financial power of attorney, will, account and password information, and funeral wishes. Then focus on time together: record their stories and voice, invite friends to share messages while your loved one can still hear them, and ask hospice for help caring for yourself as a caregiver.
How soon do I need to plan the funeral?
There is no legal deadline, though most services are held within one to two weeks, and some religious or cultural traditions call for a service within days. Many families now hold a private burial or cremation right away and a celebration of life weeks later.
One page for the whole journey
Start a living tribute during hospice, share service details when the time comes, and keep a place for memories for years after. Family and friends add photos, videos, and stories in minutes.
Create a Tribute PageFree trial · No credit card required · No accounts needed for guests
Sources & official resources
This guide is general information for U.S. families, not legal, medical, or financial advice. Rules vary by state and situation; check with your hospice team, funeral director, and a qualified attorney or advisor.
- Medicare.gov: Hospice care coverage
- National Institute on Aging: End of life
- Federal Trade Commission: The Funeral Rule
- Social Security Administration: Survivor benefits
- U.S. Department of Veterans Affairs: Burials and memorials
- IRS: Deceased taxpayers
- U.S. Department of Labor: Family and Medical Leave Act
- 988 Suicide & Crisis Lifeline