Your mother has stage four pancreatic cancer. The doctors have said there are no more treatment options. Maybe six months, they said. Maybe less.
Your siblings are in different cities. Your father is in shock. Your mother keeps saying she wants to “get things in order” but no one knows where to start.
There’s a will from fifteen years ago that needs updating. Something about advance directives that the hospital social worker mentioned. Funeral planning that feels too morbid to discuss while she’s still here. Medical decisions coming that terrify everyone.
You’re trying to be present. To spend quality time. To say the important things.
But you’re also drowning in logistics you’ve never navigated before. Insurance questions. Legal documents. Medical jargon. Family coordination across time zones. A funeral industry you know nothing about.
You google “what to do after terminal diagnosis” at two in the morning and find articles that are either too vague to be useful or so detailed you feel more overwhelmed than when you started.
Here’s what you actually need: someone who’s done this hundreds of times and can guide you through it.
That’s what an end-of-life coach does.
The Problem No One Talks About
When someone you love receives a terminal diagnosis, people show up with casseroles and kind words and offers to help. The medical system provides treatment until treatment is no longer possible, then transitions to comfort care.
What nobody provides is guidance for all the practical work that dying requires.
The legal planning. The financial coordination. The funeral shopping. The family communication. The logistics of getting someone home to die. The decisions about what matters most in the time you have.
Families are expected to figure this out themselves while also:
- Processing devastating grief
- Managing complex medical information
- Coordinating care across multiple providers
- Handling work & home responsibilities
- Supporting each other emotionally
- Being present for the person who’s dying
It’s too much. It’s always too much.
And the result is that families spend precious time spinning their wheels on tasks they’re not equipped to handle, while the things that will matter most when they look back don’t get the attention they deserve.
What Families Try (And Why It Doesn’t Work)
Most families facing terminal illness try one of these approaches:
Approach One: Figure It Out Ourselves
You divide up tasks. Someone researches funeral homes. Someone else calls estate attorneys. A third person tries to understand hospice benefits. You have family conference calls where everyone reports back on their assigned tasks.
This approach fails because:
- Nobody knows what questions to ask or what actually matters
- Information gathered by different people is inconsistent and confusing
- Critical tasks fall through the cracks because you don’t know they’re critical
- The person coordinating everything (usually one exhausted family member) becomes overwhelmed
- Time gets wasted on research that an expert could have streamlined
Approach Two: Rely on Medical Professionals
You assume the hospital social worker, the hospice team, or the palliative care doctors will tell you what to do.
This approach fails because:
- Medical professionals focus on medical care, not logistics
- Medical professionals are often focused on the curative, and may not accurately convey the seriousness of a situation
- Hospital social workers help with discharge planning, not comprehensive life planning
- Hospice doesn’t typically help with funeral shopping, estate planning, or family facilitation
- Medical teams assume someone else is handling the non-medical pieces
Approach Three: Wait Until We Have To
You tell yourselves you’ll deal with funeral planning after death happens, legal documents can wait until things are more urgent, difficult conversations can happen later when everyone is ready.
This approach fails because:
- “Later” often doesn’t come, or comes when the person can no longer communicate
- Decisions made in crisis mode are rarely the best decisions
- Waiting means less time for what actually matters: being present, saying important things, creating meaningful experiences
- Legal and financial tasks that seem non-urgent become emergencies
What all three approaches have in common: They put the burden of navigation on families who are least equipped to carry it.
What an End-of-Life Coach Actually Does
I’m going to walk you through exactly what happens when you work with an end-of-life coach, because this role is unfamiliar to most people and the title alone doesn’t explain it.
We Start With Reality Assessment
The first thing I do is help families get clear on what they’re actually facing.
Not what they hope is true. Not what the most optimistic family member believes. Not what the doctor said in the kindest possible way to avoid devastating you.
What’s actually happening. What’s likely to happen. What timeline you’re probably working with.
This isn’t about crushing hope. It’s about aligning your planning with reality so you can make good decisions about how to use the time you have.
I help families ask their doctors the questions that get honest answers:
- What does the likely disease progression look like?
- What symptoms can we expect and when?
- What will quality of life look like in one month, three months, six months?
- What medical interventions are still options, and what will they realistically accomplish?
- Are we talking about extending life or extending dying?
Many families tell me they thought they understood the prognosis until we had this conversation and they realized they’d been hearing what they wanted to hear rather than what was being said.
Once you understand what you’re facing, we can plan appropriately.
We Create Your Customized Roadmap
Every family’s situation is different. The roadmap for someone with six months is different from someone with six weeks. The priorities for someone who wants to die at home are different from someone who feels safer in a facility.
I help you understand:
- What needs to happen immediately
- What can wait but shouldn’t be ignored
- What order makes sense for your specific situation
- Which professionals you need and when you need them
- What your family can handle versus what needs to be delegated
We create checklists tailored to your circumstances. Not generic “preparing for death” articles. Specific action items for your family’s needs.
This is where having done this hundreds of times matters. I know which tasks are actually urgent versus which ones feel urgent but aren’t. I know which decisions need the whole family versus which ones can be handled by one person. I know what often causes regret and what typically ends up not mattering as much as people thought.
We Handle Professional Coordination
You need an estate planning attorney. You probably need to update or create wills, powers of attorney, healthcare proxies, living wills. You might need a financial advisor to help with asset protection or Medicaid planning.
Most families start googling, reading reviews, making phone calls, scheduling consultations, trying to figure out who’s reputable and who’s overpriced.
I already know the good professionals in your area. I refer you to vetted estate planning attorneys and financial advisors who specialize in end-of-life planning.
But I don’t just hand you a phone number and wish you luck.
I work with these providers to make sure you’re properly cared for. I ensure your needs are understood. I follow up to confirm things are getting done. I help translate legal and financial jargon into language that makes sense.
If documents aren’t coming back in a reasonable timeframe, I check on status. If you’re confused about what the attorney is recommending, I help you understand your options.
You don’t have to project-manage this yourself while also managing everything else. That’s my job.
We Navigate Funeral Planning (Without the Pressure)
At some point, funeral planning needs to happen. Most families have no idea how to approach this.
Do you shop funeral homes now while the person is still alive? Does that feel morbid? Should you wait until after death when emotions are even higher and you’re making decisions under pressure?
There’s no single right answer, but for most families, advance planning prevents crisis decision-making and allows the person who’s dying to have input on their own service.
Here’s how I help:
You tell me what matters. What kind of disposition does the person want: traditional burial, cremation, terramation (human composting), aquamation (water cremation), above-ground entombment in a mausoleum, or anatomical donation to medical science?
What kind of service feels right: religious, secular, celebration of life, no service at all? What’s the budget? What values matter most: environmental impact, religious tradition, simplicity, celebration?
Should we plan a living wake or life celebration now, before a death occurs?
I take that information and interface with funeral homes on your behalf. I narrow down options to the ones that fit your needs and price point. I handle the conversations with funeral directors so you don’t have to field sales pitches or navigate an industry you know nothing about.
When I present you with options, you’re choosing between two or three appropriate funeral homes rather than trying to evaluate fifteen based on websites and price lists you don’t know how to interpret.
You make the final decision from a place of clarity rather than confusion. And the person who’s dying gets to participate in planning their own service if they want to, which many people find meaningful.
We Facilitate Family Conversations That Aren’t Happening
There are things that need to be discussed. Wishes that need to be documented. Truths that need to be spoken.
But most families avoid these conversations because:
- They don’t want to upset the person who’s dying
- They’re afraid of saying the wrong thing
- They don’t know how to bring it up
- Family dynamics make honest conversation difficult
- Hope and denial are easier than reality
I facilitate these conversations with structure and safety.
We can start with a comprehensive planning dinner or consultation early in the illness, when there’s still time to have thorough discussions. We cover:
What the person actually wants:
- Medical interventions: What’s acceptable and what crosses the line into extending suffering rather than life?
- Location: Where do they want to be as they decline? Home? Facility? Specific room with specific view?
- Presence: Who do they want with them? Who needs to be kept away?
- Comfort measures: What music, what touch, what atmosphere brings them peace?
- Final wishes: Service details, disposition, how they want to be remembered
What family needs to know:
- Legal and financial information location
- Account access and passwords
- Who needs to be notified and in what order
- What stories and messages the person wants to leave behind
- How the person wants family to move forward after death
Then we do check-ins as needed as circumstances change. As the illness progresses and new decisions arise. As documents come back from attorneys and need explanation. As you prepare to bring someone home for final days. As family members struggle with accepting reality or coordinating care.
These meetings can be virtual or in person depending on what works. There’s no rigid schedule. We meet when you need support.
We Help You Understand Hospice and Palliative Care
One of the most common mistakes families make is waiting too long to involve hospice because they think it means giving up.
Hospice doesn’t mean giving up. It means shifting focus from cure to comfort, from length of life to quality of remaining life.
Hospice provides:
- Expert pain and symptom management
- Medical equipment and supplies
- Nursing visits and on-call support
- Medications related to the terminal diagnosis
- Social work and chaplain services
- Respite care for family caregivers
- Bereavement support after death
Many people assume hospice is only for the final week or days. In reality, hospice can be appropriate when someone has six months or less to live, and people can be on hospice for months while living relatively actively. It can be a beautiful and meaningful chapter of life for all involved.
The earlier you involve hospice, the more support you get and the better the person’s quality of life can be.
Palliative care can be even earlier, providing comfort-focused symptom management alongside curative treatment when cure is still being pursued.
Part of my role is helping families understand when these services are appropriate, what they provide, how to access them, and what you still need to arrange yourself.
Hospice is incredible at medical care and emotional support. They don’t handle estate planning, funeral shopping, family facilitation, or comprehensive life logistics. That’s where I come in.
We Plan What Dying at Home Actually Looks Like
Many people express a wish to die at home. Few families understand what that actually requires or how to make it happen.
I help you think through:
Is home actually what the person wants, or what they think they should want?
Some people feel safer and more comfortable in a facility where medical support is constant. Others desperately want their own bed, their own things, their family around them. There’s no right answer, only honest answers.
What does home setup require?
Hospital bed, oxygen equipment, medications, supplies? What does hospice provide versus what you need to rent or purchase? Where in the house makes sense? How do you create a space that’s both medical and comfortable?
What support does the family caregiver need?
Can one person handle overnight care or do you need rotating shifts? What backup do you need for when the primary caregiver is exhausted? What home health services supplement hospice?
When is the right time to transition home?
This is critical. If you wait too long, you get the person home only for the final day or hours. They die in transport or arrive home actively dying. Some who want to die at home never leave the hospital.
I help families understand the signs that it’s time to bring someone home so they get meaningful time there, not just a rushed final goodbye.
We Support Planning Life Celebrations and Living Wakes
Some families want to celebrate the person while they’re still alive rather than waiting until they’re gone.
A living wake or life celebration before death allows:
- The person to hear what they meant to people
- Closure conversations while they’re still possible
- Sharing of stories and memories with the person present
- Goodbye rituals while there’s still time
This isn’t appropriate for every person or every family. Some find it meaningful. Others find it morbid or performative.
I help you think through whether this aligns with your loved one’s values and personality, and if so, how to plan something genuine rather than forced.
We Help You Use Time Purposefully
Here’s what I’ve observed in twenty years of working with families: most people waste the precious time they have.
Not because they don’t care. Because they don’t know what will matter when they look back.
They spend weeks researching things an expert could have handled in hours. They delay difficult conversations until the person can no longer have them. They say “we’ll do that trip next month” until next month the person is too weak to travel. They focus on medical interventions that extend suffering without improving quality of life.
Then later they realize: We had three months. We could have done so much. Why did we spend so much time on logistics instead of being present?
My job is to help you identify what will matter and make sure those things actually happen.
Not in a prescriptive “you must do these things” way. In a clarifying way: Given your loved one’s values, your family dynamics, the time you probably have, what deserves focus?
Then I handle or coordinate the logistics so you can actually do those things instead of just intending to.
We Adjust as Circumstances Change
Terminal illness rarely follows a predictable path. Energy levels fluctuate. Symptoms change. Family situations evolve. Plans that made sense last month might not work this month.
This isn’t a one-and-done consulting engagement. It’s ongoing support for as long as you need it.
We check in as the illness progresses. When new decisions arise. When something isn’t working and needs adjustment. When family members are struggling.
You’re not locked into decisions we made in the first conversation. We adapt as your situation requires.
Who Benefits From End-of-Life Coaching
This is for families facing:
Terminal disease that’s no longer responding to treatment. End-stage heart failure. Advanced COPD. ALS or other progressive neurological diseases. Dementia that’s progressing rapidly. Any diagnosis where cure isn’t possible and the focus is shifting to quality of remaining life.
Advanced age with increasing frailty and repeated health crises. When it’s clear someone is declining and approaching end of life even without a specific terminal diagnosis.
This is also for families who are stuck:
Sometimes bad news arrives and the family can’t align on how to respond. Adult children see that their parent is dying and want to focus on comfort. The parent isn’t ready to give up and wants every possible intervention. Nobody will talk about it honestly.
Or the person who’s dying is ready to plan and have real conversations, but family members insist on staying optimistic and won’t engage with reality.
An outside voice can sometimes break through in ways family members can’t. When I explain what a medical intervention will actually accomplish, or what quality versus quantity of life means, families who’ve been stuck often find they can move forward.
What Makes This Different From What You’re Already Getting
You probably have doctors, maybe a hospital social worker, possibly hospice or palliative care involved. How is an end-of-life coach different?
Medical professionals focus on medical care. They treat symptoms, manage pain, provide clinical expertise. They don’t shop funeral homes, facilitate family dynamics, or coordinate estate planning.
Hospital social workers help with discharge planning. They connect you with resources for immediate post-hospital needs. They don’t provide ongoing support for the full arc of terminal illness.
Hospice teams are incredible at comfort care. They manage physical symptoms, provide emotional and spiritual counseling, support the dying process itself. They don’t handle the practical logistics of estate planning, funeral coordination, or comprehensive life planning.
Therapists and grief counselors process emotions. They help you work through feelings about loss. They don’t create checklists, coordinate professionals, or guide practical decision-making. They may not have experience in all of the other aspects involved with the end of life process.
Death doulas provide hands-on presence. They sit vigil, create rituals, offer physical and emotional support during active dying. That’s beautiful work, but it’s different from what I do.
What I provide is holistic coordination of all the practical work of dying.
I’m the quarterback looking at your entire situation, making sure all the boxes get checked, ensuring nothing falls through the cracks, coordinating across medical, legal, financial, and family domains.
I work alongside all these other professionals. I don’t replace them. I fill the gap between them, and give you the confidence in your plan. My goal is for your whole family to be able to confident in your journey and present in the moments that count.
The Cost of Trying to Do This Alone
Let me be honest about what happens when families try to navigate terminal illness without support.
They waste time on tasks that don’t end up mattering. Hours researching funeral options online when they don’t understand what they want or what they’re looking at. Days trying to coordinate family schedules for conversations that never happen. Weeks waiting for the “right time” to discuss important things.
They make decisions in crisis mode. Because they didn’t plan ahead, they’re choosing funeral homes while in shock the day after death. They’re making medical decisions without understanding what they’re agreeing to. They’re signing legal documents they haven’t had time to review.
Critical things fall through the cracks. Estate documents don’t get updated. The person becomes unresponsive without a healthcare proxy in place. Important conversations never happen because nobody facilitated them. The person never makes it home because the family didn’t know how to coordinate it in time, or they didn’t appreciate how limited the time is.
Family relationships suffer under the strain. When everyone is overwhelmed and nobody knows what they’re doing, people snap at each other. Resentments build. Old dynamics resurface. Caregiving burden falls unequally. Siblings who could have supported each other end up in conflict.
They look back with regret. Not because they didn’t love the person enough. Because they didn’t have guidance on how to navigate well.
Nearly every family I work with says some version of: “I wish we’d found you sooner. We wasted so much time trying to figure this out ourselves.”
How to Get Started
If you’re facing terminal illness in your family and you’re overwhelmed, reach out.
We’ll have an initial conversation about your situation. What you’re dealing with. What feels most urgent. What support would be most helpful.
From there, we’ll create a plan specific to your needs. Maybe we start with a comprehensive planning session where we map everything out. Maybe we address the most pressing concern first and build from there.
There’s no rigid structure. No required package. Everything is customized.
We can meet virtually or in person. We can involve just immediate family or include others who need to understand the plan. We can move quickly if time is short or take a more measured pace if you have months.
The only requirement is that you’re willing to engage honestly with what you’re facing, so we can help you navigate it well.
You don’t have to do this alone. Resources exist. People who do this work exist.
The question is just whether you’ll reach out while there’s still time to make a difference.
Contact me to discuss your family’s situation and how end-of-life coaching can help.
About Michelle
Michelle is a licensed funeral director, certified grief counselor, and end-of-life coach with over twenty years of experience serving families facing death and loss. After watching too many families struggle alone with the overwhelming complexity of terminal illness, she created comprehensive end-of-life coaching services that address all the practical, logistical, and coordination work that dying requires.
She serves families throughout the Hudson Valley, NYC Metro area, and Philadelphia region in person, with virtual coaching available nationwide. Her approach combines funeral industry expertise, medical system navigation, family facilitation skills, and practical coordination to help families make the most of the time they have and prevent the regrets that come from trying to do everything alone.
Navigating terminal illness in your family? Contact Michelle for end-of-life coaching support