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Family Wealth Legacy Interview Questionnaire:

My Final Wishes

1. Has there been a particular part of your life that has brought you most joy? The most sadness?

2. Who have you learned the most from in your life? Good and bad.

3. Is there any particular accomplishment in your life that you are the most proud of?

4. Who do you consider to be closest to you? Why?

5. Have you made any plans for how you will spend the latter part of your life? If so, what are they? What do you hope to accomplish?

6. Are you a religious or spiritual person? What is your most profound spiritual or religious belief?

7. Has a religious or spiritual practice given a deeper meaning to your life? If so, what is that belief or practice?

8. At some point we all have to consider end of life issues. Are your plans for the end of your life based on religious or spiritual beliefs?

9. If you went in to your doctor today and he told you that you had 2 weeks left to live, is there anyone you would want to talk to? If so, what would you say to them?

10. What worries or concerns you the most about your health and any decisions that need to be made about your medical care or efforts to prolong your life when you can no longer make those decisions yourself?

11. Have you designated anyone to make decisions for you regarding medical care when you are no longer able to make those decisions? Have you discussed this selection with them? Are they aware of your wishes?

12. Why did you select this particular person to make your end of life decisions?

13. Which is more important to you – quality of life or employing any and all measures available to prolong your life?

14. What would you want your physicians to know about your wishes for pain management?

15. If next Tuesday was to be your last day on earth, how would you spend it? Who would you want to spend the day with? Where would you go?

16. What frightens you the most about the end of your life?

17. Do you believe in organ donation? Are there any circumstances under which you would not wish to donate your organs?

18. Have you given any thought to how your life should be memorialized? Would you prefer a funeral or a memorial service? Cremation or burial? What would bring the most comfort to your survivors?

19. Do you have any favorite scriptures, songs, readings, poems, etc. that you would want included in the service? Who would you want to eulogize you?

20. If you would prefer not to have any kind of formal service, would you want a special day set aside for remembrance?

21. Do you currently have a will, a living trust, a living will or other legal documents affecting the disposition of your estate? If so, where are they kept?

22. How would you want your family and loved ones to honor your memory?

23. How do you want to be remembered?