In this episode of The Mental Wellness Practice Podcast, Dr. Shainna explores what she calls "the other side of grief" — the proactive planning, legacy work, and intentional end-of-life preparation that can make dying a less frightening and more empowered transition, both for the person facing it and for the family they'll leave behind.
Talking about death planning can feel morbid, uncomfortable, or even like tempting fate. But from a mental wellness perspective, there is perhaps no more loving or clarifying act than doing this work. It is, at its core, an act of profound self-knowledge and care for the people you love.
"End-of-life planning is not about death. It is about the life you've lived — what it meant, what you want carried forward, and how you want to be present for the people you love even when you're gone."
Why This Work Matters for Mental Wellness
Research in end-of-life psychology — including work by pioneers like Irvin Yalom and from the palliative care field — consistently finds that people who engage meaningfully with questions of mortality, legacy, and end-of-life wishes tend to report greater peace, less anxiety about death, and a deeper sense of purpose and meaning in their remaining time.
Conversely, dying without having addressed these questions leaves family members navigating impossible decisions under grief, often without the guidance they desperately want. The crisis of an unexpected death is hard enough. The crisis of an unexpected death combined with no legal documents, no expressed wishes, and no recorded stories is a different — and preventable — kind of suffering.
The Three Domains of End-of-Life Planning
This is the foundation: the documents that give your wishes legal force. At minimum, most adults need a will, a durable power of attorney (designating who can make decisions on your behalf if you become incapacitated), and an advance healthcare directive (also called a living will, specifying your medical care preferences). Without these, decisions about your care and estate will be made by courts and hospitals using default legal frameworks — not by the people you trust, according to your wishes.
If you have minor children, naming a guardian in your will is among the most important protective decisions a parent can make.
Beyond the legal document, it's valuable to have explicit conversations with the people who may be making decisions for you about what quality of life means to you, under what circumstances you would or wouldn't want aggressive intervention, and what your values are around pain management, hospice, and presence at the end. These conversations are uncomfortable to initiate. They are irreplaceable once they've been had. Palliative care specialists and social workers are excellent resources for facilitating them.
This is the domain that matters most for mental wellness — and the one most often skipped. Legacy work is the intentional practice of capturing what matters most about your life: your values, your stories, your relationships, your hopes for those who will grieve you. It ensures that the meaning of your life isn't lost when your physical presence is. And it tends to enrich the life that remains, as the act of articulating meaning often reveals meaning.
Legacy Work: Where to Begin
Forms Your Legacy Can Take
- Legacy letters (ethical will): A letter to loved ones capturing your values, beliefs, life lessons, hopes for them, and what you want them to know. Unlike a legal will, this passes down wisdom rather than property — and it can be rewritten as you grow.
- Recorded oral history: A video or audio recording of your stories — how you met someone important, what shaped you, what you're proud of, what you wish you'd done differently. Enormously meaningful for future generations who never knew you as a young person.
- Organized keepsakes: Photographs, letters, family objects with their stories attached. The story behind an object is what gives it meaning. Without it, objects are just things.
- Instructions for your memorial: What kind of gathering do you want? What music, what readings, what kind of tone? Many people leave this entirely to their family — and families are left guessing, often in significant distress.
- Digital estate: Accounts, passwords, social media preferences, what you want done with your digital presence. This is increasingly important and almost universally overlooked.
Having the Conversations
One of the greatest gifts of proactive planning is giving the people you love permission to have the conversation with you. When you initiate it — "I've been thinking about my end-of-life wishes and I'd like to share them with you" — you release them from the fear that bringing it up will be unwelcome or hurtful.
These conversations often become some of the most meaningful of a lifetime. Not because of what's planned, but because of what's shared — the chance to say what you mean to someone, what you want for them, and what you hope your life has given them.
Frequently Asked Questions
What is end-of-life planning?
End-of-life planning encompasses the legal, financial, medical, and personal decisions a person makes to prepare for the end of their own life. This includes documents like a will, healthcare directives, and power of attorney, as well as legacy work: intentionally documenting your values, stories, and wishes so that what matters most about your life is preserved. End-of-life planning is not about death — it's about the life you've lived, what you want it to mean, and how you want to be present for loved ones even after you're gone.
What is legacy work and why does it matter for mental wellness?
Legacy work is the intentional practice of articulating and preserving what matters most about your life — your values, stories, wishes for those you love, and the meaning you want your life to carry forward. Research shows that people who engage with questions of meaning and legacy report greater peace, less death anxiety, and a stronger sense of purpose. Legacy work is not reserved for the dying — it enriches life at any age as much as it prepares for death.
Why is end-of-life planning so hard for people?
Several forces make end-of-life planning psychologically difficult: death anxiety, cultural avoidance of mortality, the assumption that planning means giving up hope, and not knowing where to start. None of these barriers are insurmountable. Starting small — even a single conversation or one document — is meaningful. Palliative care specialists and social workers are excellent resources for facilitating these conversations.
How do I start legacy work?
Legacy work can begin simply. Write a letter to someone you love about what they mean to you. Record a conversation about the values that have guided your life. Create an ethical will capturing your beliefs and life lessons. Gather and organize photographs with their stories. Review or begin legal documents. There is no correct order and no single correct form. The goal is simply to begin — to take what lives in your heart and give it a form that can outlast you.
Is it appropriate to have end-of-life conversations with aging parents?
Yes — and these are among the most important conversations a family can have. Research shows that families who discuss end-of-life wishes experience significantly less conflict, guilt, and distress when those wishes become relevant. The goal is not to be morbid but to ensure decisions can be made with clarity and love. If direct conversation feels too difficult, a therapist, social worker, or palliative care specialist can provide a supported space for these discussions.