Terminal Illness & End-of-Life Administration in Austria: 5-Step Official Checklist

1. 1

   Coordinate Specialist Palliative Care, Home Nursing, Hospice Services, and Care Allowance

   The first step is taken through the treating medical team at the hospital or the general practitioner (Hausärztin or Hausarzt) to assess pain and symptom management needs and arrange a referral to specialist care:

   • Specialist palliative and hospice care: Because hospice and palliative care in Austria is organized by federal province (Bundesland), the national umbrella organization Dachverband HOSPIZ Österreich (Austrian Hospice Association) provides an official directory of all regional associations, mobile palliative teams (mobile Palliativteams), hospital palliative wards (Palliativstationen), and inpatient hospices (stationäre Hospize) [1].
   • Care allowance (Pflegegeld) application: At the same time, submit an immediate application for Pflegegeld (care allowance, or an upgrade of an existing care level) to the competent pension insurance institution, in most cases the Pensionsversicherungsanstalt (PVA, Pension Insurance Institution) [2]. Pflegegeld is divided into seven levels to help cover care-related expenses; for serious illness, attach current medical reports and the hospital discharge summary directly to accelerate the assessment [2].
   • Continuation of proceedings after death: If the ill person has already submitted an application before death or if Pflegegeld was due, caregiving relatives may continue the procedure within six months after the death [2].
2. 2

   Prepare a Written Advance Directive under the Advance Directives Act and an Emergency Plan

   While the ill person has full decision-making capacity, they can execute a written advance directive (Patientenverfügung) under the Advance Directives Act (Patientenverfügungs-Gesetz, PatVG) to specify in advance which medical measures (such as mechanical ventilation, cardiopulmonary resuscitation, or artificial nutrition) they refuse in a terminal condition if they can no longer express their wishes later [3]. Austrian law distinguishes between two forms, as explained on the official government portal oesterreich.gv.at [3]:

   • Binding advance directive (Verbindliche Patientenverfügung): Legally binding on physicians. It requires comprehensive medical counseling (including documentation of why the ill person accurately assesses the consequences of refusing treatment) followed by personal execution with the date before a notary (Notarin or Notar), an attorney (Rechtsanwältin or Rechtsanwalt), a patient advocacy office (Patientenanwaltschaft of the respective province), or an adult protection association (Erwachsenenschutzverein) [3]. It is generally valid for eight years (five years under older rules) and remains binding indefinitely if the person loses decision-making capacity in the meantime [3].
   • Non-binding (noteworthy) advance directive (Nicht verbindliche / beachtliche Patientenverfügung): If the document does not meet all formal requirements for a binding directive, the medical team must still consider it when determining the patient's presumed wishes [3].
   • Registration and emergency access: Once executed, the Patientenverfügung can be registered in the Advance Directives Register (Patientenverfügungsregister) of the Austrian notariat or bar association as well as in the Electronic Health Record (Elektronische Gesundheitsakte, ELGA) so emergency services and hospitals can access it immediately [3].
3. 3

   Execute a Legally Valid Enduring Power of Attorney in the ÖZVV and Bank Mandates While Capacity Exists

   Whereas an advance directive refuses specific medical treatments, an enduring power of attorney (Vorsorgevollmacht) allows your family member to appoint one or more trusted representatives to make decisions on their behalf in medical matters, choice of residence and care facility, dealings with authorities, and financial and asset management if decision-making capacity is later lost [4]:

   • Formal execution requirements: A Vorsorgevollmacht must be drawn up in writing and in person before a notary, an attorney, or (provided no real estate, businesses, or complex assets are involved) an adult protection association (Erwachsenenschutzverein) [4].
   • Registration and activation in the ÖZVV: Upon execution, the Vorsorgevollmacht is registered in the Austrian Central Representation Register (Österreichisches Zentrales Vertretungsverzeichnis, ÖZVV), maintained by the Österreichische Notariatskammer (Austrian Chamber of Civil-Law Notaries) [4][5]. In practice, the Vorsorgevollmacht only takes effect once the contingency event (Vorsorgefall - the actual loss of decision-making capacity) is also recorded in the ÖZVV on the basis of a medical certificate [4][5].
   • Dedicated bank mandates: So that relatives can already handle everyday transfers or pay bills while the ill person still has decision-making capacity, a separate bank and account power of attorney (Bank- und Kontovollmacht, optionally valid beyond death) should also be signed directly at the person's bank using the bank's own forms.
4. 4

   Apply for Family Hospice Leave, Care Leave, and Care Leave Allowance for Relatives

   Employed close relatives have statutory rights to take leave or reduce working hours to care for a dying relative and receive financial support during that period [6]:

   • Family hospice leave (Familienhospizkarenz): Under Section 14a of the Employment Contract Law Adaptation Act (Arbeitsvertragsrechts-Anpassungsgesetz, AVRAG), close relatives have a legal entitlement to full leave (Familienhospizkarenz) or part-time hours (Familienhospizteilzeit) to accompany a dying close relative [6]. It can initially be taken for up to three months and extended if needed to a total of up to six months per case; the employer must be notified in writing at least five working days before the start (and ten working days before an extension) [6]. Special protection against dismissal as well as health and pension insurance coverage apply during this leave [6].
   • Care leave allowance (Pflegekarenzgeld): To bridge the loss of income during Familienhospizkarenz or agreed care leave (Pflegekarenz), caregivers have a legal entitlement to Pflegekarenzgeld, which is applied for through the federal authority Sozialministeriumservice (Ministry of Social Affairs Service, regional office of the respective province) [6]. The amount is based on the basic unemployment benefit rate (55 percent of daily net income plus any child supplements), and in cases of financial hardship an additional grant from the Family Hospice Leave Hardship Fund (Familienhospizkarenz-Härteausgleichsfonds) can be requested via the Sozialministeriumservice [6].
5. 5

   Prepare the Will, Beneficiary Designations, Vital Documents, and Future Probate Proceedings

   While full testamentary capacity exists, your family member should review their estate arrangements and organize essential personal records for the statutory procedures that follow a death in Austria:

   • Will and essential documents: Check whether a valid will (Testament - either handwritten and signed throughout, or signed before three simultaneous witnesses, or executed before a notary) exists and whether it is registered in the Central Register of Wills (Zentrales Testamentsregister) of the Österreichische Notariatskammer [5]. Gather original vital documents (birth certificate, proof of citizenship, marriage or registered partnership certificate, life or funeral insurance policies, and written burial or cremation wishes).
   • Automatic probate proceedings (Verlassenschaftsverfahren): After a death is registered, the civil registry office (Standesamt) automatically forwards the death notice to the competent district court (Bezirksgericht) of the last place of residence, whereupon the assigned notary acting as court commissioner (Gerichtskommissär) initiates the estate inquiry (Todesfallaufnahme) ex officio and contacts the relatives [7]. Powers of attorney expire upon death, and sole bank accounts of the deceased generally become part of the frozen estate until the court issues the decree of distribution (Einantwortung) [5][7].
   • Survivor pensions and health insurance: A widow's, widower's, or orphan's pension (Witwen-, Witwer- oder Waisenpension) is not paid automatically and must be actively claimed from the competent pension insurer such as the Pensionsversicherungsanstalt; if filed within six months of the date of death, the pension is paid retroactively from the day after death [8]. Deregistration from statutory health insurance (such as the Austrian Health Insurance Fund, Österreichische Gesundheitskasse) generally takes place automatically via the umbrella association of social insurance institutions once the death certificate is issued.

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Hospice and Palliative Care Facilities in Austria — Dachverband HOSPIZ Österreich
2. [2]
   Care Allowance (Pflegegeld) - Entitlement, Levels, and Application — Pensionsversicherungsanstalt (PVA)
3. [3]
   Advance Directive (Patientenverfügung) - Binding and Non-Binding Directives — oesterreich.gv.at
4. [4]
   Enduring Power of Attorney (Vorsorgevollmacht) and Registration in the Austrian Central Representation Register (ÖZVV) — oesterreich.gv.at
5. [5]
   Enduring Power of Attorney and Adult Protection in Notarial Practice — Österreichische Notariatskammer
6. [6]
   Care Leave Allowance (Pflegekarenzgeld) and Family Hospice Leave (Familienhospizkarenz) — Sozialministeriumservice
7. [7]
   Probate Procedure (Verlassenschaftsverfahren) and Role of the Court Commissioner — oesterreich.gv.at
8. [8]
   Survivor Pensions (Widow's, Widower's, and Orphan's Pensions) — Pensionsversicherungsanstalt (PVA)