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

1. 1

   Set Up Palliative Care, 100% ALD Coverage, and Home Support

   Start by coordinating with the attending general practitioner (médecin traitant) and the hospital specialist team (such as oncology) to put the palliative care pathway and financial coverage in place [3][4][8]:

   • Organizing palliative care at home or in a facility: Depending on medical needs and your relative's wishes, the attending or hospital physician can prescribe Hospitalization at Home (Hospitalisation à domicile - HAD), call upon a Mobile Palliative Care Team (équipe mobile de soins palliatifs - EMSP), contact the departmental Care Coordination Support Service (dispositif d'appui à la coordination - DAC) to organize home care, or request admission to an inpatient Palliative Care Unit (unité de soins palliatifs - USP) or designated palliative care beds [3][4]. You can obtain official guidance on patient rights and care services from the Centre national des soins palliatifs et de la fin de vie (National Center for Palliative and End-of-Life Care) at 01 53 72 33 04 [3], as well as through the directory and helpline of the Société Française d'Accompagnement et de Soins Palliatifs (French Society for Support and Palliative Care - SFAP) at 01 53 72 33 00 [4].
   • 100% long-term illness coverage (ALD) and health insurance grants: Verify that the attending physician has established an exempting Long-Term Illness (Affection de Longue Durée - ALD) care protocol so that medical care, medications, and transport related to the condition are reimbursed at 100% of the statutory Social Security rate by Assurance Maladie (French National Health Insurance, reachable at 36 46) [8]. When palliative care is provided at home, the social service department of the local health insurance fund (Caisse primaire d'assurance maladie - CPAM) can also draw on its health and social action fund to help finance home-care assistant hours or non-reimbursable medical supplies [8].
   • Emergency Personalized Autonomy Allowance (APA): If the ill person is aged 60 or older and experiencing a rapid loss of independence (GIR 1 to 4), submit an application for home-based Allocation personnalisée d'autonomie (APA) to the departmental council (conseil départemental); in the event of a certified medical or social emergency, the president of the departmental council can grant a provisional flat-rate emergency APA (APA d'urgence) as soon as the application is filed [5].
2. 2

   Draft Advance Directives and Designate a Healthcare Proxy in Writing

   Under France's Claeys-Leonetti Act, two distinct legal instruments ensure that the ill person's medical wishes are respected if they become unable to express themselves [1][2][3]:

   • Advance directives (directives anticipées): Any adult may write their directives anticipées at any time (either on dated and signed plain paper stating their full name, date, and place of birth, or using the official template issued by the Ministry of Health and the Haute Autorité de Santé) [1][3]. These directives specify the person's wishes regarding the continuation, limitation, withdrawal, or refusal of end-of-life treatments or medical procedures, and are binding on the physician (except in a life-threatening emergency while the situation is being assessed, or if they appear manifestly inappropriate) [1][3]. If the person is physically unable to write, two witnesses (including the designated healthcare proxy) may attest in writing that the document expresses their free and informed wishes [1].
   • The healthcare proxy (personne de confiance): The ill person may designate a personne de confiance (a trusted relative, family member, or their attending physician) in writing via a document co-signed by both parties [2]. This person may accompany them to medical consultations and will be consulted first by the healthcare team to attest to the patient's wishes if the patient can no longer express them; their testimony takes precedence over any other non-medical opinion, subject only to written advance directives [1][2].
   • Storage and accessibility: Upload both documents to the shared medical record on Mon espace santé, provide copies to the attending physician and the hospital or HAD team, and keep the originals at home with the personne de confiance [1][2].
3. 3

   Secure Everyday Powers of Attorney and Legal Representation

   Designating a personne de confiance for medical matters grants no authority to manage bank accounts, housing, or property [2][6]. While your family member retains full legal capacity:

   • Bank and postal powers of attorney: Set up powers of attorney (procurations bancaires) directly with each bank for current and savings accounts, as well as a postal power of attorney (procuration postale) with La Poste, so that a designated family member can pay routine bills, manage direct debits, and collect registered mail [6]. Note that all bank powers of attorney automatically terminate on the date of death [6].
   • Future protection mandate or notarial power of attorney: To prepare for a potential decline in capacity that would prevent the person from managing their own affairs (and thus avoid court-ordered guardianship proceedings such as habilitation familiale, curatelle, or tutelle), they may execute a Future Protection Mandate (mandat de protection future) with one or more representatives [6]. This mandate can be drawn up under private signature (Form Cerfa n° 1359204, limited to routine administrative acts) or by notarial deed (acte notarié) through Notaires de France (which allows acts of disposition over the estate, including selling real property) [6]. The mandate only takes effect once a medical certificate issued by a court-approved physician confirms incapacity and is certified by the registry of the judicial court (tribunal judiciaire) [6]. In parallel, an immediately effective general notarial power of attorney (procuration générale notariée*) can be signed if the person wishes to delegate administrative or property management tasks right away [6].
4. 4

   Activate Family Solidarity Leave and the Daily Caregiver Allowance (AJAP)

   Relatives who suspend or reduce their professional activity to care for a loved one at the end of life are entitled to specific statutory leave and financial support [7][8]:

   • Family solidarity leave (congé de solidarité familiale): Any private-sector employee or public servant (ascendant, descendant, sibling, person sharing the same household, or designated personne de confiance) has the right to request congé de solidarité familiale from their employer as soon as a medical certificate attests that the relative suffers from a life-threatening condition or is in the advanced or terminal phase of a serious and incurable illness [7]. Granted for a maximum of 3 months, renewable once (up to 6 months in total), it may be taken continuously, in blocks, or on a part-time basis with the employer's agreement, and the employer can neither refuse nor postpone it [7].
   • Daily End-of-Life Caregiving Allowance (AJAP): When the ill person is cared for at home (or in an EHPAD care home), Assurance Maladie (or the MSA agricultural fund, depending on affiliation) pays the Allocation journalière d'accompagnement d'une personne en fin de vie (AJAP) to recipients of family solidarity leave (as well as to self-employed workers or benefit-receiving jobseekers who suspend their activity) for up to 21 days (or 42 half-days for part-time leave), which can be shared among several family caregivers [8]. For full administrative rules and forms covering statutory leave and social rights, consult the official portal Service-Public.fr (or call 39 39 Allô Service Public) [7].
   • Alternative prior to the terminal phase: If loss of independence requires regular support before the strictly terminal stage, a caregiver may apply for Caregiver Leave (congé de proche aidant) compensated by the Daily Caregiver Allowance (Allocation journalière du proche aidant - AJPA) through the Family Allowance Fund (Caisse d'allocations familiales - CAF) [7].
5. 5

   Organize the Will, Life Insurance Beneficiary Clauses, and Funeral Wishes

   • Drafting and registering the will (FCDDV): The person may draw up a holographic will (testament olographe, entirely handwritten, dated, and signed by them) or dictate an authentic will (testament authentique) before a notary [9]. Even for a handwritten holographic will, it is strongly advisable to deposit it with a notary's office through the Notaires de France network so that it is kept safely and recorded in the Central Register of Last Wills (Fichier central des dispositions de dernières volontés - FCDDV), ensuring it will be located when the estate is settled [9].
   • Life insurance policies and Social Security death grant: Ask your relative to review the exact wording of the beneficiary clauses (clauses bénéficiaires) in their life insurance (assurance-vie) and retirement savings contracts (which pass outside the civil estate) and gather the insurers' contact details. Also check eligibility requirements for the Social Security lump-sum death grant (capital décès) with Assurance Maladie if the person was recently employed, receiving benefits from France Travail, or drawing an invalidity pension or permanent disability annuity [8].
   • Funeral wishes and administrative file: Encourage your relative to record their funeral preferences in writing (choice between burial and cremation, civil or religious ceremony, organ or body donation to science, and details of any prepaid funeral contract - contrat obsèques) and assemble the family record book (livret de famille), birth certificate, property deeds, bank statements, and digital credentials in a single folder [3][9].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Advance directives: last wishes regarding end-of-life medical care (Fiche F32010) — Direction de l'information légale et administrative (Service-Public.fr)
2. [2]
   Official template for designating a healthcare proxy (personne de confiance) — Direction de l'information légale et administrative (Service-Public.fr)
3. [3]
   Parlons Fin de Vie: palliative care, advance directives, and patient rights — Centre national des soins palliatifs et de la fin de vie (CNSPFV)
4. [4]
   French Society for Support and Palliative Care (SFAP): palliative care and end of life — SFAP
5. [5]
   Personalized Autonomy Allowance (Allocation personnalisée d'autonomie – APA) — Direction de l'information légale et administrative (Service-Public.fr)
6. [6]
   Future protection mandate (Mandat de protection future) — Direction de l'information légale et administrative (Service-Public.fr)
7. [7]
   Family solidarity leave (Congé de solidarité familiale) — Direction de l'information légale et administrative (Service-Public.fr)
8. [8]
   Daily End-of-Life Caregiving Allowance (AJAP) — Assurance Maladie (Ameli.fr)
9. [9]
   Wills and the Central Register of Last Wills (FCDDV) — Conseil supérieur du notariat (Notaires de France)