Terminal Illness & End-of-Life Planning in Ghana: 5-Step Official Checklist

1. 1

   Coordinate Palliative Care, Home Nursing, and Health Coverage

   • Specialist palliative and pain-management clinics: You can request a referral from your family member's treating specialist to dedicated multidisciplinary palliative care units operating within public teaching hospitals overseen by the Ministry of Health of Ghana and the Ghana Health Service, including the Palliative Care Units at Korle Bu Teaching Hospital in Accra, Komfo Anokye Teaching Hospital in Kumasi, and the Tetteh Quarshie Memorial Hospital [1] [5]. These teams manage complex pain control (including regulated oral morphine prescriptions), symptom relief, and domiciliary nursing visits [1] [5].
   • National Health Insurance Scheme (NHIS) coverage: You should verify that your family member's membership with the National Health Insurance Authority is active so that covered inpatient admissions, outpatient consultations, diagnostic investigations, and essential medicines on the NHIS Medicines List are billed directly at accredited public and private facilities [2].
   • Home care and private health insurance: If your family member holds private health insurance or an employer medical plan, contact the insurer early to confirm pre-authorization rules for home nursing care, medical equipment rental, and specialist oncology or palliative consultations [1] [2].
2. 2

   Record Advance Healthcare Preferences and Designate a Medical Proxy

   • Patient's Charter and informed consent rights: Under the Public Health Act, 2012 (Act 851) - which incorporates the Ghana Health Service Patient's Charter - every patient with decision-making capacity has the statutory right to receive full clinical information, to consent to or refuse specific medical treatments, and to involve designated family representatives in care decisions [1] [4].
   • Written advance care plan and treatment directives: Although Ghana does not have a standalone Living Wills statute, your family member can sign a written Advance Care Directive while mentally competent, clearly stating their preferences regarding cardiopulmonary resuscitation, mechanical ventilation, intensive care admission, pain management, and preferred place of care (hospital vs. home) [1] [4].
   • Designating a healthcare representative in clinical records: Your family member should formally name a primary and alternate healthcare representative (medical proxy) in writing, have the document witnessed and placed directly into their hospital medical file, and review these wishes with the lead clinician at the Ministry of Health of Ghana facility so the care team knows whom to consult if capacity later declines [1] [5].
3. 3

   Execute Financial and Legal Powers of Attorney and Bank Mandates

   • Statutory requirements under the Powers of Attorney Act, 1998 (Act 549): While your family member retains full mental capacity, they can execute a formal Power of Attorney under the Powers of Attorney Act, 1998 (Act 549) authorizing a trusted attorney-in-fact to manage property, sign legal instruments, and handle administrative affairs [4]. Under Act 549, the instrument must be signed by the donor (or at their direction in their presence) and attested by at least one witness (or two witnesses if signed by someone else at the donor's direction) [4].
   • Notarization, stamping, and registration: To be accepted by public registries, courts, and financial institutions, the Power of Attorney should be notarized by a Notary Public, stamped for stamp duty at the Lands Commission / Ghana Revenue Authority, and registered where land or real property transactions are involved [4]. Note that under Ghanaian common-law agency rules, an ordinary Power of Attorney is suspended or ceases to operate if the donor loses mental capacity, after which family members would need to apply to the High Court within the Judicial Service of Ghana for a formal guardianship or receivership order under the Mental Health Act, 2012 (Act 846) [4].
   • Direct bank mandates and digital access: Because commercial banks in Ghana enforce strict internal verification rules, your family member should visit their bank branches in person (or request a domiciliary relationship-manager visit) to sign the bank's own third-party mandate or joint-signatory forms while fully lucid [4].
4. 4

   Activate Invalidity, Critical-Illness, and Caregiver Support Benefits

   • SSNIT Invalidity Pension: If your family member is an active worker under retirement age who has become permanently incapable of any normal gainful employment due to a severe or terminal physical or mental condition, they can apply for an Invalidity Pension from the Social Security and National Insurance Trust [3]. Under the National Pensions Act, 2008 (Act 766), the member must have contributed for at least 12 months within the last 36 months and must be certified as permanently invalid by a recognized Medical Board following a report from an accredited medical practitioner [3].
   • Tier 2 and Tier 3 pension disability withdrawals and insurance: Approved invalidity status also entitles the member to claim lump-sum accrued balances from their Second Tier mandatory occupational pension scheme and Third Tier voluntary provident fund managed by their NPRA-licensed trustee, as well as any critical-illness or permanent-disability rider on private life insurance policies [3].
   • Employment leave and workplace protections: Under the Labour Act, 2003 (Act 651), employees in Ghana are entitled to statutory paid annual leave and certified medical/sick leave, and family caregivers can negotiate compassionate leave or flexible working arrangements with their employer while supporting a seriously ill family member [4].
5. 5

   Organize the Will, Beneficiary Nominations, and Property Records

   • Executing or updating a valid Will under the Wills Act, 1971 (Act 360): Preparing a clear written will prevents the delays and potential family disputes associated with intestacy under the Intestate Succession Law, 1985 (PNDCL 111) [4]. Under the Wills Act, 1971 (Act 360), the testator must be at least 18 years old and of sound mind, and must sign the will in the simultaneous presence of at least two witnesses (neither of whom may be a beneficiary or spouse of a beneficiary under the will) [4].
   • Safekeeping at the High Court Registry: Once executed, the original will can be sealed and deposited for official safekeeping at the Probate Registry of the High Court within the Judicial Service of Ghana, ensuring it cannot be lost, altered, or suppressed [4].
   • Updating SSNIT and pension beneficiary nominations: Because First Tier Survivors Lump Sum Benefits and Tier 2/Tier 3 occupational pension funds are paid primarily according to recorded beneficiary nominations, your family member should contact the Social Security and National Insurance Trust to review and update their beneficiary nomination records and ensure all dependents' Ghana Card details and birth certificates are accurate [3].
   • Consolidating property titles and cross-border assets: Gather original Land Title Certificates, registered indentures, vehicle registration books, and bank details in a secure folder [4]. If your family member owns assets outside Ghana or has heirs living abroad, ensure any foreign Power of Attorney or separate situs will is executed and legalized through the Ministry of Foreign Affairs and Regional Integration and the relevant foreign embassy [4].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Ministry of Health - Public Health Facilities and Clinical Services — Ministry of Health of Ghana
2. [2]
   National Health Insurance Scheme - Benefits Package and Accredited Providers — National Health Insurance Authority (NHIA)
3. [3]
   SSNIT Benefits and Member Forms (Invalidity and Beneficiary Nominations) — Social Security and National Insurance Trust (SSNIT)
4. [4]
   Ghana Legal Information Institute - Legislation (Wills Act 360, Powers of Attorney Act 549, Public Health Act 851) — Ghana Legal Information Institute (GhaLII) / Judicial Service of Ghana
5. [5]
   World Health Organization - Ghana Country Health Portal — World Health Organization (WHO)