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

1. 1

   Coordinating palliative care and hospital or home medical support

   • Clinical coordination and symptom management: The family should establish a continuous care and pain-management plan with the attending medical team at referral hospitals (such as the Simão Mendes National Hospital in Bissau or regional hospitals) or private clinics, requesting updated medical reports that document the diagnosis, prognosis, and prescribed therapy [1] [3].
   • Medical assistance and medical evacuation allowance: For beneficiaries registered under the general social security system, the National Social Security Institute (Instituto Nacional de Segurança Social) provides medical and medication coverage as well as a medical evacuation allowance (subsídio de evacuação) when specialized treatment cannot be provided in the patient's habitual place of residence [3].
   • Organizing home care: When the person who is ill is cared for at home, it is advisable to keep a daily medication log, identifying the nearest emergency hospital unit, and maintaining physical copies of clinical reports and prescriptions accessible to family caregivers [1] [3].
2. 2

   Advance medical directives, informed consent, and healthcare proxy

   • Written statement of medical preferences: Although Guinea-Bissau does not maintain a standalone electronic living will registry, the person who is ill may exercise the right to informed consent by signing a written declaration - ideally with a notarized signature at a public notary office - setting out instructions regarding invasive interventions, hospitalization, and comfort-focused care [1] [2].
   • Designating a primary medical spokesperson: It is advisable to designate a trusted family member in writing to serve as the primary healthcare spokesperson before the attending physicians and hospital management, and to request that a copy of this authorization be placed in the patient's medical file [1].
   • Authorization to access clinical records: While retaining full lucidity, the person who is ill should sign a written authorization enabling the designated family representative to collect medical reports, diagnostic test results, and prescriptions needed for ongoing care [1] [3].
3. 3

   Executing a notarial power of attorney and banking mandates

   • Notarial public power of attorney: While the person who is ill retains full civil capacity, they should appear before a Notarial Office (Cartório Notarial) supervised by the Directorate-General of Civil Identification, Civil Registry and National Archives (Direção-Geral de Identificação Civil, Registo e Arquivo Nacional) to execute a public power of attorney (procuração pública) granting specific administrative, financial, and property management powers to a trusted attorney-in-fact [1] [2].
   • Home or hospital attendance by a notary: If the person who is ill has severely limited mobility but remains fully lucid and able to understand the legal act, the family may request that a notary officer attend the home or hospital ward to verify mental capacity and record the public instrument [1].
   • Bank-specific account mandates: Because commercial banks in Guinea-Bissau routinely require their own internal mandate forms to operate accounts, it is advisable to register the public power of attorney directly at the patient's bank branch or updating the authorized signature card while the account holder can confirm the mandate [1] [2].
4. 4

   Claiming sickness or disability benefits and caregiver support

   • Sickness allowance and disability pension: If the person who is ill is an insured worker who has become temporarily or permanently unable to work, an application should be submitted to the National Social Security Institute for sickness allowance (subsídio de doença) or a disability pension (pensão de invalidez), supported by a medical certificate confirming incapacity and the contribution record [3] [4].
   • Formal pension application requirements: Filing a pension application with the National Social Security Institute requires the official pension request form, a copy of a valid National Identity Card (Bilhete de Identidade), the social security beneficiary card, and a clinical certificate issued by the competent medical board or hospital service [3] [4].
   • Employment documentation for family caregivers: Working family members who accompany the person who is ill to medical appointments, hospital admissions, or medical board assessments should request hospital attendance certificates to justify leave or arrange workplace accommodations with their employer [3].
5. 5

   Preventive preparation of wills, insurance beneficiaries, and property records

   • Public or sealed will before a notary: To ensure that the wishes of the person who is ill are respected within the disposable portion (quota disponível) permitted by the civil succession rules applicable in Guinea-Bissau (which protect the reserved forced share of statutory heirs such as a spouse, descendants, or ascendants), a public will (testamento público) or sealed will (testamento cerrado) should be executed before a notary under the Directorate-General of Civil Identification, Civil Registry and National Archives in the presence of two qualified witnesses [1] [2].
   • Reviewing civil identification and property documents: It is prudent to check the validity of the National Identity Card of the person who is ill and close relatives, gather updated birth and marriage certificates, organize land registry titles and bank contracts, and verify designated beneficiaries on life insurance policies [1] [2].
   • International and consular coordination: Where the person who is ill holds assets, bank accounts, or has heirs residing abroad, powers of attorney or public instruments executed in Guinea-Bissau must be legalized through the Ministry of Foreign Affairs, International Cooperation and Communities (Ministério dos Negócios Estrangeiros, da Cooperação Internacional e das Comunidades) to take legal effect outside the country [5].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Public Services Portal of Guinea-Bissau - Civil Registry and Notarial Services (DGICRAN) — Governo da Guiné-Bissau (GOV-GB)
2. [2]
   Civil Identification Services and Official Documentation (DGICRAN) — Governo da Guiné-Bissau (GOV-GB)
3. [3]
   Social Security Benefits and Allowances - Sickness, Disability and Medical Assistance — Instituto Nacional de Segurança Social da Guiné-Bissau (INSS)
4. [4]
   Disability and Old-Age Pension Application Form and Procedure — Instituto Nacional de Segurança Social da Guiné-Bissau (INSS)
5. [5]
   Consular Acts Performed - Powers of Attorney, Civil Registry and Legalizations — Ministério dos Negócios Estrangeiros da Guiné-Bissau