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

1. 1

   Coordinate State-Funded Palliative Care and Mobile Home Care Teams

   • Request a medical council evaluation: In Latvia, integrated multidisciplinary palliative care at home and in inpatient units is coordinated and financed by the National Health Service (Nacionālais veselības dienests) [1][2]. To access state-funded mobile palliative care teams at the patient's residence, the family doctor (ģimenes ārsts) or treating specialist submits an e-health referral to a Level IV or Level V hospital medical council [1][2].
   • Activate 24/7 mobile palliative care at home: Once a hospital medical council confirms eligibility for a life-limiting illness, a regional coordinator registers the patient for mobile team visits covering physician and nursing care, pain and symptom relief, medical equipment, psychosocial support, and social care at no patient co-payment [1][2]. Service delivery begins within 24 hours of registration or hospital discharge [1][2].
   • Arrange regular home health care (veselības aprūpe mājās): For ongoing nursing procedures such as wound care, infusions, or symptom monitoring outside the mobile team framework, the family doctor can also issue a referral for state-funded home health care contracted by the National Health Service [1][2].
2. 2

   Record Advance Healthcare Preferences and Designate a Medical Representative

   • Appoint a healthcare representative under the Law on the Rights of Patients: While your family member retains full decision-making capacity, they can formally authorize a trusted person to access confidential medical records and make healthcare consent decisions if they become unable to express their will [1][3]. This authorization can be recorded in the national e-health portal (e-veselība) or executed as a notarized mandate through the Council of Sworn Notaries of Latvia [3][4].
   • Document treatment preferences with the clinical team: The ill person should discuss specific boundaries regarding cardiopulmonary resuscitation, artificial ventilation, and intensive care interventions with their attending specialist and mobile palliative care physician so these instructions are documented in their official clinical care plan and e-health record [1][2].
   • Verify organ and tissue directives: Any personal declarations regarding consent or refusal for post-treatment tissue use can also be reviewed directly in the national e-health system using an eID card or eParaksts signature [1][2].
3. 3

   Execute Financial Powers of Attorney and a Future Power of Attorney

   • Establish a Future Power of Attorney (nākotnes pilnvarojums): Under Latvian Civil Law, a person with full legal capacity can execute a notarized Future Power of Attorney before a sworn notary belonging to the Council of Sworn Notaries of Latvia [3][4]. This instrument enters into force only if and when the principal loses the capacity to understand and direct their actions, allowing the chosen attorney-in-fact to manage property, healthcare decisions, and financial affairs without requiring court-appointed guardianship [3][4].
   • Execute immediate notarial and banking powers of attorney: For immediate assistance with property, taxes, or administrative errands while capacity is intact, your family member can also execute a standard notarized power of attorney (pilnvara), which is recorded in the official Power of Attorney Register [3][4]. Always verify directly with the ill person's commercial banks in Latvia whether they require an in-branch bank mandate or specific notarial clauses for payment authorization [3][4].
   • Use remote video notarization or home visits: As highlighted by the Ministry of Justice, if the ill person cannot travel to a notary office, a sworn notary from the Council of Sworn Notaries of Latvia can authenticate powers of attorney via remote video conference on the official notary portal using eParaksts, or visit the patient at home or in the hospital [3][4].
4. 4

   Activate Disability Assessments, Care Allowances, and Benefits

   • Apply for disability and special care assessment: With a referral from the family doctor, submit an application to the State Medical Commission for the Assessment of Health Condition and Working Ability (VDEĀVK) to establish a severe disability group and obtain an official opinion on the need for special care [5].
   • Claim state disability pensions and care benefits: Once VDEĀVK establishes disability status and special care needs, the State Social Insurance Agency grants and disburses the corresponding disability pension or state social security benefit alongside the monthly allowance for a person with a disability requiring care (pabalsts invalīdam, kuram nepieciešama kopšana) [5].
   • Coordinate municipal social assistance and technical aids: Contact the local municipal social service department to arrange home care assistants, municipal housing adaptation grants, and state-subsidized technical mobility aids [1][5].
5. 5

   Organize Wills, Property Records, and Cross-Border Documents

   • Draft a public notarial will or inheritance contract: While capacity is fully intact, your family member can execute a public will (publisks testaments) or an inheritance contract (mantojuma līgums) before a sworn notary of the Council of Sworn Notaries of Latvia [3][4]. The notary registers the document in the Public Testament Register, ensuring its validity and immediate discoverability [3][4].
   • Compile property, pension, and civil status records: Organize Land Register (Zemesgrāmata) title deeds, vehicle certificates, second- and third-pillar pension beneficiary designations, and civil status documents [4][5].
   • Coordinate cross-border representation and assets: If your family member holds assets in other countries or if their designated representative resides outside Latvia, consult a sworn notary via the Council of Sworn Notaries of Latvia and guidance from the Ministry of Justice regarding European Union succession law elections, remote digital signing, and Apostille certification for foreign use [3][4].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Information on state-funded palliative and hospice care services — National Health Service of Latvia (NVD)
2. [2]
   Paliatīvā aprūpe (State-funded palliative care guidelines) — National Health Service of Latvia (NVD)
3. [3]
   Features of the portal of the Latvian Sworn Notaries — Council of Sworn Notaries of Latvia
4. [4]
   Use notary services remotely at the Latvian Sworn Notary client portal — Ministry of Justice of the Republic of Latvia
5. [5]
   State social insurance pensions and care benefits administration — State Social Insurance Agency (VSAA)