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

1. 1

   Coordinate State-Funded Palliative Care and Home Nursing Services

   • Obtain a referral for Compulsory Health Insurance coverage: In Lithuania, inpatient supportive treatment and nursing care (stacionarinė slauga ir palaikomasis gydymas), multidisciplinary palliative care (paliatyvioji pagalba), and outpatient home nursing (ambulatorinės slaugos paslaugos namuose) are financed by the Compulsory Health Insurance Fund administered by the National Health Insurance Fund [1][2]. Access requires an active referral from the patient's family physician (šeimos gydytojas) or treating specialist [1][2].
   • Choose an inpatient, day-care, or home palliative care provider: For patients with progressive life-limiting conditions whose active curative options are exhausted, the National Health Insurance Fund covers inpatient hospice and palliative units as well as multidisciplinary home palliative care teams (comprising a physician, nurse, nursing assistant, psychologist, and social worker) without rigid duration limits, provided the facility holds a contract with a Territorial Health Insurance Fund [1][2].
   • Activate outpatient home nursing (ASPN): While your family member remains at home, their family doctor clinic coordinates regular outpatient home nursing visits for pain control, infusions, catheter or wound management, and vital sign monitoring at zero extra cost for insured residents [1][2].
2. 2

   Record Advance Healthcare Directives and Designate a Medical Representative

   • Designate a patient representative in the e-health portal: Under Lithuania's Law on the Rights of Patients and Compensation for the Damage to Their Health, while your family member has full capacity, they can designate a trusted spouse, partner, or representative inside the national Electronic Health Services and Cooperation Infrastructure Information System (esveikata.lt) or in their clinic records so that person can access medical information and participate in clinical decisions [1][2].
   • Document palliative and resuscitation preferences: The ill person should discuss their treatment goals, pain management preferences, and boundaries regarding cardiopulmonary resuscitation or intensive life-sustaining interventions with their attending specialist so these clinical instructions are recorded in their medical file [1][2].
   • Execute a notarized Advance Instruction (išankstinis nurodymas): Under the Civil Code of the Republic of Lithuania, an adult with full legal capacity can execute a notarized Advance Instruction before a notary of the Lithuanian Chamber of Notaries [4]. This binding document specifies how personal care, medical consent, and property administration must be handled, and names the preferred representative or guardian, if the person later loses decision-making capacity [4][5].
3. 3

   Execute Financial Powers of Attorney and Bank Mandates While Capacity Is Intact

   • Execute a notarized power of attorney (įgaliojimas): For real estate transactions, asset administration, tax representation, and official procedures, your family member should execute a notarized power of attorney before a Lithuanian notary belonging to the Lithuanian Chamber of Notaries [4]. All notarized mandates and Advance Instructions are registered in the official Register of Powers of Attorney maintained by the State Enterprise Centre of Registers [4][5].
   • Use electronic powers of attorney or remote video notarization: For simpler administrative errands and receiving correspondence, the ill person can register an electronic power of attorney online via the portal of the State Enterprise Centre of Registers (igaliojimai.lt) [5]. For full notarial acts when mobility is restricted, a notary from the Lithuanian Chamber of Notaries can conduct a remote video consultation via the eNotaras platform or visit the patient at home or in the hospital [4].
   • Verify commercial bank mandate rules: Contact each commercial bank in Lithuania where your family member holds accounts to verify whether they require a specific in-bank authorization or explicit notarial banking clauses to manage daily payments and online banking while capacity is intact [4][5].
4. 4

   Activate Participation Level Assessments, Care Compensations, and Benefits

   • Apply for disability and participation level assessment: Request the treating physician to submit medical documentation digitally to the Agency for the Protection of the Rights of Persons with Disabilities, known as ANTA (Asmens su negalia teisių apsaugos agentūra) [3]. ANTA assesses the person's participation level (dalyvumo lygis, which replaced the former working capacity level) and evaluates special needs for first- or second-level individual care or assistance compensation [3].
   • Claim targeted nursing or care compensations: Once ANTA establishes a need for permanent nursing (slaugos) or assistance (priežiūros/pagalbos), submit an application through the Social Support for Families Information System (spis.lt) or the local municipality to receive monthly targeted compensations (tikslinės kompensacijos) calculated from the statutory targeted compensation base [3].
   • Claim sickness or work incapacity pensions via Sodra: Working-age individuals who have lost 45 percent or more of their participation level and meet social insurance contribution requirements should apply to the State Social Insurance Fund Board Sodra for a social insurance work incapacity pension, while employed family caregivers can claim temporary sickness benefits from Sodra when caring for a seriously ill family member [3].
5. 5

   Review Wills, Civil Records, and Cross-Border Estate Documents

   • Execute an official notarial will or register a personal will: While your family member retains full legal capacity, they can execute an official will (oficialusis testamentas) before a notary of the Lithuanian Chamber of Notaries, or deposit a handwritten personal will for safekeeping [4]. The notary records the will in the Register of Wills administered by the State Enterprise Centre of Registers so it is automatically located when succession opens [4][5].
   • Organize property titles and beneficiary records: Gather Real Property Register extracts from the State Enterprise Centre of Registers, vehicle certificates, life insurance contracts, and second- or third-pillar pension fund agreements [4][5].
   • Coordinate cross-border assets and foreign representatives: If family members or property are located outside Lithuania, consult a notary of the Lithuanian Chamber of Notaries regarding European Union choice-of-law provisions in the will, remote eNotaras authentication, and Apostille certification for powers of attorney used abroad [4][5].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Nursing and supportive treatment services covered by Compulsory Health Insurance — National Health Insurance Fund under the Ministry of Health (VLK)
2. [2]
   Access to nursing and palliative care services at home and in hospitals — National Health Insurance Fund under the Ministry of Health (VLK)
3. [3]
   Disability, participation level, and special care needs assessment — Agency for the Protection of the Rights of Persons with Disabilities (ANTA)
4. [4]
   Tasks and functions of notaries in Lithuania — Lithuanian Chamber of Notaries
5. [5]
   Register of Powers of Attorney and Register of Wills — State Enterprise Centre of Registers (Registrų centras)