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

1. 1

   Coordinating Palliative Care, Home Support, and Health Coverage in Monaco

   • Supportive and Palliative Care Department at the CHPG: Ask the treating medical team for a referral to the Supportive and Palliative Care Department (Service de Soins de Support et de Soins Palliatifs) at the Princess Grace Hospital Centre (Centre Hospitalier Princesse Grace - CHPG, telephone +377 97 98 99 00) [1]. This department operates both a dedicated inpatient unit and a multidisciplinary Mobile Palliative and Supportive Care Unit (Unité Mobile de Soins Palliatifs et Supportifs, UMSPS) focused on pain management, physical comfort, and psychological support for patients and families [1].
   • Home care coordination and the Monaco Gerontological Coordination Centre (CCGM): To set up home nursing care, personal care assistants, or specialized medical equipment at home, contact the social and medico-social services outlined on the public service portal of the Gouvernement Princier de Monaco (Directorate of Social Action and Aid - Direction de l'Action et de l'Aide Sociales, DASO, and the Centre de Coordination Gérontologique de Monaco for older patients) [2].
   • 100 percent long-term illness coverage (affection de longue durée): The attending or hospital physician submits an application for co-payment exemption (exonération du ticket modérateur for serious or long-term illness) to the medical advisory board of the Caisses Sociales de Monaco (CCSS or CAMTI) or the State Medical Benefits Office (Service des Prestations Médicales de l'État, SPME) to secure full coverage for specialist treatments, nursing care, and home medical equipment [2][3].
2. 2

   Recording Medical Wishes and Designating a Healthcare Proxy in Monaco

   • Statutory focus on palliative care and pain relief: The public health and ethical framework in the Principality of Monaco guarantees the right to comprehensive pain relief and palliative support, while excluding active euthanasia or assisted suicide [1]. A patient with full decision-making capacity has the right to be informed of their diagnosis, to express treatment preferences, and to refuse disproportionate or futile life-prolonging interventions [1][5].
   • Putting written medical wishes on file: While the ill person retains full mental clarity, it is advisable to write, date, and sign a statement of end-of-life care preferences (such as limits on cardiopulmonary resuscitation, mechanical ventilation, or intensive-care transfers, as well as priorities for pain control and sedation) and have it placed directly in the patient's medical file at the Centre Hospitalier Princesse Grace and with their primary physician [1].
   • Written designation of a trusted person (personne de confiance): Have your family member designate in writing (dated and co-signed by the appointed person) a trusted healthcare representative (personne de confiance - a relative, spouse, or close contact) authorized to accompany them to medical consultations, receive health information with their consent, and convey their wishes to the medical team at the Centre Hospitalier Princesse Grace if the patient later becomes unable to express themselves [1].
3. 3

   Bank Powers of Attorney, Notarial Mandates, and Legal Protection in Monaco

   • Bank powers of attorney at Monegasque banks: Banks in Monaco strictly require powers of attorney over current accounts, investment portfolios, and safe-deposit boxes to be executed on the bank's own internal mandate forms in the presence of a relationship officer (or via an authentic power of attorney executed before a Monegasque notary) while the account holder retains full legal capacity [5]. If the ill person can no longer travel to the bank branch, ask the bank to arrange a home or hospital visit, or arrange for a Monaco notary to attend in person [5].
   • General or special power of attorney before a Monaco notary: Under the agency (mandat) provisions of the Monegasque Civil Code (published on the official legal portal LégiMonaco), the ill person can execute an authentic general power of attorney for administration or a special notarial mandate before one of the Principality's notaries, empowering a trusted relative to manage property, sign leases, and handle ongoing financial affairs [5].
   • Judicial adult protection measures (tutelle or curatelle): Under Monegasque law, an ordinary power of attorney ceases to operate or becomes legally vulnerable if the grantor subsequently loses mental capacity [5]. If a lasting impairment of mental faculties occurs, the Court of First Instance of Monaco (Tribunal de première instance / guardianship judge) may be petitioned under the Monegasque Civil Code (Articles 410-1 et seq. on LégiMonaco) to establish a tailored judicial protection measure (judicial administrator, curatelle, or tutelle) supervised by the Monegasque courts [5].
4. 4

   Activating Invalidity Benefits, Dependency Support, and Family Caregiver Aid

   • Invalidity pension and third-party assistance supplement (CSM): If the ill person is an employee insured with the Compensation Fund for Social Services (Caisse de Compensation des Services Sociaux, CCSS) and their condition permanently reduces their earning capacity by at least two thirds, the attending physician files an invalidity application with the Caisses Sociales de Monaco (telephone +377 93 15 43 43) [3]. Where total incapacity requires another person's help to perform ordinary activities of daily living, the invalidity pension is increased by a third-party assistance supplement (majoration pour assistance d'une tierce personne) [3].
   • Autonomy benefits, disability status, and retiree social allowances: Through the support programs detailed on the MonServicePublic portal of the Gouvernement Princier de Monaco, the ill person or their family can apply to the Directorate of Social Action and Aid (DASO) and the Town Hall (Mairie de Monaco) for home-support services (autonomy allowance, home care aides, tele-alarm, meal delivery), as well as retiree social allowances administered by the Autonomous Pension Fund (CAR) of the Caisses Sociales de Monaco [2][4].
   • Support and respite resources for family caregivers: Contact the DASO of the Gouvernement Princier de Monaco and the hospital social workers at the Centre Hospitalier Princesse Grace regarding home respite support, financial assistance, and psychological counseling available to family caregivers living or working in Monaco [1][2].
5. 5

   Early Review of the Will, Life Insurance Beneficiaries, and Cross-Border Estate Planning

   • Drafting or updating a Will under the Monegasque Civil Code: While testamentary capacity is intact, review or execute a last will and testament with the assistance of a Monaco notary in accordance with the Monegasque Civil Code published on LégiMonaco [5]. Monegasque law recognizes three forms of wills: the holographic will (testament olographe, written, dated, and signed entirely by hand by the testator), the public/authentic will (testament par acte public, executed before a notary in the presence of witnesses), and the mystic (sealed) will [5]. When a person is seriously ill or receiving strong analgesics, an authentic notarial will (supported by a contemporaneous medical certificate confirming full mental clarity) provides the strongest protection against future legal challenges [5].
   • Forced heirship rules (réserve héréditaire) and life insurance designations: The Monegasque Civil Code protects the statutory reserved share (réserve héréditaire) of descendants (or ascendants in the absence of descendants) and defines the freely disposable portion (quotité disponible) [5]. At the same time, review the beneficiary clauses on life insurance and capitalization policies held in Monaco or abroad so they accurately reflect the ill person's current wishes.
   • Cross-border coordination (Law No. 1.448 on Private International Law): If your family member holds foreign citizenship, owns real estate or financial assets outside Monaco, or has heirs residing abroad, consult a Monegasque notary on whether to include an explicit choice-of-law clause (professio juris, electing the testator's national law to govern their succession under the Monegasque Code of Private International Law) and organize all civil status certificates and property title deeds in a single accessible file [5].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Mobile Palliative and Supportive Care Unit (UMSPS) and Palliative Care Department — Centre Hospitalier Princesse Grace (CHPG)
2. [2]
   Social Aid, Autonomy, Disability, and Home Support Services in Monaco — MonServicePublic - Gouvernement Princier de Monaco
3. [3]
   Invalidity Insurance and Third-Party Assistance Supplement — Caisses Sociales de Monaco (CSM)
4. [4]
   Autonomous Pension Fund (CAR) - Social Allowances and Retiree Support — Caisses Sociales de Monaco (CSM)
5. [5]
   Monegasque Civil Code - Mandates, Adult Protection, and Wills — LégiMonaco - Gouvernement Princier de Monaco