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

1. 1

   Coordinate Palliative Care, Pain Management, and Health Insurance Coverage

   • Specialist palliative care units: The Federal Ministry of Health and Social Welfare, together with the National Cancer Control Programme, coordinates oncology and palliative care services across federal teaching hospitals and tertiary medical centers in Nigeria (such as University College Hospital Ibadan, Lagos University Teaching Hospital, National Hospital Abuja, and University of Nigeria Teaching Hospital Enugu) [1, 2]. Ask the primary specialist for a formal referral to the hospital's multidisciplinary Pain and Palliative Care Unit for symptom control, regulated oral opioid pain relief, and home-care guidance [1, 2].
   • Hospice and home nursing support: Where the patient prefers care at home, coordinate through the hospital palliative team and accredited community hospice providers affiliated with the Hospice and Palliative Care Association of Nigeria (HPCAN) to arrange home nursing visits, caregiver training, and medical equipment [2].
   • National Health Insurance Authority and HMO coverage: Review your family member's enrollment under the National Health Insurance Authority (established under the NHIA Act 2022), state social health insurance agencies, or private Health Maintenance Organizations (HMOs) [3]. Request that the treating consultant submit clinical reports for chronic, oncology, or catastrophic health fund coverage so eligible hospital admissions, medications, and supportive therapies are pre-authorized [1, 3].
2. 2

   Record Advance Healthcare Directives and Appoint a Medical Proxy

   • Patient autonomy and written treatment preferences: Under Nigeria's National Health Act 2014 and constitutional protections of personal dignity, every mentally competent adult has the right to participate in healthcare decisions and to give or refuse informed consent to medical treatment [1]. While your family member has full capacity, they can sign a written Advance Healthcare Directive recording their preferences on cardiopulmonary resuscitation, mechanical ventilation, intensive care admission, and comfort-focused palliative care [1, 2].
   • Designating a Healthcare Proxy (Medical Representative): In the same directive, the ill person should nominate a trusted primary and alternate family representative authorized to receive confidential medical disclosures, consult with doctors, and make treatment decisions if the patient later becomes unable to communicate [1].
   • Physician attestation and notarization: Because clinical teams in Nigeria often consult extended family members during serious illness, having the attending consultant document the patient's mental capacity in the hospital case file and having the directive signed before a Notary Public or Commissioner for Oaths helps prevent family disputes and gives clear legal reassurance to medical staff [1].
3. 3

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

   • Power of Attorney for property and administration: While your family member retains full legal capacity, instruct a Nigerian legal practitioner (Solicitor and Advocate of the Supreme Court of Nigeria) to draft a formal Power of Attorney authorizing a trusted agent to manage financial obligations, collect rents, represent the principal before government agencies, and handle property matters [4].
   • Execution by deed, stamping, and registration: If the Power of Attorney authorizes the agent to execute deeds or deal with land and real estate, it must be executed as a Deed (signed, sealed, and delivered), attested by a Notary Public, magistrate, or judge, stamped at the Federal or State Stamp Duties Office, and registered at the relevant State Lands Registry.
   • Commercial bank mandates and common-law capacity limits: Nigerian commercial banks frequently require the account holder to execute the bank's specific Third-Party Mandate Form and complete Bank Verification Number (BVN) and National Identification Number (NIN) biometric confirmation in person or through a branch relationship manager while capacity is intact. Because an ordinary common-law Power of Attorney in Nigeria can be challenged if the donor subsequently loses mental capacity, establish clear joint or mandated operating accounts and consult a solicitor early regarding a living trust if long-term cognitive incapacity is anticipated.
4. 4

   Activate Invalidity Pension, Disability, and Workplace Benefits

   • Contributory Pension Scheme (CPS) invalidity and medical retirement: If your family member holds a Retirement Savings Account (RSA) regulated by the National Pension Commission, an employee who is certified by a properly constituted medical board as no longer mentally or physically capable of carrying out the functions of their office due to total or permanent disability may access their RSA balance under the Revised Regulation on the Administration of Retirement and Terminal Benefits [4]. Contact the employer and the Pension Fund Administrator (PFA) to initiate medical board certification for invalidity retirement [4].
   • Employees' Compensation Scheme disability claims: If the severe illness or permanent disability is occupational or work-related, file a disability compensation and medical expense claim with the Nigeria Social Insurance Trust Fund under the Employees' Compensation Act [5].
   • Employer sick leave and caregiver arrangements: Review the ill person's employment contract or Public Service Rules regarding extended paid medical leave and medical board evaluations, and obtain an official medical report from the treating tertiary hospital so employed family caregivers can request compassionate or family leave from their employers [1, 5].
5. 5

   Review the Will, RSA Beneficiary Records, and Vital Documents

   • Executing or updating a valid Will: Under the Wills Act and applicable State Wills Laws (such as the Wills Law of Lagos State), a valid will must be in writing and signed by the testator in the simultaneous presence of at least two independent adult witnesses, who must also sign in the testator's presence (witnesses and their spouses must not be beneficiaries) [4]. For enhanced security against later tampering or contestation, the original sealed Will can be lodged for safekeeping during the testator's lifetime at the Probate Registry of the State High Court.
   • Updating PFA next-of-kin and insurance records: Ensure that the named beneficiaries and next-of-kin records held by the Pension Fund Administrator under the supervision of the National Pension Commission [4] and by the employer's Group Life Insurance underwriter match the ill person's wishes, and verify that all family members' names match their official civil registration records with the National Population Commission [6].
   • Cross-border assets and diaspora family coordination: Assemble original Certificates of Occupancy, registered deeds of assignment, share certificates, and civil status records in a secure file [6]. If family members, executors, or assets are located outside Nigeria, remember that Nigeria is not a party to the Hague Apostille Convention, so cross-border powers of attorney or legal instruments must be notarized and legalized through a Nigerian embassy or high commission abroad (or the Ministry of Foreign Affairs in Abuja).

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Federal Ministry of Health and Social Welfare - Official Portal — Federal Ministry of Health and Social Welfare
2. [2]
   Cancer Control and Palliative Care Framework in Nigeria — National Cancer Control Programme (NCCP)
3. [3]
   National Health Insurance Authority Act 2022 — National Health Insurance Authority (NHIA)
4. [4]
   Revised Regulation on the Administration of Retirement and Terminal Benefits (Invalidity and Health Retirement) — National Pension Commission (PenCom)
5. [5]
   Employees' Compensation Scheme - Disability and Medical Benefits — Nigeria Social Insurance Trust Fund (NSITF)
6. [6]
   Civil Registration and Vital Records — National Population Commission (NPC)