You may feel uncertain about your future after a cancer diagnosis. Small-cell lung cancer (SCLC), in particular, is a fast-growing disease. It’s common to be diagnosed after the cancer has spread to other parts of your body. You may wonder how you’ll respond to treatment, or how you’ll feel from week to week.
Making a “peace of mind" folder can help create a sense of control and proactivity during this time. It’s an organized place that holds information your loved ones need if you become seriously ill or die. It may include medical information, financial records, passwords, legal paperwork, household instructions, and your personal wishes.
It’s normal to feel scared or sad at the thought of not being able to manage these parts of your life. But organizing important personal, financial, legal, and medical information ahead of time can help ease stress and confusion for you and your family, especially in a crisis, says Angie Swaim, thoracic oncology nurse navigator at Novant Health in Winston-Salem, North Carolina.
“You can think of it as a way of caring for the people you love,” says Swaim. “It says, ‘I thought about what you might need. I wanted to make this easier for you.’ That’s an extraordinary gift.”
Start With Information Your Family Would Need Immediately
One way to approach your folder is to think of what’s most important in an emergency. If you were suddenly hospitalized tomorrow, what information would your loved ones need within the first 24 to 48 hours?
Start by gathering:
- Emergency contacts
- Doctors’ names and phone numbers
- Insurance information
- Current medication lists
- Household account information
- Legal documents
- Basic financial records
Keep this information in one secure location. It’s a good idea to have both a hard copy and a digital copy that you share with trusted family members or friends.
Then think about simple household details that only you normally remember in your day-to-day life.
“Many people assume their spouse or adult children already know how everything works, but in many families, one person handles most of the operational side of life,” McKenzie says. “That person may be managing autopay accounts, renewing insurance, keeping track of medications, remembering passwords, and coordinating communication between doctors and relatives.”
Consider writing down things such as:
- Wi-Fi passwords
- Alarm codes
- Mailbox keys
- Trash pickup schedules
- Pet feeding instructions
- Lawn service contacts
- Preferred pharmacies
“You don’t need to organize everything perfectly at once,” says Swaim. “Even partial organization can make a major difference. One folder with updated medical contacts and account information is far better than nothing at all.”
Decide Where to Keep Your Information
You may prefer to put your important paperwork in a physical binder that sits in a fireproof safe or locked drawer. Or you may feel more comfortable with a digital folder stored securely online. Both are helpful in different ways.
Be sure not to leave sensitive financial information, Social Security numbers, or passwords in an unsecured place. Protect sensitive information with strong passwords and multifactor authentication whenever possible.
A physical binder can work well for:
- Copies of legal documents
- Insurance cards
- Medication lists
- Emergency phone numbers
- Household instructions
- Funeral preferences
A digital system may work better for:
- Scanned medical records
- Passwords
- Financial spreadsheets
- Backup copies of documents
- Photos and account details
Your loved ones should know where the information is stored and how to access it during an emergency. You may feel most comfortable separating different types of information into tiers. For example, some people may know where your binder is but may not have digital passwords, or vice versa. You can also assign this information to a lawyer to give out in an emergency if needed.
Digital accounts and email
One option for helping others access your digital information is to use a password manager, which stores passwords securely in one place. Password managers can generate strong passwords so you don’t have to write dozens of passwords on paper.
If you use a password manager, make sure a trusted person knows:
- Which password manager you use
- Where the master password is stored
- How to access backup recovery information
If you prefer a handwritten “emergency book” with key passwords and account instructions, make sure you store it securely and update it regularly.
Your email account often controls access to everything else, so it’s especially important that someone can access it in your absence, says Swaim.
“Password reset links for banks, insurance companies, subscriptions, and social media accounts are usually sent there first,” she says. “If nobody can access your email, your loved ones may struggle to manage the rest of your accounts.”
Some platforms, such as Facebook, allow you to assign a legacy contact or memorial contact who can manage parts of your account after your death. You can also leave instructions explaining whether you would like your accounts memorialized, deleted, or preserved for family photos and memories.
Financial Information
Money issues can become overwhelming quickly during cancer treatment, especially if your financial information is spread across multiple banks or physical folders. Your loved ones don’t necessarily need immediate control over every account right away after your diagnosis. But they do need a clear overview of what exists, including:
- Bank accounts
- Credit cards
- Retirement accounts
- Investment accounts
- Life insurance policies
- Safe deposit boxes
- Mortgages
- Vehicle titles
- Outstanding loans
Swaim says another helpful step is creating a simple monthly expense sheet. Your family may not know which bills are automatic, which insurance policies need continued payment, or which subscriptions can be canceled immediately.
“A one-page summary or spreadsheet is all you need,” says Swaim.
Include information for things such as:
- Electric and gas companies
- Water and internet providers
- Cell phone accounts
- Mortgage or rent payments
- Car payments
- Streaming services
- Newspaper or magazine subscriptions
- Lawn service
Medical Information
Cancer care creates huge amounts of paperwork. Scan reports, pathology records, prescriptions, insurance approvals, lab results, and specialist referrals are just a few of the paperwork pieces you’ll manage.
Having an organized medical section can make life easier for you and your loved ones.
Consider keeping:
- Your diagnosis information
- Current treatment plans
- Medication lists
- Allergies
- Insurance cards
- Medicare details
- Doctors’ contact details
- Pharmacy information
- Copies of scan summaries and pathology reports
Your current medication list is especially important. If you become hospitalized unexpectedly, accurate medication details can help reduce delays and medication errors.
Include:
- Medication names
- Dosages
- When you take them
- Why you take them
Include your patient portal login information in your folder so your loved ones can communicate with your doctors and access records there if you’re unable to.
Putting Legal Documents in Order
Legal planning can feel intimidating, but these documents are designed to protect both you and your family during hard times.
Important legal documents often include:
Will. A legal document that says what will happen to the things you own and your money after your death.
Durable power of attorney for health care or health care power of attorney. This allows another person to make medical decisions on your behalf if you become unable to do so yourself. This document gives someone you trust legal authority to make health care decisions for you.
Advance directive or living will. Documents that communicate your wishes for future medical care if you cannot speak for yourself. These forms can include your decisions about treatments such as resuscitation, feeding tubes, ventilators, or other life-sustaining care.
“Some advance directive forms are available directly through hospitals or state health departments, meaning you may not always need an attorney for basic documents,” says Swaim. “But legal guidance can be especially helpful if you have a blended family, complicated finances, or concerns about family conflict.”
Not every important decision is medical or financial. You may also write down personal wishes that may not appear in formal legal paperwork, such as your memorial service preferences, pet care instructions, or notes about sentimental belongings.
You can also write what is called a letter of intent. This is not usually a legal document. Instead, it explains the thinking behind certain decisions you’ve made. For example, you may explain why one person was chosen as power of attorney or why you wanted a certain family item passed to a specific person.
These explanations can help prevent misunderstandings and resentment later, says Swaim.
Telling Your Loved Ones About Your Folder
You may worry that talking to your loved ones about your wishes and telling them about your folder means you are giving up hope. But you can approach the conversation with matter-of-fact language that shows that you’re coming from a place of love and care, says Swaim.
“You can simply say, ‘I organized some important information in case you ever need it, to make things easier for everyone,’” she says. “Sometimes that’s all it takes to ease people’s fears and reassure them that you’re in this together.”
