If you find your verdict for the plaintiff, then in determining the damages to which he is entitled, you shall include, but are not limited to, any of the following which you believe by the greater weight of the evidence were suffered by the beneficiaries and caused by the defendant’s negligence:
(1) any sorrow, mental anguish, and loss of solace suffered by the beneficiaries, Solace may include society, companionship, comfort, guidance, kindly offices, and advice of the decedent;
(2) any reasonably expected loss in income of the decedent suffered by the beneficiaries;
(3) any reasonably expected loss of services, protection, care, and assistance which the decedent provided to the beneficiaries;
(4) any expenses for the care, treatment and hospitalization of the decedent incident to the injury resulting in his death; and
(5) reasonable funeral expenses.
If you award damages under paragraphs (1), (2), and (3) above, you may distribute these damages among [between] (name of spouse, children, and children of any deceased child or decedent) or (names of surviving statutory beneficiaries).
If you award damages under (4) and (5) above, you shall specifically state the amount of damages for each.
9.100 Instruction No. 9.100
Damages: Death by Wrongful Act