Talking with your Aging Parents Before They Are in Crisis

Discussing end-of-life issues can be one of the hardest conversations a family has, but also one of the most important. As people age, they and their families face numerous decisions about healthcare, assisted living, the prolongation of life and even funeral arrangements.

While it may be tempting to avoid these topics all together because they are so uncomfortable, finding out what your parents wishes are can be very relieving. If you wait until one or both of them are in crisis, you may be left to make agonizing decisions without knowing clearly what they would have wanted. By talking about it early on, you will have the peace of mind of knowing that the decisions you make will represent their wishes. You might even be surprised to find that your parents are relieved to talk about these things. These topics may have been weighing on their minds, too, but they may have been afraid to bring them up for fear of distressing you. Here are some ideas that may make this vital conversation easier and more productive.

Starting the conversation

Choose a time when everyone involved is relaxed and comfortable. If you’re meeting at your parents’ home, bring some cookies or doughnuts and start a pot of coffee. This conversation is important, but so is your relationship. You want the atmosphere to feel cooperative, not confrontational. Be sure that you have several hours of free time ahead of you; there should be plenty of time to bounce ideas back and forth without feeling the need to rush. Start by reassuring your parents that you are not trying to make these important decisions for them; you simply want to know their wishes. Many older people are fiercely independent; your parents may feel that you are trying to take their independence away from them. Stress to them emphatically that this is not the case. Also bear in mind that this will probably not be a single conversation but an ongoing dialog. Many of the topics that will come up in your first discussion will spawn other topics that will need to be addressed at another time. Your parents might also need some time to digest all the information that is in front of them, and they might also change their minds about some of it once they have had time to think it over. Plan to have another meeting later, even if it is only to reiterate what was said in the first one, and to be sure that everyone is in agreement.

Write things down

While it may seem a bit formal for a family discussion, this is too important a conversation to go unrecorded. Remember, too, that the topics themselves might be stressful, and when people are stressed, they often forget things more easily. Writing down what’s been said will help everyone remember what decisions have been made. Your parents might also feel relieved to see their decisions in writing. It will reassure them that their wishes are being acknowledged and will be respected. It will also give them a concrete record of your meeting. They will be able to look at it later and consider whether they have questions or have changed their minds about anything written there. You can even prepare ahead of time by labeling several sheets of paper with each of the topics that you want to cover. This will help focus the conversation and ensure that nothing of import gets overlooked. When you are done with your discussion for the day, you can make copies for everyone. That way you will all have a clear recollection of what was decided, eliminating the possibility of future misunderstandings.

What should be covered

Every family is different and has different needs, preferences, financial arrangements and spiritual concerns. Only you know which of these need to be included in your talk with your parents. Some things that you might want to cover include :

• Recordkeeping – Write down the location of your parents’ vital records. While you do not need access to any of these right now, in the future, if one or both of them should become incapacitated, you may need these documents to pay their bills, arrange their care or make medical decisions for them. You should find out if they have medical insurance, where they keep their medical records and also write down the names of their physicians. If they have an attorney, you should know how to contact him or her as well. You might also want to find out if your parents have a will and where it is kept, what bank accounts and investments they have, if they keep a safe deposit box and whether or not they have life insurance.
• Healthcare decisions – This part of the discussion should cover such topics as who your parents want to make their medical decisions if they cannot make them themselves. It can also touch on the topic of using extraordinary medical intervention at the end of life. Do your parents, for instance, want to be resuscitated if they are terminally ill? Would they want to be kept alive on a respirator? An advanced care directive — or living will — is a legal document which will allow your parents to request that they not be kept alive artificially if they are deemed to be terminally ill or in a vegetative state. A medical power of attorney will let them appoint a family member to make medical decisions for them in the event they cannot make those decisions themselves. If they don’t already have these, encourage them to do so.
• Long-term care – Some people are adamant about staying in their own homes as long as possible when they grow older; others would prefer to move into a care facility as their needs grow. Ask your parents which is true for them. There are many levels of assisted living, from occasional in-home care to full-time institutionalization. Knowing what matters to your parents will help you focus your efforts should you have to make these kinds of arrangements for them in the future.
• Final arrangements – This is perhaps the most personal topic of all, yet can be the hardest to broach. Death is a difficult subject for most of us to contemplate, and particularly so when we think about the loss of our loved ones. Your parents, however, may have very specific ideas about what they want done after they are gone. Now is the time to find out so those wishes can be honored. Do they want to be cremated or buried? Do they want to be celebrated in a joyous way, or would they feel more honored by a formal church service? They may even have very specific ideas about the details of their funerals. Write down what music should be played, for instance, and who should be asked to speak. They may also want certain events and accomplishments included in their obituaries.

As difficult as it may be to face the mortality of your aging parents, you will be better prepared to deal effectively and compassionately with their end-of-life issues if you know in advance what is most important to them.

If you’ve been procrastinating about preparing yours or your aging parents’ end-of-life documents, call or stop in at one of California Document Preparers‘ three Bay Area locations. We include an Advance Healthcare Directive and Power Attorney in our comprehensive Living Trust package.