How to Talk to Your Parents About End-of-Life Wishes

Why this talk is easier before a crisis

In a crisis, people are scared, tired, and short on time. Someone still has to answer the doctors. If the wishes were never said out loud, the family is left guessing.

An ordinary day gives everyone a chance to listen and to change their minds later. Medicare Opens in a new tab. covers a voluntary talk with a clinician about future care, including during the yearly wellness visit. You can start at the kitchen table before that visit.

The Conversation Project Opens in a new tab. is another free place for families who want more help starting. The words below are ours. They are not a script from that project.

Pick a calm time and place

You do not need a special occasion. You do need a time when no one is in a hurry.

• A quiet afternoon at home.
• A drive, or a walk, when eye contact is easy to pause.
• After a doctor visit, while the topic is already in the room.
• After a friend or neighbor has been ill, if that feels gentle rather than frightening.

Skip the holiday table, a family argument, and the emergency room. If a visit is already tense, wait.

10 conversation starters you can use word for word

Use one. Then stop and listen. You can save the rest for another day.

1. I read a short guide about health care wishes. May I tell you what I would want, and then you can tell me if you want to share yours?
2. If you got very sick and could not speak, who should the doctors ask?
3. What does a good day look like for you right now?
4. If doctors said treatments might not get you back to a life you value, what would you want them to know?
5. How do you feel about CPR, the pushing on the chest if the heart stops?
6. Would you want a breathing machine if you could not breathe on your own?
7. How do you feel about a feeding tube if you could not swallow?
8. If you were very ill, where would you want to be: home, a hospital, or somewhere else?
9. What would comfort look like for you? People in the room, quiet, music, prayer, pain control?
10. Is there anything you want us to know so we do not have to guess?

When a parent says they do not want to talk

That answer is allowed. Pushing usually closes the door.

• Say, We can leave it for today. I will be here when you want to talk.
• Offer to go first. Share your own wishes, then stop.
• Ask if they would rather talk with a doctor, a faith leader, or a different family member.
• Leave the checklist on this page. Some people will read it alone.
• Try again on a different day. Do not turn it into a test of love.

The main topics

Five topics cover most of what a care team will ask later.

• CPR. What they want if the heart stops. The DNR guide explains what that order does and does not do.
• A breathing machine. What they would want if they could not breathe on their own.
• Feeding tubes and IV fluids. What they would want if they could not eat or drink.
• Who decides. The person who can speak if they cannot. That is a health care power of attorney, also called a proxy.
• Where they want to be. Home, a hospital, or somewhere else, and what comfort means there.

If a doctor has said time may be short, you can also ask about hospice and palliative care and about a POLST. A healthy parent usually needs the advance directive, not a POLST.

Family conversation checklist

Print this page and check items when you are done. Blank boxes are part of the printout.

• We picked a calm time.
• We named the person who should speak if they cannot.
• We talked about CPR.
• We talked about a breathing machine.
• We talked about feeding tubes and IV fluids.
• We talked about where they would want to be.
• We talked about what comfort means.
• We know whether they already have a living will.
• We know where the papers are kept.
• We know who else should have a copy, including the clinician.

After the talk, put it in writing

A conversation helps. Papers and a video help the people who were not in the room.

• Complete the living will and health care power of attorney for their state. Start at the forms page.
• Give a copy to the person they named, and tell that person they were named.
• Take a copy to the next medical visit. Medicare may cover that planning talk.
• Ask the clinician if a DNR or a POLST is appropriate. Do not download a medical order and sign it alone.
• Record a short video in their own words, if they want to. The video does not replace the forms.