#9 – My parents are in their 70s. Do we need to talk about their healthcare preferences?

Click here to see the prior item in this series:  What information should a caregiver keep track of?

My parents are in their 70s and have not said anything about their future healthcare preferences. Since they are still relatively healthy, do we need to talk about that now?

For most of us, talking with people about the kind of medical care they would want if they are seriously ill and unable to make decisions can be difficult. But, when the conversation is with someone close to you, it can be many times harder for everyone. Yet, it’s important to be prepared, especially in case of unexpected illness.

As a long-distance caregiver, you might want to wait until you are face to face with your parents, rather than try to handle this sensitive subject on the phone. During a visit, you could try saying that you have just made your living will, or you could tell them you’ve chosen someone to make your healthcare decisions. A friend or neighbor’s illness might also jumpstart a conversation about healthcare preferences. For some families, a conversation about, for example, who would like Grandma’s china could be a gentle way to start the discussion. Would you rather begin on a less personal note? Discussing a TV show, newspaper article, or movie might be the way to start. When talking about medical care, assure your parents that as long as they are alert, they will be the ones to make decisions. But documenting their healthcare wishes is important. Healthcare providers can’t know your parents’ preferences unless they are included in their medical records. Having these wishes on the record allows your parents to receive the care they want. It may also help avoid some of the conflicts that can occur when family members disagree over treatment decisions.

Advance care planning is often done through an advance directive, which includes verbal and written instructions about future medical care. There are two types of advance directives—a living will and a durable power of attorney for health care. A living will states in writing what kinds of life-sustaining medical treatments, if any, a person wants if he or she is unable to speak or respond and at risk of dying. A durable power of attorney for health care names someone to make medical decisions in that same type of situation. This person, called a healthcare proxy, can decide on care based on what he or she knows the patient would want. It is vital for your parents to discuss their wishes with the healthcare proxy.

Naming a healthcare proxy is an extremely important decision. Living nearby is not a requirement to be a healthcare proxy, also called “healthcare agent” or “surrogate.” Even a long-distance caregiver can be one. Most people ask a close friend or family member to be their healthcare proxy. Some people turn to a trusted member of the clergy or a lawyer. Whoever is chosen should be able to understand the treatment choices, know your parents’ values, and support their decisions.

Advance directives are not set in stone. You might want to let your parents know that they can revise and update their instructions as often as they wish. Patients and caregivers should discuss these decisions—and any changes in them—and keep the healthcare team informed. Consider giving copies of advance directives to all caregivers and to your brothers and sisters. Keep a copy at home as well. Because state laws vary, check with your local and state agency on aging.

Click here to see the next item in this series:  How can I find information about financial assistance for my parents?

Acorn wishes to acknowledge the National Institute on Aging for this valuable content.


Within Acorn’s service area of Chapel Hill, Durham and surrounding areas in North Carolina (Hillsborough, Pittsboro, Morrisville, Cary, and Apex) the following resources may be especially helpful:

  • Orange County Department on Aging, 2551 Homestead Road, Chapel Hill, North Carolina 27516, (919) 968-2070
  • Durham Center for Senior Life, 406 Rigsbee Avenue – Suite 202, Durham, North Carolina   27701, (919) 688-8247
  • Chatham County Council on Aging, 365 North Carolina 87, Pittsboro, North Carolina   27312, (919) 542-4512
  • Triangle J Area Agency on Aging, 4307 Emperor Boulevard
- Suite 110, Durham, NC 27703, 919-558-2711
  • Resources for Seniors (Wake County), 1110 Navaho Dr.  – Suite 400, Raleigh, NC 27609, 919-872-7933