Do Your Folks Have an Advance Healthcare Directive? Do You?

Dear Carrie,

I'm trying to help my parents who are in their late 60s with estate planning. They're okay talking about the financial part, but they're reluctant to deal with the possibility of a serious medical issue. They say they're not that old yet! How can I nudge them along? 

—A Reader

Dear Reader,

With people living longer and healthier lives, it's not surprising that your parents are avoiding talking about the possibility of a serious medical issue. They'd probably rather plan their next trip. But now is exactly the time—when they're clearheaded and feeling good—that they should be thinking about it.

In fact, in my opinion, everyone—even young adults—should think about and document how they would want to handle a medical crisis. That's the only way to ensure that others will make decisions that are in keeping with your wishes.

Start with an advance healthcare directive

I'd start by putting your wishes in writing with an advance healthcare directive.  Getting the documents is the easy part. The hard part is thinking through your decisions before you commit them to paper. The questions on the form will help focus your thoughts, but it's important to be honest with yourself and discuss your feelings with your family before putting anything in writing.

You might help your parents start the thinking process by getting a copy of their state’s form—as well as one for yourself. You can download a state's specific advance directive from a number of websites such as, or get it from your state's Attorney General's office or your doctor or hospital.

Each state has its own version of an advance healthcare directive (and it may go by a slightly different name) but, generally, it will include two parts:

  1. Instructions for healthcare: This lets you put in writing the type of treatment you do—or don't—want if you're facing a life-threatening crisis. For instance, do you want your doctors to use life-sustaining treatments regardless of the circumstances or potential outcome? By putting your wishes in writing, you're helping your family make very tough decisions on your behalf.
  2. A power of attorney for healthcare: This appoints someone—a friend, a family member, whomever you choose—to make medical decisions for you if you can't speak for yourself. These decisions aren't necessarily just about the end of your life. They can be any type of medical decisions—from medications to surgery. The key is that someone you trust will be your spokesperson and interact with medical personnel if you're unable to do it.

Depending on the state, these may be two separate documents or they may be rolled into a single form.

Talk to your doctor and your family

Working through the questions on the form and making these literal life and death decisions can be a real challenge. If you're unsure about something, it may help to talk to your doctor.

When I filled out my own advance healthcare directive, it was tough to confront my mortality so directly—especially deciding when to "pull the plug." My doctor helped me put certain things in perspective. You might offer to visit your parents' doctor with them, so you can help them ask the difficult questions.

And don't stop there. Once you get your parents talking, make sure the rest of the family, or anyone who would be affected, knows about and accepts your parents' decisions.

Explore housing alternatives

While you have your parents' attention regarding potential health issues, open the door to discussing their wishes about possible housing concerns such as assisted living. This can also be a difficult decision. I know of two recent situations that demonstrate the need for this type of discussion.

In one case, a couple refused to leave their home until they were in their early 90s. By this time, they really needed assisted living, and the responsibility for selling their house, choosing a facility, and orchestrating the move fell on their daughter. It was hard on all of them. In an opposite situation, a couple in their early 80s decided to move to assisted living while they were still well and able to handle the details of the move themselves. Shortly after, one of them fell ill, and they were happy not to have to overburden their kids.

Your parents may never have to make this type of move, but knowing their thoughts on the issue will be helpful should the need arise. It's all part of being both financially and emotionally prepared.

Do it now

No matter how difficult it might be, I encourage you and your parents to take these steps now. It isn't just a question of age. Whether you're 25 or 65, having an advance healthcare directive and confronting possible life changes means you—and your loved ones—can put these concerns aside. Then you can all enjoy life to the fullest. 

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