How to Talk to Your Children About Health Care Decisions

“Can’t we talk about something more pleasant?” This is so often the response that we get when we try to speak with our loved ones about health care and end-of-life decision making. These conversations often make everyone uncomfortable, because it is dealing with issues and decisions that we often times don’t want to face or think will never happen to us. But, statistics provide us with a different picture: among the population aged 65+, 69% will develop disabilities before they die, and 35% will eventually enter a nursing home.[i]

It’s critical that you take the time to think about your health care wishes. The first step to this important planning process is for you to think about what is important to you with respect to your health care. Do you want to stay in your home for as long as possible should you need care? Is there a point when you would no longer want to be hospitalized or resuscitated? Who will make health care decisions for you if you are unable to make them for yourself?

Next, make sure that you have written legal document regarding your health care. In Massachusetts, we utilize a Health Care Proxy. This is a written document that communicates who you appoint to make health care decisions should you be incompetent or incapacitated. Although you can utilize the one page document that many hospitals and physicians’ offices offer, be aware that this document does not provide authorization for your health care proxy to deal with many important concerns, such as authorizing the use of antipsychotic medications or allowing for the admission to a psychiatric care facility.

And last, but by no means least, you must communicate your wishes with your loved ones and your health care provides. Make sure that they have copies of your Massachusetts Health Care Proxy. Also, provide your named proxy with copies of your Living Will, if you have one, and any other written documents that you may have created (personal memo, The Five Wishes document from Aging with Dignity, etc.) that provides them with more detailed about your specific wishes. If you have a MOLST (Medical Orders for Life Sustaining Treatment), make sure that this is in a clear and conspicuous place (such as taping a copy on the front of your refrigerator on the wall over your bed).

The health care discussion with your children can be difficult to start, but let your children or other loved ones know that it is important to you that they understand your desires and are willing to follow them. Sharing this information often lifts a burden from their shoulders because, should a health crisis occur, they will know what your wishes are and are not left guessing and wondering whether they did the right thing on your behalf.


[i] The Retirement Project (2007) Meeting the Long-Term Needs of the Baby boomers:  How Changing Families Will Affect Paid Helpers.