Learn Their Wishes
One of the most important things you'll need to discover is what your parents' wishes are concerning their care as they age and die. This isn't an easy subject to discuss, but it is one that you must address. This information is something you will need to share with your siblings and other key players in your particular circumstances.
Your primary role in caring for your aging parents will be to incorporate as many of their wishes as is possible. Preserving their dignity and respecting them is vital to the success of this new relationship. Listen to their wishes.
Start with the simpler issues to open the lines of communication and build a rapport for discussing such issues. Look at family history. How long did their parents live and what issues did they face in their last years? Sometimes this is helpful and other times completely irrelevant. How did your parents deal with their aging parents? What did they feel worked, and what would they have done differently? Even if your parents won't discuss their own mortality issues, this can give you an idea of what they may expect from you.
Begin a dialog about the what-ifs. Where do they hope to live out their life? Do they want to remain in their own home? What if they can't do it alone? Are they willing to have help from caregivers or a live-in? What if that doesn't work out? How do they feel about nursing homes? Would they consider living in a senior complex or assisted-living facility? Do they expect to move in with you? What if that is not possible?
Understand that they may completely change their minds as their own condition deteriorates. None of us would want to be a burden to family members and would hope we could do something to prevent that from happening. In reality, situations can change rapidly and the best-laid plans get sidetracked. The important thing is to get a feel for what they want and expect.
Put It in Writing
If your parents have very specific wishes, these should be put in writing in a will or other legal document such as a health-care proxy, advance directive, or durable power of attorney for health care. Recording a conversation can be helpful as well, especially for siblings or other relatives who may not like or agree with choices made.
One of these issues could be burial versus cremation. Some people have very strong feelings about one or the other and they can stem from religious beliefs to issues of claustrophobia or fears of being buried alive. Then there is the issue of where to bury or how to handle the ashes. If all of this is set and decided ahead of time, it can be a blessing in disguise when the time comes.
Perhaps the touchiest of all issues is that of heroic measures to be taken (or not) and where to draw the line. When do you consider having a Do Not Resuscitate (DNR) order written? A DNR means that no heroic measures will be taken should your heart stop. It is the simplest form of health-care proxy. However, because there may be different circumstances under which you or your parent would want some heroic measures taken, a more complex document such as a health-care proxy, advance directive, or durable power of attorney for health care should be explored with an attorney.
Under what circumstances would your parents consider resuscitation measures?
Do your parents expect everything possible should be done at any time and do they expect to be kept alive even on respirators or with other measures? At what point is it okay to give up? If they haven't made out a will, appointed a power of attorney for health care, or signed an advanced directive, start thinking about it now, and get these issues in writing as soon as possible.
Planning for all types of possibilities may not be feasible, but having in writing what the general wishes are is one of the most important issues you can address with your aging parents. It is also something you should consider for yourself. (See Chapter 21.)
Religious beliefs and rituals should be discussed, especially if there are strong feelings or disagreements in the family. Are there specific things they want followed, or not? Perhaps they just want you to do what is important to you and the other surviving family. These are all important decisions to make together and to ensure all key players involved understand and agree to respect your parents' wishes.
Getting Your Parents to Discuss Mortality
Your parents may be very reluctant to discuss any matters about their own mortality. Gently try to prod them along, but you may have to back off and try again another time. You may have more luck discussing a hypothetical situation or one that happened to a friend or other family member. They may be very willing to express opinions about what happened to a widowed elderly aunt who shut herself away in her house with thirty-six cats and left all her money to the ASPCA instead of her children who abandoned her. Or an uncle who just wanted to spend his days sitting in his deceased wife's favorite chair and die at home, but his children had him placed in a nursing home and never went to visit him.
Sometimes it takes a seemingly insensitive situation to evoke emotions and feelings and get them talking. Then you can slowly guide the conversation into how they'd feel if they were in that situation.
Another point for discussion is their needs and concerns for the future. Do they feel that they have accomplished their major goals? What goals or tasks still need to be met? Do they feel they have had a full life, or do they have regrets? What things are important to them now? For example, is playing golf every Wednesday the major focus of their life? What things fill their days and make them happy?
Where once their own personal relationships, work, and hobbies fulfilled most of their needs, being near family and friends can be even more important as your parents age in order to fulfill their need to love and be loved.
