Q How can I convince my aging parents to get their end-of-life affairs in order?

Asking an aging loved one to face the reality of end-of-life care typically elicits two polar opposite reactions: understanding and acceptance or avoidance and, at times, obstinance. If it sounds as if your parents may fall into the latter category, know they are not alone: Two thirds of U.S. adults do not have an advance directive, according to a 2017 University of Pennsylvania study.

Here's what you should know and tell your parents. Everyone should have an advance directive, not just your aging parents. However, it's critical for seniors to have their end-of-life health-care decisions mapped out, or family members will be forced to make those decisions for them.

Start by asking them a series of "what if?" questions. What if they get sick? What if they get to a point where they can't walk up steps? Can you put the hospital bed in the living room? What if Mom has a heart attack? What happens if Dad has a debilitating stroke that leaves him comatose?

An advance directive can empower your parents. Like many people, your parents may feel strongly about certain care choices that may be offered during a serious illness or at the end of life. An advance directive gives them the power to accept or reject medical treatment. By making their preferences known, others will know to respect those wishes, too.

The different types of advance directives are:

  • A living will. It puts into writing what medical care is wanted — and not wanted — if recovery isn't likely. For example, your dad can say whether he would want to be on a breathing machine or to have CPR to revive him.
  • A medical power of attorney. This appoints a trusted person to speak on your parents' behalf on medical matters if they are unable to make decisions. This should be someone who understands and respects their wishes.

If your parents do write an advance directive, be sure to make multiple copies. Keep one for yourself and give one to the person they've chosen to make health-care decisions for them and one to their primary-care doctor. And bring a copy with you if you have to go to the hospital.

The time to make an advance directive is before a crisis happens. It does not have to be a complicated legal document. Free standard forms are available from various local and national organizations. You can find forms for Pennsylvania at caringinfo.org/files/public/ad/Pennsylvania.pdf.

Donna Raziano, MD, FACP, AGSF, is the chief medical officer of Mercy Home Health and Mercy LIFE.