How to Talk to Your Ageing Parents About Their Wishes (on a Holiday Visit)

The best way to talk to ageing parents about the end of life is to start small, in a quiet moment, with a question about what matters to them. Do not start with death, money or nursing homes. Say why you are asking: you want to get things right for them one day. Then listen more than you talk. You do not need every answer in one visit. You need the door to open.

If you will see your parents at Thanksgiving on 26 November, or at Christmas, this page gives you a plan. It covers when to raise it, what to say first, the questions to ask, the papers to look for and what to do if they say no.

Why is this conversation so hard to start?

Roz Chast is a cartoonist for The New Yorker. Her parents, George and Elizabeth, lived in the same small Brooklyn apartment for almost 50 years. When they reached their late 70s, she began to worry. She had moved to Connecticut. Who would help them when they could no longer cope alone?

But every time she raised it, her father changed the subject. "He would say can't we talk about something more pleasant?" she told NPR's Fresh Air in 2014 (NPR).

"We would sort of dip our toe into these unpleasant waters and then pull the toe out again," she said. "We did this for many years."

Then a crisis came, as it often does. Her mother fell and spent two weeks in hospital (Forbes, 13 May 2014). Her parents later moved into assisted living. George died at 95, and Elizabeth at 97. Roz turned those years into a memoir. She named it after her father's line: Can't We Talk About Something More Pleasant? It won the National Book Critics Circle Award in 2014 (Wikipedia).

If you have tried and failed, you are in good company. Most families want this talk. Few have it. In a 2018 US survey by The Conversation Project, 92% of people said it is important to talk about their wishes for end-of-life care. Only 32% had done it (The Conversation Project).

Here is the hopeful part. In the same survey, 95% said they would be willing to talk. More than half said they would feel relief. Your parents may be waiting for someone to go first.

Is a holiday visit a good time to bring it up?

It can be. A holiday is often the one time you are all in the same place. You can also see, face to face, how your parents are coping. Is the post piling up? Are there new bruises, or new pill bottles? Is the fridge almost empty? Those details are hard to see on a video call.

But choose your moment with care. Do not raise it at the big meal, with everyone at the table and feelings already high. Our guide on talking to your family about your own wishes gives the same advice.

Better moments are:

• a walk after lunch, side by side;
• a drive to the shops, when nobody has to look at anyone;
• washing up together, when your hands are busy;
• the quiet morning after the big day, over coffee.

Talk with one parent, or both, but not the whole family at once. Keep the first talk to about 15 minutes. Stop while it still feels okay.

Plan ahead. If you have brothers or sisters, tell them before the visit. Say what you hope to ask, and agree that nobody will ambush your parents.

What can I say to start?

Start with "I," not "you." Say why you care. Then ask one open question. Here are some openers that work for many families. Pick the one that sounds most like you.

Lead with your own planning.

"I've just been sorting out my own papers, in case anything ever happens to me. It made me wonder. Have you two ever written down what you'd want?"

Use a story.

"A friend's mum went into hospital last month. Nobody knew what she wanted, and it was awful for them. I never want that for us. Could we talk about it a bit?"

Ask about values, not treatments.

"If you got very ill one day, what would matter most to you? What would make a day still feel like a good day?"

Ask for their help.

"I want to be able to speak up for you if you ever can't. But I'd only be guessing right now. Can you help me get it right?"

Make it small.

"I'm not asking for big decisions today. I just want to know who you'd want to make choices for you, if you couldn't."

If a parent jokes or changes the subject, that is fine. Say, "Okay. Can we come back to this tomorrow?" Then do.

What questions should I ask my parents?

You do not need to cover all of these. Pick two or three for this visit. Write the answers down afterwards.

What matters most to them

• What does a good day look like for you now?
• What worries you most about getting older or sicker?
• Are there treatments you would never want? Are there any you would always want?
• Where would you want to be cared for at the end: at home, in a hospice, in a hospital?
• What part do your faith or traditions play?

Who speaks for them

• If you could not speak for yourself, who should make medical choices for you?
• Have you put that in a legal form? In the US, this is often called a health care proxy or a durable power of attorney for health care. In England and Wales, it is a lasting power of attorney for health and welfare (GOV.UK).
• Who would handle your bills and bank accounts if you could not?

Where things are

• Do you have a will? Where is the original?
• Where do you keep your important papers?
• Who are your doctors? What medicines do you take?
• Is there a list of your bank accounts, pensions and insurance?

The end and after

• Have you thought about a funeral or memorial? Burial or cremation?
• Is there anything you want people to know, or to have?

Our guide on how to choose a health care proxy helps with the "who speaks for them" part.

What papers should I help them find?

The US National Institute on Aging suggests everyone keep their key papers in one place. They should tell someone they trust where that is (NIA). You do not need to read them. You just need to know they exist and where they are.

The NIA lists these common documents:

Document	What it does
Will	Says who gets their money, property and things after they die.
Durable power of attorney for finances	Names someone to handle money if they cannot.
Living will	Says which medical treatments they would want or refuse.
Durable power of attorney for health care	Names the person who makes health choices if they cannot.
Any medical orders, such as a do-not-resuscitate (DNR) order	Tells doctors and paramedics what to do in an emergency.

The NIA also suggests a written list of:

• Social Security or national insurance details, and birth and marriage certificates;
• bank accounts, pensions, investments and debts;
• insurance policies, with policy numbers;
• doctors, medicines and health insurance;
• the location of the will and any safe deposit box key.

In England and Wales, the papers have different names. The main ones are a will and two kinds of lasting power of attorney, one for health and one for money (GOV.UK). Scotland and Northern Ireland have their own versions. In Canada and Australia, search for Advance Care Planning Canada or Advance Care Planning Australia for your province or state's forms.

If you find that a paper is missing, do not fix it all on the visit. Write it down. Agree on one next step, such as booking a lawyer or getting the state's free form.

In the US, a doctor can help too. The NIA says talking about advance care planning with a doctor is free through Medicare at the Annual Wellness Visit.

What if my parents refuse to talk?

Some parents will say no, or laugh it off. That is not failure. It is the first step. Roz Chast and her parents dipped their toes in "for many years." Here is what can help.

• Take one small topic. "Just tell me where your will is" is easier than "What do you want at the end?"
• Let someone else lead. Roz hired an elder law attorney. Would her parents talk to him about things they would not tell her? "Amazingly, they did," she said (NPR). A trusted doctor, lawyer or faith leader can do the same.
• Leave something to read. The Conversation Project has free guides for starting the talk and choosing a proxy (The Conversation Project). Some parents prefer to think alone first.
• Go first. Fill in your own papers and show them. It is hard to refuse a child who has already done it.
• Respect their choices. It is their life and their plan. Your job is to understand it, not to write it for them.

If a parent seems confused or forgetful, gently raise it with their doctor. Legal papers like a power of attorney need the person to understand what they are signing. This is one reason not to wait.

How do I include brothers and sisters?

Families often fall apart over guesses. One sibling remembers Mum saying "no machines." Another remembers "do everything." Both are sure.

The fix is simple. Everyone should hear your parents' wishes in their own words, or read them in writing.

• Before the visit: agree on what to ask and who will ask it.
• During: let one person lead. The others listen.
• After: write a short summary of what your parents said. Send it to everyone, and to your parents, so they can correct it.
• Share the jobs. One sibling finds the papers. One books the lawyer. One handles the doctor.

If one sibling lives nearby and does most of the care, say thank you out loud. Ask what would help.

What should I do after the visit?

The talk is not the end. It is the start. Within a week of getting home:

1. Write down what you heard, in your parents' words where you can.
2. Send it to them and ask, "Did I get this right?"
3. Pick one next step, such as signing a health care proxy form or finding the will.
4. Set the next talk. The next visit, a birthday, or a call next month.
5. Check yourself. Have you done your own papers? Your children may need this talk with you one day.

Our free end-of-life readiness check takes a few minutes. You can do it for yourself, or sit with a parent and go through it together. It shows which plans are missing.

If you want help running the talk itself, the Complete Planning Library includes a Family Conversation Kit. It has starter cards, a family meeting agenda with roles, scripts for hard moments and a "What Matters Most to Me" page your parent can fill in. It is for families who are ready to sit down and actually have the talk. If you only wanted ideas for what to say, this page is enough.

The honest lesson

Our parents prepared for our first days. They chose names, bought cots and read the books. It is fair, and loving, to help them prepare for their last days too.

Death is a normal part of life, not a failure. Talking about it does not bring it closer. It just means that when the time comes, you will know what they wanted, and you can give it to them.

You may only get one quiet morning this holiday. Use it to ask one good question. Then listen.