Before the Crisis: A Guide to Talking to Your Parents About Future Care

Most of us know that at some point, we’ll need to talk with our parents about their plans for the future. Yet few of us know when to start, what to ask, or what we’re actually planning for. What should we assume and then do if a parent suffers a major healthcare incident, they become immobilized, they lose cognitive abilities, their physical capabilities deteriorate, or worse, they are facing death? When the options are unclear and there isn’t an obvious starting point for a family trying to figure out what to do next, it’s easy for the conversation to get pushed off until the next crisis.

These conversations don’t have to start with a crisis or a serious illness or injury. They can begin with broader questions about how your parents want to live as they get older: where they want to live, what independence means to them, what activities and routines are most important, and what kinds of help they would or would not want if things become harder over time.

It is during the next crisis that we feel the consequences of not having had prior conversations about the future. It can become clear that no one knows what they actually wanted, and family members can disagree about how to move forward.

When a family can effectively talk with one another, a difficult conversation during a crisis can turn into a shared plan made months earlier, during calm moments. LifePlans and CaringInfo exist for exactly this moment: to help families build the knowledge and the confidence to start these conversations proactively, before a crisis requires them.

Where to Start the Conversation About the Future

Follow these steps to have an ongoing, open, and effective dialogue about your parents’ care wishes.

1) Notice how you feel

Before you have the conversation, name the emotions that are motivating you to have it. When you understand your own reaction ahead of time, you’re better able to stay present if those feelings come up during the conversation.

Common emotions include:

• Frustration, fear, worry, resentment, or anger may appearas you begin to take on more caregiving tasks. Acknowledge these emotions and tend to them with care.
• Grief and sadness may arise related to new evidence of your parents’ health declining. Identify what helps you process your grief as it arises, such as journaling, talking to a friend, or working with a therapist. CaringInfo’s Anticipatory Grief post can help you better understand what you’re feeling and find support.
• Defensiveness, tension, and stress are commonly experienced while planning for the conversation. Use grounding exercises to help you feel less reactive during the conversation.
• Be gentle with yourself when family dynamics make it difficult to remain grounded, and you find yourself having an emotional reaction before, during, or after these conversations. You don’t have to be perfect, no one is.

2) Build your knowledge base

Learn what types of support may be available, when they might be available, and how they are typically paid for. Start by learning about the kinds of support that can help someone age safely and independently, even when there isn’t a specific medical crisis.

Think about things like transportation, meals, household tasks, home modifications, social connection, and help with everyday activities. If a particular diagnosis or symptom is already part of the picture, look into the care options tied to it. Note the preferences you already know about, like a parent’s wish to stay in their home.

• CaringInfo’s Planning Overview covers the full range of topics families run into, from advance directives and financial matters to in-home care and care outside the home.
• CaringInfo’s Types of Care guide explains the difference between curative, palliative, hospice, and comfort care in plain language, which can help you understand what your parent’s doctor is recommending and why.
• Eldercare Locator, a service of the federal Administration for Community Living, connects you with your local Area Agency on Aging, the regional office that can point you toward services, benefits, and programs specific to where your parent lives.
• BenefitsCheckUp, from the National Council on Aging, helps you check what benefits your parent may be eligible for, including help with housing, health care, prescriptions, and other daily costs.
• The Alliance’s Find a Provider tool helps you locate a hospice, palliative care, or home care provider near your parent.
• CaringInfo’s guide to finding local caregiving help walks through how to search for the right local resources, including tips for finding community groups and local agencies you might not know exist.
• Where You Live Matters, from the American Seniors Housing Association, walks through different senior living options, from independent and assisted living to memory care and skilled nursing, along with what each typically costs.

3) Choose the right moment

This conversation should be planned for and scheduled, rather than being triggered by a particular symptom or behavior.

• Before the conversation, share what you would like to address, so that no one is caught off-guard. Emphasize the importance of working together, and sharing what their hopes and wishes are, so that you can help them honor them.
• Set aside at least an hour, so no one feels rushed. Understand that this is the first of many conversations, and that everything will not be accomplished during the first talk.
• Put phones away and turn off the TV, so there are no distractions.
• Check in with each other before you start, to make sure everyone is in a good headspace.

4) Ask before you assume

Your parents may have already thought about these issues, even if they haven’t written anything down or talked to you about it. Start by finding out what they’ve already considered, and how they’re feeling, rather than assuming you already know.

• Ask about paperwork directly: “Do you have any documents in place, like a will or a healthcare directive? Is there anyone else who knows about them?” A document not being visible to you doesn’t mean it doesn’t exist.
• Ask how things feel day to day: “How have things felt for you lately? What’s changed over the last few months or years?”
• Ask what’s on their mind: “What worries you about the future? What worries you about your care?”
• Ask what they want their future to look like, not just what they are worried about. You might ask, “What’s most important to you as you get older?” or “What would you want to keep doing for as long as possible?”
• Ask open questions that let them lead, rather than ones with a built-in answer: “What would help you feel safest and most comfortable at home over the next few years?” or “What would you want to stay the same, and what changes would you be open to?”
• Let your parents share their own goals and fears, rather than telling them what they should do or what they should be worrying about.
• Reflect back what you heard to check your understanding. If something is unclear, ask additional open-ended questions. Ask questions calmly, without judgment.
• Ask about the emotions that are coming up for them, and be honest about your own emotional reactions. This conversation does not need to be about everyone’s feelings, but they are important to acknowledge.

5) Share your hopes and worries directly

When you’re ready to share your own perspective, use “I” statements to talk about your hopes and concerns. Approaching the conversation this way can make it feel less like you’re trying to solve a problem and more like you’re working together to adapt to life changes.

• Use “I hope” and “I worry” to talk about the future: “I hope you’re able to stay in your home for as long as you want,” or “I worry that if something happened suddenly, we wouldn’t know what you would want.”
• Share what you’re observing without sounding accusatory: “I’ve noticed you’re having a harder time with some things around the house, and I want to make sure I’m supporting you in the way you want” or “I feel worried about your safety when I see you struggling with the stairs.”
• You can also share hopes that aren’t about a crisis: “I hope you can keep doing the things that are important to you,” or “I want to understand what independence looks like for you so I can support you in the way you want.”
• Ask if it’s okay to think through solutions together, and keep their independence at the center: “How do you want to handle things if you ever need a little extra help?”
• Ask how you can help: “How can I help?” or “What would be most helpful to you right now?”

6) Make a plan

This is where the conversation moves from exploration into strategy.

• Share what you know about resources or care options that might apply to their situation, including the resources you gathered earlier on in the process.
• Don’t make any promises about their care or where they will live. Your plan will adapt and change as their needs change, and promises can lead to resentment and guilt if they need to be broken.
• Decide together what to prioritize first, and what can wait. The plan can include everyday preferences as well as medical or legal decisions. Write down where they hope to live, what kinds of help they would welcome, and who they would want involved if their needs change. These preferences can evolve over time, so revisit them as circumstances change.
• If your parent doesn’t already have an advance directive, Five Wishes is an easy-to-use option that lets them document their wishes for medical treatment, comfort, and who can make decisions on their behalf, legal in most states without an attorney.
• Document what was decided, and identify who is responsible for each step, so nothing gets overlooked or forgotten.
• Store physical copies of legal, medical, and estate planning documents in one unified place, and keep digital copies somewhere secure and accessible to the people who may eventually need them. A shared planning and document-management tool, such as the LifePlans Vault, can help families keep this information together.
• Share documents from the Vault with siblings, attorneys, or other providers who need access.
• Choose a date to follow up with one another and share what progress has been made, or where you’ve hit roadblocks.

7) Ask for help

This is a complicated, sometimes messy process, and you don’t have to do it alone.

• Turn to the Alliance’s Find a Provider tool to locate a hospice, palliative care, or home care provider near you.
• Schedule a meeting with a Life Planner if you aren’t sure where to start. They can support you in identifying the right next step, researching local resources and organizations, and ensuring everyone gets the care they need.

You Don’t Have to Have All the Answers to Begin

You don’t have to solve your parents’ future in one conversation. You don’t need to have every document completed, know every care option, or agree on every possible scenario.

You just need to start.

Ask questions and listen to what they say. Share your hopes and concerns. Find out what they’ve already put in place. Talk about what matters to them now and what they hope their life will look like as they get older. Then keep the conversation going as circumstances change.

The earlier you start, the more time your family has to make decisions together, rather than making them in a crisis. And the more you understand your parents’ wishes, the easier it can be for everyone to know what to do when the time comes.

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LifePlans and the National Alliance for Care at Home are here to help families build that understanding, from learning about palliative and hospice care, to finding the right provider, to putting important information and wishes into a plan that everyone can follow.