37

So, this weekend my mom and dad both signed some official paperwork, which my dad handed to me with a 'read it carefully please'. The paperwork gives me and my brothers the power to make decisions for our parents with regard to finances but also medical stuff when they can't make those decisions themselves and the other parent also can't make them. They're not in trouble yet, but they are both in their fifties and realize that this could save both their partner and us kids a whole lot of trouble if something actually happened.

Basically, they've ensured that doctors can disclose their medical information to us, so we can make decisions about their treatment for them.

Now, my dad never talks about things like whether he wants to be an organ donor (even mom doesn't know), let alone that I can get information from him on whether he wants e.g. treatments that only extend his life but will never cure him, or what he still considers 'quality of life'.

Basically, I now have a document giving me and my brothers the power to make decisions. But the document doesn't give any guidance on the medical part (there are some wishes in the financial part of the document).

My brothers and I tried to get a conversation about it going this weekend, but although my mom answered some of our questions about her wishes, our dad remained quiet (not even a 'don't know' or 'never thought about it').

After a few minutes, he tried to shut down the conversation, without explanation. I gave it one last try, telling him something about my own viewpoints on unnecessary medical treatment (which are pretty extreme), and explaining that if I didn't know his point of view, I would go by my own compass and thus might make the wrong decision for him. He wasn't convinced and didn't show any reaction. There was nothing that encouraged us to believe he genuinely wants us to make the decisions for him without having his input, but also nothing that indicates that he needs time to think about it and will inform us when he has made up his mind.

We later tried getting some answers from my mom, but basically

  • We don't know why he doesn't want to talk about it, only that he seems to loathe the subject.
  • We all have no clue what his wishes are.

So, one way or another, we have to get that conversation going. Because I don't like having this responsibility but not knowing what he wants us to decide, and neither do my mom and brothers.

How do I make my dad realize that he has to think about this stuff and provide us with some guidelines? How do I get him to provide us with information on his last wishes?

  • 1
    @Nobody, as far as I was explained, they did it because a good friend advised them to do so, now that they were both in their fifties... So, as far as I know, it's basically a case of 'it's a good idea to have such things on paper now that we're getting older'. – Tinkeringbell Jan 29 '18 at 11:27
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    "There was nothing that encouraged us to believe he genuinely wants us to make the decisions for him" Hm - seems to me there is something that tells you (and, more importantly, the doctors) that he wants you to make decisions for him: a written document. But what happens in case you siblings don't agree? Who gets the final say in the matter? Disagreement in life-and-death situations can lead to some festering familiy issues... – AllTheKingsHorses Jan 29 '18 at 13:49
  • @AllTheKingsHorses I might have mis-written that... I'll attempt to clarify it. There was nothing that encouraged us to believe he wanted us to make those decisions for him, without considering his input :) I'm well aware that the document implies he wants us to make the decisions, but the document also has led me to believe that I will have to take his wishes into account :/ – Tinkeringbell Jan 29 '18 at 13:55
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    @Tinkeringbell It's called medical and financial power of attorney, at least in the US. – Laurel Jan 29 '18 at 14:38
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    @Tinkeringbell I understand why you feel burdened, but imagine the situation without it. The doctors are likely to consult with you as close relatives anyway for these sorts of situations. How would you feel about making them without your parents making it clear they trusted you to do so? What if the doctors weren't allowed to reveal all the relevant information to you without it? And what if something financially important needs to be done during it? God forbid you ever need it, but if you do, this will make it a little easier to do what you can for your parents if that time comes. – jpmc26 Jan 30 '18 at 6:19

15 Answers 15

24

If I understand correctly - your parents have simply enabled you to make a decision when they're unable to. In effect: "If we're both incapable of making a decision ourselves, we trust our children's judgement" - is this correct?

If so, then it could be that they want their kids to have a say in such matters, but genuinely haven't thought about the exact decisions you'd need to make (aside from the financial ones you mention). And to be fair, pondering your own mortality isn't exactly a fun topic! Quite frankly, it's a terrifying subject to have to consider in such detail as "if X happens I want you to Y"

As such, I'd approach gradually. This could well be the first time they're having to consider such big decisions too! So take it slow and move together. They're not ceding all responsibility, so you (hopefully) won't have to exercise this anytime soon. Approach one bit at a time and give them plenty of space to process this too. This could well be the first time your father is having to think seriously about decisions around death, so I'd take care to make sure he feels supported in these discussions.

  • 1
    This is exactly what I was thinking. IMHO, the OP's father has done this without really thinking about what this can mean for his childs. The OP already tried to have this conversation, and so planted the seed. Now I'd just step back and wait for him to realize what he wants; if in a couple of weeks he hasn't raised this topic again, maybe I'd ask again for guidance on this kind of decisions, but I'd keep in mind that this kind of opinions may take a lot of time to form.. – frarugi87 Jan 30 '18 at 9:59
8

Both my parents and I are doctors in India, and my sister and I have for some years been in a situation similar to yours (if not the exact same situation) with regard to not being told our parents' actual wishes in case of some unforeseen health crisis. Moreover we have seen our patients' families struggle with this problem when one or both parents are suddenly struck down with illness or injury.

Unlike in some other countries, Indian medical practice naturally allows close family members to make health care decisions on behalf of critically ill patients without needing special authorization. Both parents becoming simultaneously incapacitated is a rare but very possible event. And age has not much to do with it.

A man in his fifties whom we had treated for a minor illness a few years ago died recently in hospital of a sudden heart ailment and his wife passed away within 2 days of a brain hemorrhage. Their two young daughters aged 24 (married) and 19 were abruptly in the position of needing to take vital medical decisions on their parents' behalf and had been given no instructions about their parents' wishes, although that didn't affect the outcome of those tragic cases.

The problem, of course, is many of our parents' extreme discomfort with discussing their own mortality with their children, which is entirely understandable in context, as pointed out by at least two earlier answers. It is the toughest and most unpleasant thing for families to discuss and most parents including mine prefer not to go into such a discussion. So I have often been anxious about what decisions I and my 2-years-younger sister might have to take in such a situation. Not to shy away from alarming and unpleasant possibilities, this is what I could understand by reviewing the problem:

  1. It is rare for both parents to be seriously ill and incapable of taking medical decisions at the same time. It is generally much more likely in our clinical experience that one parent falls critically ill and health care decisions are taken by the other parent in consultation with their adult offspring.

  2. As it is supposed to be a joint decision to be taken by siblings if both parents are rendered incapable, each sibling will need to consider the others' points of view if a future decision needs to be taken, and each would thus have only 1/2 or 1/3 responsibility for such decision-making.

  3. By giving multiple children joint responsibility to make future decisions (assuming in your case that you do not have any higher responsibility as the eldest child: or else please edit question to clarify) parents are actually reducing the decision-making burden of any one family member.

  4. It would certainly be more useful for parents to make their wishes explicit regarding future medical decisions, but we can't make them do it, especially if neither of them has yet been diagnosed with a life-threatening illness.

Since your father is currently unwilling to discuss this delicate matter, it might be counterproductive to bring up the topic with him repeatedly at present. I would advise you to try and bring up the matter with your mother instead. She might be more communicative and might also illuminate you about what your father is thinking. You could also discuss the matter with your 2 brothers independently or together to learn what they feel about taking such sensitive decisions in future.

I think your father will become more willing to discuss the particulars of this topic with you in future, after he comes to terms with the implications of this, your parents' difficult but correct decision to entrust you 3 siblings the future joint responsibility of their health care, in the particular case where they are both unable to decide for themselves.

Since your parents are both relatively young and healthy now, it is to be seen as a currently hypothetical long-term contingency planning for the future and you can expect both parents to communicate their wishes much more explicitly to you in due course, based on more specific future health events.

  • 1
    The joint responsibility thing can also backfire though... When you realise that your brothers have a fundamentally different idea about quality of life only when there's a critical decision to be made it may not be the best time for a calm and rational discussion. So I agree with you that Tinkeringbell should talk with her brothers before this becomes an issue. – AllTheKingsHorses Jan 30 '18 at 16:22
  • Yes indeed @AllTheKingsHorses. I do wonder how 2 or 3 persons could decide on a particular course of action if they have very different opinions about what is the best option? – English Student Jan 30 '18 at 18:08
5

Here is my personal viewpoint, which I hope is helpful to you and anyone else facing a similar issue.

I think that you can find the answers to your question by not asking them directly. The first step is to find out not the answers to the medical-related questions but what your father actually desires in his life. Is it the ability to do certain activities, or just having the presence of his family, or being a regular part of some community, or absence of pain, or to help some people, and also how much of each of these? Notice that if you knew the answer to this question, it sort of tells you the answer to how he is likely to choose (if ever forced to) between prolonging life and enjoying life and helping others' lives, and at what costs.

The second step is to build for yourself a mental framework consistent with his desires for making medical-related choices, still without asking him directly. In many such decisions, the answer can be sort of deduced. When you cannot deduce what he is likely to choose, it suggests that you don't really know enough about his desires (and also moral principles). Remember that if you wish to be able to help him choose on his behalf, then you really need to build such a framework that is as accurate as possible.

The third step is to wait until the time is right to bring the topic up again with your father, still not to ask him for his answers to the medical questions, but to tell him (if you do) that you truly want to be able to choose for him if you need to, and tell him what you believe would be his preference in some common scenarios, and ask whether you got his preference wrong in any of them.

The fourth step (which hopefully never comes) is to actually follow this framework to the best of your ability (and within reason) if the situation arises, and not deferring to your personal viewpoints unless it strongly conflicts with your own morality, in which case it would be best to discuss openly with your siblings.

Very few people would want to be kept alive if they are likely to be completely paralyzed for the rest of their lives, consistent with their desires, but family members may find it extremely difficult to come to terms with such an outlook unless they have carefully thought through such a decision framework beforehand. When we need to make such decisions quickly, having a framework to rely on will greatly reduce anxiety and minimize rash actions, so one should start thinking about these things when they are not under stress, as one may not have the heart to think about them in adverse circumstances.

And I wish to address a very important issue that is especially pertinent if the fourth step is ever taken. Never blame yourself for any decision you make if you did not at the point of decision intend to allow harm to come to innocent people, even if you later see in hindsight that a different decision would likely have a better outcome. This could be part of why you (and perhaps your father too) are quite stressed by such a medical directive, since it is indeed very taxing to deal with life-and-death decisions in light of hindsight, even hypothetically like now.

It is true that you are responsible to try to deal with any consequences of your past decisions within reason and your ability, but you should not hold yourself responsible for any choices that you could not reasonably have foreseen at the time to be a mistake, and neither should you let anyone try to make you feel guilty.

The above may not be so easy if you and your parents do not talk much about 'deep' stuff. However, there are usually sufficiently many opportunities that you need to grab quickly before they vanish. A person's remarks can subtly indicate his feelings about the environment he is in, and you can try to engage him further about related topics. Just off the top of my head, if talking about the weather you could ask him offhand what he would make the weather be if he could control it, or something along that line. Often, when people are asked open-ended questions, they tend to open up the most about their innermost desires and feelings. And if he starts talking about his work, you can try asking him more details about what he did for work today and generally about the people he interacted with at work. Based on little actions and remarks one can often build quite a good picture of a person's character and principles.

For people who are more comfortable with direct questions, here are some that can really help you to understand them better:

  1. What things in this world do you treasure the most?

  2. If you were granted a wish to have any kind of life that you want, what would you ask for?

  3. If you were given power to change anything in the world, what are the most important aspects you would change?

  4. If you were given a million US dollars, what would you do with it? What about a billion?

  • 2
    Also, it is a bit late now, but try to understand that making people decide on how they want to die can be easily misunderstood, whatever the good intentions. Such delicate topics are best handled with gentleness. =) – user21820 Jan 29 '18 at 16:50
4

Another way to look at this is that it is less important that you know your fathers wishes, and more important that you and your brothers agree on what you would do in certain situations. Approaching it this way could lead to getting feedback from your father.

Making difficult decisions for your father without guidance would be extremely challenging, but this would be even more difficult and damaging if you and your brothers have different ideas about what should happen. These kinds of disputes can tear families apart and lead to long term estrangement from one another.

I would start there, with your brothers. You could outline a variety of health situations and talk about what you all think would be best in those situations, document those cases and your agreements on them. Because the scenarios are hypothetical, you can all take the time to discuss them in detail and work through differences of opinion without emotions running high as they would in a true medical situation.

Finally, once you have this outline on paper, you could present it back to your father for his review. He might feel more inspired/able to make notes on specific decisions with regards to specific scenarios, and doing so in writing on his own time makes the process more detached and less emotional.

However, even if your father does not respond to the document at all, at least you and your brothers will be prepared to handle future decisions in a coordinated way and avoid it causing long term disputes between you.

Once this is done, you might want to consider reviewing such documents every year or two, to see if opinions have changed and keep it up to date.

4

I am a retired physician who for a time worked in a hospice within a nursing home in the state of Connecticut USA. I mention a specific jurisdiction because states in the U.S. vary widely in how these documents are constructed and what they cover. It sounds as though there were two documents: a power of attorney for financial affairs as well as a durable power of attorney for medical matters. It seems unlikely that they were part of the same document, but as I said the laws vary considerably, so that remains a guess.

I tend to be more limited (compared to my physician wife) in what I want to be done to prolong my life if recovery is unlikely and want to minimize the time I might spend in a bedridden or painful existence and also minimize the expenses to what might become my familiy's estate. If your father remains unwilling to discuss the specifics, then you will need to use "substituted judgment" in the event of a crisis requiring decisions for accept surgery or invasive medical treatment. In the absence of an expressed wish to limit care, the default in law as well as in practice is that medical efforts are chosen on the basis of the potential for prolonging the duration of a patient's life. So at the moment, my strategy is to rely on my wife and son with whom I have had discussions over the years about my values and specific scenarios. Your father, on the other hand, is choosing not to express a specific rule or principle regarding limiting medical care. I see that as an implicit choice.

Take some comfort that you should have medical support to help frame the choices. Your father's physicians should present options and then ask what you think your father would choose. The fact that he is not interested in expressing even an overall set of principles to guide you is really saying that he has not come to grips with making any particular choice to limit care. As I said before the decision not to make a limiting decision leaves the matter at the default position of choosing to maximize life's duration. Perhaps he can be encouraged to discuss such issues with his physician.

As time goes on you father will probably encounter situations where he will have the opportunity to reflect on his current implicit decision not to limit care. Stay available to discuss it in light of his reflections regarding illnesses of friends and family, or regarding portrayal he encounters in television, literature, or movies.

  • I appreciate and upvote this expert answer. Have you seen many cases where both parents fell seriously ill at the same time and were incapable of taking medical decisions? – English Student Jan 30 '18 at 18:26
  • I have not experienced that concern but my wife, the former ER physician has seen several in her several decades of experience. Car accidents. – 42- Jan 30 '18 at 18:59
4

Death is scary, it's no wonder you Dad doesn't want to talk about it.

From the information provided in your question, I can only conclude that your father does not want to make those decisions.
He has: A) given you (and siblings) the legal power to make those decisions with him.

B) And refuses to have any conversation about but he would wish.

you ask :

How do I make my dad realize that he has to think about this stuff and provide us with some guidelines?

first you don't make any one do/say/want anything.
Second it's clear given your fathers behavior that he does not want to think about end of life decisions at all. He has even gone so far as to give you the legal power to make these decisions for him. He has given you the responsibility to think about and make these decisions. While I personally think it is a little cowardly to put that burden on your children, it is how he wants to do it. You can either accept this responsibility or refuse it. If it were up to me I would accept it and just not bring it up again, ( though I would say my piece if some one else brought it up). But you should decide if you want/ and are capable of that shared responsibility with your siblings and make that choice yourself.

You also ask:

How do I get him to provide us with information on his last wishes?

Bellow are some ideas that might help. But be warned it could take years doing these things for you Dad to open up and he still may not.

1) Don't be pushy. It sounds like the more you all push him for info the more he digs in his heals. That is typical behavior for us human beings. Pushing him will probably be counter productive to your goals.

2) in a one on one conversation, tell him, you appreciate his trusting you with these end of life decisions. wait 3 seconds for him to respond if he doesn't or if he gets grumpy talk about football of fishing, or work. The goal is to get him used to hearing about the subject with out pushing him too hard.

3)Tell him that it is scary to think about his death. or that you don't like thinking about his passing. This shows empathy and understanding which should help him feel more comfortable opening up to you over time.

4) tell him you love him and thank him for specific things he has done for you in your life. Feeling your love and affection for him may over time convince him that he needs to return the favor and talk about things (end of life decisions) that you want him to talk about with you.

Good luck,

3

Assuming no miscommunication happened and both parties have the same idea of the conversations so far as depicted by you: You don't and you go by your own compass, it's the only way to honour his wishes as stated so far.

You made clear what would happen if he didn't explicitly state his wishes and he was fine with that. Some people honestly don't care (yet) and that is within their rights. All you need to do is eliminate all doubt that he understands that a) you have no idea about his wishes, b) you would proceed as you would for yourself and c) you are not comfortable with this. As a final resort you can make clear that you'll refuse to take a decision (I don't think this is smart, but if it gives you peace of mind, you might as well).

I also disagree with Markino's answer and your premise that he should be forced to talk about this immediately unless it is likely you will have to make these decisions shortly.

3

Getting old is scary. You need to give up on things you're able to do one by one, knowing it will never get better again. This starts with no longer beïng able to run or having some pain in your knees or back when working in bad positions (like pulling weeds in the garden). You can no longer read without glasses, and those glasses need to become stronger as your sight deteriorates further.

It gets worse when you can no longer walk to wherever you want without help of a walking cane, or even worse, a walker. Eventually you can't even get up the stairs without help.

Sure there are aids to still give you a bit of independence (the cane, walker, stair elevator, ...) but those only feel as a reminder that you're really getting old. That you're that one step closer to the end.

Perhaps your father just doesn't want any more reminders than strictly needed. He provided that document so that when the time comes he can no longer decide, at least it'll get taken care of. This takes away some of the worries he might have.

He has to choose between really thinking about it so he can tell you what he wants later, and thus admitting for himself that he really is nearing that state, or just pushing it away and stay in the current state of nobody really knowing. It may be too mentaly taxing for him to choose the first option which explains why he defaults to the second of not thinking about it at all.


A second major aspect I want to point out here is that when someone is so far down the line that others have to make decissions for him/her it actually becomes harder on the relatives on what to do. Perhaps the person himself/herself is ready to pass on (but can no longer say so) but the children aren't ready to let go yet. Or perhaps that person really doesn't want to die yet, but also doesn't want to be a hindrance to his/her family anymore.

You can't know beforehand what you would think when you finally get into that situation. No matter how much you think about it now.

It might just be that he wants you to decide what will be easier for you when it's time. But voicing this is really dificult because it can go against his own choice.


The thing I would do in your situation is try to get a feel about what your father thinks is more important.

  • Not thinking about it anymore and giving up his own choice in the end so that you can (/have to) decide what you, the people staying behind, think is best.

  • Putting up a lot of mental effort to admit the time will come (sooner than he wants) and decide what he wants, knowing this might change later when he can no longer say so.

The problem for you is ofcourse that it will ALWAYS be really difficult to decide on the last steps in your parents life. No matter if you know what they would want or not.


Since you already told him what you would do in the extreme situations and he didn't object (or looked horrified) then it may be okay to no longer force him to think about it, since in the end, it's not him who has to live with that final decission.

3

First of all, try to talk with him alone. Maybe it is just so difficult because you were together with his wife. This would certainly be the case with my parents.

Maybe your mother is really the driving force, and he does not want to give you that responsibility. Try to get at that angle, something like "if you don't really want to do this, we can skip the papers".

At the end of the day, when you do have those papers signed, and you do end up in such a situation (parents totally incommunicado, and heavy decisions having to be made), then you will have no choice but to make the decision. By definition, you cannot ask them at that time, so you have nothing like your own opinion about the issue at hand, together with whatever you believe would be best for them. You will decide. You will decide. And as far as I can tell, you have specific opinions on this, so it is in your favour that you will be able to legally decide.

As long as your father knows your stance on these things, as you said, and does not tell otherwise (and has his wits around him currently, which you imply), then it seems fine to me. Not answering is an answer.

  • Maybe your mother is really the driving force This is what the question in my comment was trying to find out. I suspect the father might just be dragged into this by his wife and not yet ready to make this decision. – Nobody Jan 29 '18 at 12:21
3

Your parents have already preformed a very difficult first step in preparing for their future. This has taken a toll, and it will take them some time to come to terms with what it means.

You've given them some additional information - now that they have placed themselves in your care should something happen they understand what your likely response is to certain situations, and they've either spoken up (mom) or not (dad) and thus have more to think about and accept about what might happen in those situations.

At this point, you should probably give them some time and space to come to terms with all of this, then re-approach this issue later.

You might want to go through the process yourself in the meantime to make sure you have your power of attorneys, medical directives, and living will in order. This will give you some perspective and knowledge about the process and requirements for your region/government. It'll also give you resources you can use to help your parents.

For instance there's a process called "Five Wishes" which provides a lot of discussion points and a method to help someone determine what their preferred medical directives are by suggesting possible conditions, and what they would like done for each of them. If you search for this you'll find free printable PDFs from various medical providers if the website isn't helpful.

The AARP provides free printable advance directives which may be helpful as well, though those don't provide as much of the guidance you're asking for, they do provide some.

While the above two resources are US based and only have legal standing in the US, they can provide you with the information you are asking for, even if they have no legal standing where you are located. You've already completed the legal portion anyway, so these would only need to help you understand your parent's wishes, and if filled out and available when needed they will help you remember what their wishes were during a time of great stress and emotional difficulty for you. You may find it very useful and reassuring when that time comes to have a written document.

Lastly, remember that these are desires for an unimaginable time. Revisit them every few years and review them with your parents. As they age the answers may change, it migt be more reasonable to provide extensive life saving measures in their 50's than their 80's, and while you'll have the opportunity to make that decision it'll make it much easier if your parents have given you that information and updated it recently. Plus you don't want to have to search for a 30 year old document at that point, so keeping it up to date will keep it available when needed.

3

I have been involved in two life-or-death decisions for family members, one for my father (that was a joint family decision, he is dead now) and one for my wife (that I had to take alone; she is alive, and only time will tell if this was a good idea). While this does not make me an expert on anything I can at least offer a been-there-done-that perspective.

Two minor points first. Some of the answers seem to suggest that there is no time to hurry with laying out emergency procedures. Now the thing about emergencies is that the sometimes emerge rather quickly - while my father had been ill for a long time he seemed to be on the mend when he suffered from pulmonary embolism. My wife went from being healthy to hemiplegia and aphasia in less than 36 hours without any prior signs of warning. So it’s better to be prepared.

On the other hand you probably do not need to worry too much about the organ donor thing - you can be an organ donor only if you are brain dead but otherwise in reasonable shape, which is not how most people die. And if he has made to other provisions you should give permission to use his organs, because they may save lives and he does not need them when he is dead (I would not usually be so crude, but that’s basically what my wife said before she went into surgery).

As for your main point, I have to say that the virtues of talking about sickness and death in advance are greatly exaggerated.

It certainly does nothing to lessen the emotional impact - in my, and my wife’s family we talked a lot about death and other catastrophes, but when my father died, and when the wife’s surgeon botched that operation, I felt sad and desperate all the same.

It does not necessarily help with any decisions, either, because when push comes to shove the situation will probably not be all that clear cut. Should your father end up brain dead then the decision is a no-brainer, horrible pun intended, and if the prognosis is good there is no decision to make. In between is a vast field of possible outcomes, to many to have contingency plans for them all. And if my experience is anything to go by medical guidances will be a lot less specific than you hope for, in part because doctors do not want to make any promises to avoid legal trouble, and in part because often they cannot really say what is going to happen (in case of my wife they could tell me she would not recover completely, but they gave me a range somewhere between walking on a stick and being in a permanent vegetative state, which did not help a lot with a decision).

More importantly, if you are in a situation where you have to make a life-or-death decision this is not really about your father anymore. At least where I live you are expected to contribute significantly to the care of close relatives, and I mean both morally (with time invested) and legally (i.e. money). When I made a decision that I wanted my wife to survive I effectively (being no longer mobile) buried my career plans and rather consciously signed on to a life where all my time and money would go towards the healthcare of my wife. I am happy to do this for her, but by the sound of it you would not do this happily for your father (and I don’t think anybody would expect that you basically give up your own life for your father). And frankly, if anything bad happened to you father, would you want your mother to spend the rest of her life looking after him? Even if your father had any specific ideas the needs of others (including your own) will still outweigh his wishes, so it does not matter all that much if his input is missing.

Still, is there anything you can do? Probably yes - sickness and death has an annoying bureaucratic side, and whatever paperwork your parents signed there, I bet is not nearly enough to cover all eventualities (e.g. I realized only recently that, while I could have let my wife die without any question asked I would have committed a felony if I had touched her bank account).

My father was a meticulous bookkeeper, and he liked to brief his sons on the elaborate plans he had made to make sure that his family was taken care of should anything happen to him (frankly I think that was his way of keeping his fear of death at bay, since it gave the illusion of some control of events after his death).

So if you want to your father maybe that is an angle to get through to him - tell him you want make sure that his estate is in order, and discuss what funds are available to pay for this healthcare should he end up disabled, stuff like that. I don’t know your father so this might be horrible advice, but if he is even a little like my own father he might find it easier to talk about death when it’s just about money and not personal.

2

Often, people are reluctant to talk about end-of-life topics (funeral, wills, wishes on treatments) because to talk about it makes it real, and that is frightening.

Here are two approaches.

First, the Direct Approach.

Dad, I am deeply honored that you would put me in a position to make decisions for you if you cannot. I certainly hope I will never be in that situation. My hope is for you stay healthy and strong.

I was thinking, considering how enormous this responsibility is, how do I know what you would want me to do? I would hate to make a decision that would go against what you want. So, I made a list of a few things that I am not sure where you stand. If it's ok with you, could you think about it and we can sit down over coffee and talk about what you would want me to do in those situations? If you don't want to talk about, it's fine. But if god forbid, that day ever does come, I will have to base my decisions on my best guess of what you would have wanted.

Second, the Indirect Approach

This is less exact and more time-consuming. Determine what questions you need to be answered. Then, over the course of time, bring the subjects up, one at a time, around your dad. Maybe while talking to your mom. Make sure your dad is not the subject of the conversation. Something like "My buddy Mike and I were talking, and he said he didn't want to be put on life support if there wasn't any hope of getting better. What do you think, mom?" (note, be more subtle than this.) Then watch his reactions or responses. Sometimes, people feel free to talk about a topic when the conversation isn't about them.

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You have the power to make decisions for your parents at a point in time where your parents can't make the decisions themselves.

Right now, your parents don't know what would be the right decisions to make, because they would be in a situation that is completely outside their life experience. So they cannot tell you how you should decide, because right now they don't know themselves.

What they want you to do is when they time comes, to take responsibility, and make decisions to the best of your ability. Why does your father not talk about it? Because it is an utterly unpleasant subject. What are his wishes? For you to do the best you can.

Consider that most likely by the time you need to act you will have a lot more life experience than you have today. Your dad doesn't have to think about this at all. You will do the thinking when the time comes.

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    This is a massively unhelpful answer. Some people want to have life extended as far as possible; others (including me), don't. Finding out where the OP's father is on this scale would be massively useful to the OP - but the father doesn't want to talk about it. – Martin Bonner supports Monica Jan 30 '18 at 15:50
  • Why unhelpful? The poster is on the completely wrong track wanting to force his father to decide. The father cannot foresee what the situation will be like in twenty years from now. – gnasher729 Feb 1 '18 at 18:27
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Disclaimer: I am in no way affiliated with any of these types of products.

There is at least one book, "I'm dead, now what?" which contains questions about end of life decisions and spaces to answer. Some of the questions provide some comic relief, making this somewhat awkward conversation a little bit easier to deal with. The books are quite thorough and cover topics like life support, who gets what, preexisting burial plans, and more.

Now that they are starting this conversation with you, I would either get a pair of books like this for your parents as a gift, or suggest to them that they look at them. The humor included in some of the questions may be enough to persuade him to fill it out. Some people I know love making lists, the fact that this type of book lists out the questions for them has encouraged them to fill it out.

My personal experience with the book doesn't pertain to this situation very well. I just thought it was a good thing to have around, just in case.

If the humor and lists do not persuade him to help, you may benefit from picking a copy up for yourself. It may help you by showing important questions that you have not thought of. You could also keep these questions in mind while spending time with your parents - they may answer them over the course of normal conversation (this will take time). If all else fails having a copy for yourself will allow you to slowly insert the important questions into your conversations, avoiding the need to know everything right now.

If they do decide to fill them out, you do not need to be present, but you should know where to find them in the event that the books are needed.

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    Personally I think the idea behind this is a good (valid) answer, but answers here are best if you include the reasoning why you think this is a good idea. See this meta post for more info on "try this!" answers with no explanation are discouraged. – Em C Jan 30 '18 at 2:34
  • If either of you have any suggestions please share. I thought the answer was quite complete, suggesting humor and various tools that can be used to break the ice. – rogerdeuce Jan 30 '18 at 13:51
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    @rogerdeuce I think you've explained the book well enough, but perhaps you could talk a bit more about how this approach would work, e.g. breaking the ice and how to encourage him to actually fill it out. Any experience you have would be helpful too to back it up. (eg I know for myself, it can be easier to "talk" about tough subjects via writing it down vs. having a face-to-face conversation, which is why I really like this suggestion :) ) – Em C Jan 30 '18 at 14:32
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mom and dad both signed some official paperwork, which my dad handed to me with a 'read it carefully please'. [...] The paperwork gives me and my brothers the power to make decisions for our parents with regard to finances but also medical stuff

They involved you in extremely important and delicate decisions.

Therefore, it's a subject they have not right to shy away from.

Therefore, they need and must give you guidelines about those decisions, also - and especially - because it's in their first interest.

Therefore, go ahead and openly and directly ask and keep asking until they comply. They must and need to comply with your request as soon as possible.

Imho, it's absolutely not fair to involve someone in delicate matters and abandon him/her to his/her fate "just because" the subject is "disliked": state this while you directly ask for guidelines in case they keep on refusing.

Unfortunately, life does not allow you to only do or say things you like to do or say: they, as adult people, need to understand this.

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