For many caregivers, the idea that they will one day find themselves sitting at a parent’s bedside making a difficult decision about their day-to-day care and medical treatment is not an easy one. But as the number of Americans dealing with chronic conditions like diabetes and Alzheimer’s continues to grow, it is increasingly likely that an adult child will have to make difficult decisions on behalf of a parent. As chronic health conditions and declining mental and physical abilities become the norm for many older Americans, it is critical that caregivers are ready and able to make important health decisions for their elderly loved ones.

As difficult as it may be to discuss end-of-life decisions in advance, they number among the most vital decisions of a lifetime. However, those same end-of-life decisions may contribute to heart-rending choices that must be made by a caregiver. Should the worst happen, you want to know that the decisions you are making are in line with your parent's wishes. Making sure that both mom and dad have the right paperwork in place can give you the peace of mind of knowing that you have made the right choices even under difficult circumstances.

Get the Right Paperwork in Place

There are many different kinds of paperwork that can be used to layout an individual’s wishes for their care should they become incapacitated:

• Medical Power of Attorney
• Living Will
• Healthcare Proxy
• Advanced Directive

You may already be familiar with the DNR Order, which dictates that no extraordinary efforts should be made to resuscitate an individual in the event that their heart stops beating, there are also a wide variety of other medical treatments and issues that should be discussed ahead of time from pain-relieving narcotics to breathing assistance to feeding tubes.

Consider such circumstances as emergency care, coma management, long-term nursing care, heart resuscitation, pain relief, feeding and life support issues, and palliative care.

Laws can vary from state to state, so if your parents have moved recently, have residences in two states, or travel extensively, make sure that you cover all those bases with documents that address all contingencies. Whether your parents’ wishes are contained in a Durable Power of Attorney for Medical Care, a Living Will, or a series of directives, it is important that they are thorough and binding in all circumstances.

Once the paperwork is in place, it is also important that they are shared with other members of a parent’s care team (such as primary care physician or residential care home) and that copies are stored in a safe place where they will be readily available as needed.

Designating a Proxy

Making these kinds of decisions is no easy task—for you or for your parents. That’s why it is critical that your parents name someone they trust absolutely to make health decisions on their behalf. But you must be prepared that mom, dad, or even both of your parents, may opt not to choose you as their proxy. You must accept that.

While it’s easier said than done, the last thing you want is to start an argument that could lead to a rift in the family or, worse yet, require a court to step in to make decisions about life-sustaining or life-saving medical care. Honest discussion, not only with elderly loved ones but also with other family members as well as medical, legal, and financial advisers, is vital to making sure that a parent’s eldercare wishes are carried out.

If you’re at a loss for how to start planning or even begin a conversation on such a sensitive topic, resources provided by organizations like the Elder Care Alliance and HelpGuide.org can help.