10 End-of-Life Care Questions to Ask Your Aging Parents

Author: Hospice Foundation of America
Published: 22 Jul 2014 - Updated: 6 Oct 2026
Publication Type: Instructive / Helpful

Table of Contents:
Synopsis - Definition - Overview - FAQs - Insights, Updates - Related Content

Synopsis

This information, written by Amy Tucci, president and CEO of Hospice Foundation of America, gives adult children a practical starting point for talking with aging parents about how they want to be cared for at the end of life. It sets out ten open questions covering terminal illness, aggressive treatment, pain tolerance, extended hospitalization, dying at home and who should be trusted with care decisions, then outlines the three routes available after a poor prognosis - continued curative treatment, palliative care alone or alongside treatment, and hospice. Its value comes from the source, a national nonprofit that works directly with hospice professionals and families, and from the plain way it frames a subject most families put off until a crisis. Seniors, people with disabilities or serious chronic conditions, and the relatives who may one day have to speak for them can use the questions to get wishes on record while the person is still able to state them clearly.*

At a Glance

• 1 - Holiday gatherings, when family is together, are suggested as a good time to raise the subject.
• 2 - Parents who would rather not talk it through can record their wishes in a living will, a dated letter or even an email.
• 3 - End-of-life preferences are not permanent and can be changed later for as long as the person can competently communicate.
• 4 - If a family conversation is unworkable, a trusted friend or a health or social service professional can facilitate and document the discussion.

Topic Definition

Advance Care Planning

Advance care planning is the process of thinking through, discussing and recording the medical care a person would want if a serious illness or injury left them unable to speak for themselves. It usually involves conversations with family and health care providers about values and treatment limits, naming someone to make decisions on the person's behalf, and putting those choices in writing through documents such as a living will or a durable power of attorney for health care. The plan is not fixed - it can be reviewed and changed at any time while the person still has the capacity to make decisions.

Overview

The following is written by Amy Tucci, who is president and CEO of Hospice Foundation of America:

If you have aging parents, now is the time to discuss what's important to them as they near the end of their lives. Too many adult children wait to have end-of-life conversations when their parents are dying or in the midst of a crisis.

The topic may seem downright frightening, but it is important to know your parents' preferences at the end of life, particularly if they develop a serious illness or condition that leaves them unable to make decisions.

A good time to have an end-of-life talk is during the holidays when family is together.

If your parents wish to avoid such a conversation altogether, they can record their preferences in a living will, a dated letter or even in an email. None of their decisions are permanent, and they can always change their preferences at a later date as long as they can competently communicate.

Because starting a discussion about life-and-death issues can be difficult, here are 10 questions to help guide the conversation:

• Thinking about your death, what do you value most about your life?
• If you were diagnosed with a terminal illness, would you want to pursue every possible cure?
• Do you imagine wanting to stop curative efforts if they were unsuccessful?
• What kinds of aggressive treatments would you want (or not want)?
• Do you want to die at home?
• How do you feel about an extended hospitalization?
• How much pain is acceptable to you?
• Do you want to be with your family when you die?
• What decisions regarding care do you want to entrust to others?
• What do you hope for most regarding your death?

There are three care options to consider if your parents are facing a diagnosis with a poor prognosis.

• They can choose to continue efforts to cure or treat an illness or condition.
• They can receive palliative care (pain and symptom management and relief) alone or in addition to curative care.
• Or they can choose hospice care.

With hospice, a Medicare-covered benefit, futile curative measures cease and palliative care eliminates or greatly reduces pain and symptoms. The patient receives medical and social services, typically at home, and the entire family receives supportive services.

You can get a glimpse into the hospice experience in the 2014 special program, "Hospice: Something More," produced by Hospice Foundation of America and funded by a grant from the John and Wauna Harman Foundation.

If having an end-of-life discussion with your parents is simply unworkable, consider asking a trusted friend, health or social service professional to facilitate and document a discussion. Again, do not wait until an illness forces you to have this conversation. One of the most common comments that hospice professionals hear from patients and families is that they wish they had started hospice care earlier.

Frequently Asked Questions

NOTE: Researched FAQs by Disabled World (DW)

What is the difference between a living will and a health care power of attorney?

A living will states which medical treatments a person does or does not want if they cannot speak for themselves. A health care power of attorney names a specific person to make medical decisions on their behalf. Many people complete both, and together they are often called advance directives.

What is the difference between palliative care and hospice care?

Palliative care focuses on relieving pain and symptoms and can be given at any stage of a serious illness, including alongside curative treatment. Hospice is palliative care for people nearing the end of life who are no longer pursuing a cure.

Who qualifies for the Medicare hospice benefit?

A person generally qualifies when they have Medicare Part A and a hospice doctor and their regular doctor, if they have one, certify a terminal illness with a life expectancy of six months or less. The person also agrees to receive comfort care instead of treatment aimed at curing the illness.

Can someone leave hospice care if they change their mind?

Yes. A person can stop hospice at any time and return to curative treatment, and can choose hospice again later if they still meet the eligibility requirements.

Does a living will need to be prepared by a lawyer?

In most U.S. states a lawyer is not required. State-specific advance directive forms are widely available at no cost, though each state sets its own rules on witnesses or notarization, so the signing requirements should be checked.

What is a POLST form and how is it different from a living will?

A POLST form is a set of medical orders signed by a health care provider for someone who is seriously ill or frail. Unlike a living will, which states general wishes for the future, it gives emergency responders and clinicians specific instructions they can act on immediately.

Where should advance directive documents be kept?

Copies should go to the named health care agent, close family members and the doctors involved so they can be added to the medical record. The original should be kept somewhere easy to reach at home rather than locked in a safe deposit box.

What happens if a parent can no longer make decisions and has no advance directive?

Decisions usually fall to a surrogate set out in state law, most often a spouse, then adult children, then other relatives. If family members disagree or no one is available, a court may need to appoint a guardian.

Insights, Analysis, and Developments

Editorial Note: Hospice professionals hear the same regret again and again from patients and families - that they wish they had started sooner - and that says a good deal about what delay costs. Hospice is a Medicare benefit that stops futile curative measures and shifts the focus to controlling pain and symptoms, usually at home, with support extended to the whole family, yet many people reach it only in the final days because nobody asked the questions early enough. The conversation is uncomfortable for an afternoon; not having it can leave relatives guessing about treatment, place of care and comfort at the worst possible moment, and that burden falls hardest on families already managing disability, dementia or long-term illness.*

Attribution/Source(s): This quality-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Hospice Foundation of America and published on 22 Jul 2014, this content may have been edited for style, clarity, or brevity.

* Editorial additions by Ian C. Langtree.