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I just had a conversation with my brother, who has POA and Medical POA for both parents. From reading the posts on this website, I realize that my parents do not have any EOL plans. When I asked my brother about what would happen if Mom got really sick, and needed to be resuscitated or needed a feeding tube, he said that he would then consult with all the siblings about what to do. I then told him that I thought that was a lot to put on us and why couldn’t we get Mom’s and Dad’s thoughts on this? That way we could have their wishes to guide us. He told me that the conversation was too depressing and I could talk to them if I wanted to. My father is still capable of conversation and can be quite lucid at times. My mother, I would have to catch on a good day. I have read on this site about documents with various letters, DNR, etc, but can’t remember all of them. My elder care attorney had told me that these forms come from a doctor. What are all the EOL plans that they should have in place? Where do we get them? Who keeps them? How should I approach my parents about this?

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My parent's Elder Law Attorney put together a "Medical Directive" for each of my parents which spells out what they both wished to have done, or not done as they were aging or if they became seriously ill. It was an excellent blueprint for me to follow, no guessing on what to do next.
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Treeartist, these are good, sensible discussions to have (you're right, we all should), but I can think of two reasons not to push them too hard if you find your mother isn't receptive.

One, they're not mandatory. If you have your mother's wishes known and in writing, that's certainly helpful; but whether you have or not you and your brother and her doctors and health care team will still do the best you can in whatever circumstances arise. So you don't *need* her participation to make her end of life care as gentle and supportive of her wishes as possible, it just helps.

And speaking of circumstances... any advance directive or expression of wishes can only ever be a best guess. Nobody knows either what will happen to her, or even more so how she will feel about it when the time comes. I do sometimes look at my own form, which (cough) is a bit of a work in progress, and think "where's the I've-changed-me-mind section?"

I did try to make my mother go through the process formally too, during the period when we were discussing Community DNACPR forms which in the NHS are held by GPs on behalf of their "don't be surprised if they die" patients. Her wise GP listened to me telling her we needed to know her wishes, then printed off an information leaflet for her and said she should read it in her own time and let him know if she wanted to talk about it at the next appointment. Which I think was also his kindly way of telling me to leave my poor mother alone, though he'd never have been so harsh as to say so.

In fact... if you dig around online, you may well find that there are leaflets written specifically for very elderly people or people living with dementia that provide a good starting point for discussions. You can always censor them beforehand to check that they're a good fit with what you know of her own personal hopes and fears.
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97yroldmom, thank you for your response.  Based on the suggestions here, I did read Being Mortal. I guess I need to update my profile as things have changed. My siblings and I, along with professional caregivers) have been helping my parents to remain in their home for the last 16 years, the last seven years have been 24/7. My mother is currently in a nursing facility and, if everything works out, my father will soon be joining her in the same room. We decided on this move due to what you mentioned in your post, it was affecting our own health to the point of mental and physical breakdowns. Yes! Like you said, of course the doctor needs to be the one to talk to them about these issues and I suppose she has the necessary paperwork. Because my parents have excellent medical insurance in addition to medicare, they seem to be besieged with doctor visits. Six or seven years ago, my dad’s heart doctor wanted to put in a pacemaker though he didn’t tell him about any dangers this prodedure could incur. As a family, we discussed this with him and he chose not to do it. As he was already in a wheel chair with very few ADLs he didn’t want a pacemaker keeping him alive after he became bedridden. His last heart appointment we were told that his heart was working better than his doctor’s! So I have an idea of what my father’s wishes would be. We just need to get it in writing and the same for my mother. Then I’m going to do mine and get my siblings to address theirs also.
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Treeartist,
Check out author
Atul Gawande who wrote
‘Being Mortal
Medicine and What Matters in the End’
This is a book you and your sibs should read.
And it’s not what you and sibs want. It’s what your parents want that is important. So you are absolutely right to want their input.
Your brother needs to tune into the fact that he is POA FOR his parents. Not OVER his parents. How can he do what they want if he doesn’t know what that is?
You could make an appointment with your parents doctors to have them go over a life directive for those tough questions.
Do your parents want a machine to breath for them? Do they want a feeding tube? Do they want CPR to revive them?
This can open the door for a discussion on their funeral or cremation.
They are living at home now according to your profile.
Do they want to die at home? Do they have a support team? How will they manage transportation when they can no longer drive? At what age or circumstance do they see themselves no longer driving? Perhaps that has already happened? Do they have their bills set up to be paid automatically? Is their home safe? Does it need modification in the tub or shower? Are they trying to stay fit? Do they walk now? We all need aerobic exercise, balance exercise, strength exercise and flexibility.
What happens if living at home is no longer an option? Do they have savings for private pay or will they need Medicaid? Does brother understand how your parents would qualify should they need more care than they can pay for? And what happens if brother decides he’s tired of being POA, has an emergency or dies before your parents? Make sure your parents have an alternate appointed.
Does brother attend dr appointments with his parents? Does he understand their medical issues?
How will you and siblings decide who will nurse your parents when they become ill? Many are MIA when the parents are really needing help. There are many many more details to caring for aging parents. This website is full of information that can help. Read everything you can. Remember to take care of yourselves as you care for your parents. A large percentage of caregivers die before their patients do. When you notice you are changing the way you live in order for your parents to not have to change the way they live, you are off tract. It’s time to regroup. Be careful that you don’t create a false expectation for them that you will abandon your spouse, your children, your grandchildren, your friends and your career to keep their home and life running smoothly. You are wise to work these issues out in advance.
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