The three documents every family needs before a parent's health crisis

Your mother is in intensive care and cannot speak. The doctor needs a decision. Three siblings have three opinions, and nobody has anything in writing.

Only about one in three American adults has completed an advance directive, according to a 2017 study in Health Affairs.¹ Most families are one phone call from making the largest decisions of a parent’s life with no instructions, in a hospital hallway, guessing.

The paperwork that prevents that night is three documents. None of them is about dying. They decide who is allowed to help your parent while they are alive: who can speak to the doctor, who can pay the mortgage, and what your parent actually wanted.

What are the three documents?

1. A health-care proxy. Depending on the state, this is also called a health-care power of attorney or a medical power of attorney.² It names the person who makes medical decisions if your parent cannot. Without it, doctors turn to the default list in state law, and the person the law picks may not be the person your parent would have chosen.

2. A durable financial power of attorney. This is the one families discover missing at the worst possible moment. Without it, nobody, in some situations not even a spouse, can access accounts held solely in your parent’s name to pay the mortgage, the utilities or the caregivers. The fallback is guardianship court: months of delay, thousands of dollars in fees, and a judge deciding who manages your parent’s affairs. The word “durable” matters. It means the authority continues after your parent loses capacity, which is exactly when it is needed.

3. An advance directive. Often called a living will.² This is your parent’s own wishes about treatment, machines and comfort, in their own words. It is the document that ends the 2 a.m. guessing, because the answer is written down.

How do you start the conversation with your parent?

Do not stage a summit. Ask in the car, on a walk, over coffee. Sideways conversations work better than sit-downs, and if your parent waves you off, plant the seed and come back another day. Three questions cover the ground:

• “If you ever couldn’t live at home, what matters most to you?” You are not deciding anything. You are learning what they value.
• “If you couldn’t speak for yourself, who do you want making the call?” That is the health-care proxy, and everyone in the family should hear the name from your parent’s mouth.
• “Where are your important papers?” The will, the insurance policies, the deed. At 2 a.m., nobody can find anything.

Asked calmly, most parents are relieved someone finally brought it up.

From Next Chapter TodayThe Social Security PlaybookWhen to claim, how to protect a spouse, and the 75 questions people actually ask. By Kwame Kuadey.About the book →

What should you do next?

1. Have the conversation first. The documents are easier to complete once your parent has said out loud who they trust and what they want.
2. Find your state’s official forms. Many states post their advance directive and health-care proxy forms free online, often through the state health department or attorney general’s office. Many require only witnesses or a notary.
3. For the durable financial power of attorney, use your state’s statutory form if it has one, or have an elder-law attorney draft it. Ask your parent’s bank whether it also wants its own form on file; some do.
4. Make copies. Give one set to the named proxy and one to your parent’s primary doctor, and keep the originals where every sibling knows to look.
5. Review the documents every few years and after any major change: a move to another state, a death, a divorce, a new diagnosis.

One in three families have this handled. Send this to your siblings and get yours into that third.