As parents of adult children age into their twilight years, bouts of severe illnesses become more frequent.

Thoughts about Mom or Dad's end of life are often not discussed, and as parents decline, angst amongst family members increases. For many of us the holidays offer a rare occasion to meet as an extended family and have time for a meaningful discussion to honor our parents' end-of-life wishes.

We had this opportunity when my wife's parents visited along with four of their five adult children, along with spouses and grandkids. Grandpa had aged a lot since our last major family event. As he sat on the deck with us he brought up his failing health. Anxious whispers were followed by confusion over his end-of-life wishes. As the vacation week came to a close I finally asked if any of the adult children had seen Dad's advanced care directive and was met with blank stares. No one wanted to bring it up even though everyone admitted it was a great concern.

After the grandparents and kids went to sleep we stayed up late in the living room discussing this topic and I was asked to approach their dad and mom about a plan. I took the plunge the following morning while the kids played on the beach. Over coffee we learned a basic plan existed but had not been shared with anyone. My wife agreed to help Mom and Dad track it down and verify if it met the advanced care plan standards using our state's form. Thank goodness the process has been started.

While this topic is awkward, stressful and painful for many family members to have, it is well worth it in the end. I became an advocate for end-of-life documents, family discussions and hospice 18 years ago when my mother died after a long battle with breast cancer. In the preceding months we spent many hours with her sometimes talking and more times just being quiet together. She passed on at home with dignity and grace.

Many health care systems, including Essentia Health, have materials online and staff to help answer your questions. Please share end-of-life forms with your primary care doctor and request that they be scanned into the electronic medical record. These documents only have value if they can be accessed by your health care team when an event occurs.

This topic deserves meaningful family conversations, respectfully listening and clarifying their choices. I hope you find peace honoring your parents' final wishes.

If you'd like more information on Essentia's Advance Care Planning, call 218-828-7100 to set up an appointment with a facilitator trained to help you and loved ones begin these conversations and complete an advance directive. Honoring Choices, a public health initiative focused on advance care planning, also has some great ideas to start the conversation with family and friends, along with some videos to help guide discussions at

The conversation

• 60 percent of people say making sure their family is not burdened by tough decisions is "extremely important," but 56 percent have not communicated their end-of-life wishes.

• 82 percent of people say it's important to put their wishes in writing, but 23 percent have actually done it.

• 90 percent of people say talking with their loved one about end-of-life care is important but 27 percent have actually done so.

Data is from