Unpleasant But Necessary Holiday Conversations

Make an effort to talk with your aging relatives about their end-of-life wishes.

Family and neighbors gather together in senior woman's home to prepare Thanksgiving dinner.
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When families gather for the holidays, it's a good time to talk with older relatives about the realities of aging. Take a moment to find out your parents' or grandparents' health and long-term care wishes, whether they've filled out the correct paperwork and what you can do to make the whole process easier. Here are a few difficult but important topics to broach this holiday season:

What are your health care wishes? Almost all Americans (94 percent) say it's important to have a conversation with older loved ones about their wishes for end-of-life care, but only about a quarter (24 percent) have had such a discussion, according to a recent Kelton Global survey of 1,067 adults commissioned by the Conversation Project, a nonprofit dedicated to helping people talk about end-of-life care. Even fewer people (20 percent) say they have discussed arrangements for a health care proxy or a document specifying someone to make health care decisions if they become unable to do so. "A living will specifies how you would like your affairs to be handled in the event that you are still alive but no longer able to make your own decisions," says Phillip Rumrill, a professor at Kent State University and co-author of "The Sandwich Generation's Guide to Eldercare." "Specify the medical measures you are willing to take to save your life and the people you would like to be in charge of making decisions if you are no longer able to make decisions."

[Read: 10 Ways to Make the Most of Medicare.]

One way to get the conversation started is by mentioning a friend whose parents are having some health problems. You could say something like, "My friend Mary just had a crisis and her mom was put in the hospital and they are talking about looking for care," suggests Sandy Markwood, CEO of the National Association of Area Agencies on Aging. "That really worries me. Is there anything that I can help you to do to organize that?" Ask what your parents or grandparents would want if they were ever in a similar situation.

Where's the will and other important paperwork? Getting the proper paperwork in place can make things much easier in the event that your loved ones develop health problems. "The worst time to try to deal with all of these issues is during a crisis, and a crisis can occur at any point," Markwood says. "Parents get rushed to the hospital and relatives don't know who the doctors are and what medications people are on." Only a small fraction of adults have discussed a will (20 percent) or life insurance policy (21 percent) with their loved ones. "We encourage people to make a kit for the person who is going to be taking care of you in the event that you need help," Rumrill says. "Write down all of your account numbers, include your will and fill a shoebox with these important documents for whoever in the younger generation is going to be taking care of you."

[Read: How to Budget for Health Costs in Retirement.]

What are your preferred funeral arrangements? Discussing funeral arrangements with loved ones allows you to honor them the way they would have wanted. Just 28 percent of adults have had a conversation with their relatives about their desired burial and funeral arrangements.

Will you need to move into age-appropriate housing? Sometimes senior citizens get to the point when they can no longer safely live on their own. "If you need to be in a different kind of environment in order to be safe and in order to get the care that you need, that's a conversation to have with the children or whoever is going to be responsible for their care," Rumrill says. It can be helpful to talk about a future move instead of an immediate one. Consider saying something like: "You've been in your home for 42 years. Are you thinking you would like to stay in it indefinitely, or do you ever get tired of maintaining this house or cleaning the gutter or shoveling snow?" Rumrill recommends. It's also a good idea to offer to help make arrangements instead of simply pointing out the problems.