Have your parents slowed down? Complained of some aches and pains and wrinkles?

Those are normal signs of aging.

Have you noticed that your parents appear depressed or helpless? Have they lost interest in the hobbies they’ve always enjoyed? Are they overeating or have they lost their appetite?

As a physician, I can tell you these are not normal signs of aging.

As a daughter, I’ve had to watch for these symptoms and realize that I am now, like many people, parenting my parent.

Sometimes it’s hard to do, because many of us don’t live down the street or across town from our parents.

My mom lives on her own in another state. She is 84 years old and still drives, gets groceries and cleans her house. But I worry about her. I’m not there every day to see if any of the symptoms I mentioned are taking place. I have to rely on open, honest conversations with her.

What I’ve learned is that autonomy is important to my mom. She’s fiercely independent and will keep doing things herself until she can’t. And when that happens she wants to die at home.

It’s been very important to have conversations with her about how she wants to be treated if a serious accident or illness should occur.

For example, my mother is taking a blood thinner, and she also falls frequently. What if she falls, hits her head and she has bleeding on her brain? How does she want me to handle that? Does she want to be on a breathing machine, have a feeding tube or her heart restarted if it stops?

Asking specific questions like this is essential. And it isn’t just one conversation but many that need to take place.

I’ve had many talks with her over the last 10 years to confirm her wishes, because she has fallen six times and broken a few bones. The first conversation was hard, but now they are more of a check-in chat to make sure nothing has changed. My siblings are also aware of how she feels, and it is documented.

For help, I have often pointed patients and friends to the Centers for Disease Control and Prevention’s advanced care planning website.

I’ve used it myself. Eight years ago I received a transplant and had to face my own mortality. Knowing what would happen if I died gave me the freedom to live.

End-of-life conversations are hard to have, but peace of mind can come from them.

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