Last month was National Elder Law Month, which helps raise awareness about our growing senior population.  Issues that affect our elders are getting more press recently, and for good reason.  Here are some eye-opening statistics:  In 2014, there were 46.2 million people in the United States age 65 and older, representing 14.5 percent of the total population and 3 million more than the year before.  By 2060, 98.2 million people will be age 65 and older, nearly 25 percent of U.S. residents at that time! Of this number, 19.7 million will be 85 or older.

For most of us, the issues faced by seniors are brought into focus by our interactions with our own parents.  This is particularly true with respect to issues related to health care and financial decision-making.  Decisions regarding end-of-life care are particularly difficult, but also among the most important.  I meet with elderly people every day who want to talk about this topic.  Many have seen a spouse, friend or family member face the end of life, some with good experiences and some with bad, and have very clear ideas about what they want for themselves.

Here are five ways you can help your elderly parents ensure that financial and health care decisions will be made for them by someone they choose and trust, and that their wishes will be expressed clearly and carried out to the greatest extent possible.

1. Sign a Power of Attorney. A Durable Power of Attorney is a legal document in which the maker (the principal) designates a person (the attorney-in-fact) who will have the authority to manage the principal’s financial affairs.  It is used to address the possibility of future incapacity.  Without a Durable Power of Attorney in place, you will be forced to pursue a conservatorship through the probate court if your elderly parent is in an accident or suffers a medical event that makes him unable to handle his own financial affairs such as paying bills, signing a tax return, managing investments, filing an application for long-term care benefits, or paying for assisted living, home care or long-term care.

2. Sign a Health Care Proxy. A Health Care Proxy is a document by which your elderly parent can designate an individual to serve as her Health Care Agent.  The Health Care Agent is the person who will make health care decisions for your parent if she is ill and unable to communicate with her doctor.  An attorney can prepare a Health Care Proxy, or a form can be obtained from your parent’s physician or online – just be sure to use a Massachusetts Health Care Proxy as these documents are state-specific.  The selection of a Health Care Agent is important.  Your parent should choose someone with whom she can have frank discussions about her health care wishes, and who she can trust to carry out those wishes, even if other family members may object.  Consideration should also be given to choosing someone who will be a good advocate within the health care system.

3. Sign a Living Will. A Living Will is a document that expresses wishes about end -of-life care in general terms.  In Massachusetts, Living Wills are not legally binding on the patient’s doctor or Health Care Agent.  However, this document is another way to ensure an elderly parent’s wishes are known.  A Living Will can be created by an attorney, or simply by your parent expressing her wishes in writing to family members.

4. Talk to a Physician about MOLST. MOLST is an acronym for Medical Orders for Life Sustaining Treatment and is a medical document completed by a patient and her physician. If your elderly parent has a serious chronic or terminal illness, encourage her to meet with her physician to complete a MOLST form, which is a medical order confirming how certain aspects of a patient’s care should be handled.  The form notes whether or not aggressive treatment should be employed to keep the patient alive under certain circumstances, and gives the patient and physician, after discussion, the ability to opt out of certain aggressive measures.

5. Have a Conversation about End-of- Life Care. The most important thing you can do for your elderly parents is to encourage conversations about how they want to be cared for at the end of their life.  It is important to encourage your elderly family members to express preferences for care to their family while they are still able to do so.  Most elderly individuals have opinions about the care they wish to receive and want to make sure their family members know their wishes and will carry them out when the time comes.  Although these conversations are not always easy, your parents will feel better after making their wishes known and you will also feel better after receiving guidance from them.  A family is put in a difficult situation when an elderly parent becomes too ill to make decisions about his own care and his family has no idea what type of care he wants to receive. The Conversation Project is a local initiative that encourages conversations about end-of-life care.  To get started, visit theconversationproject.org and download the “starter kit.”

One of the most important things you can do for your elderly parents is to help them get their affairs in order.  This will give them peace of mind that their wishes have been clearly expressed and a plan is in place.  It will also give you peace of mind that you will know what to do and have the tools you need to assist your parents when assistance is needed.  It will also help siblings maintain good relationships while having confidence they have honored the wishes of their parents.  So, in recognition of National Elder Law Month, take your favorite elder out to lunch and have a conversation about what they can do to ensure their wishes are carried out if they become unable to make decisions for themselves.

Attorney Maria Baler is an estate planning and elder law attorney and a partner with the Dedham law firm of Samuel, Sayward & Baler LLC. She is also a director of the Massachusetts Chapter of the National Academy of Elder Law Attorneys (MassNAELA). For more information, visit www.ssbllc.com or call (781) 461-1020.  This article is not intended to provide legal advice or create or imply an attorney-client relationship. No information contained herein is a substitute for a personal consultation with an attorney.