Approaching End-of-Life Discussions With Aging Parents

Mother and son sitting on the sofa at home and communicating
Kristian Sekulic/iStock

“Your eyes saw my unformed body; all the days ordained for me were written in your book before one of them came to be.” Psalm 139:16 (NIV)

Conversations about death and dying are not easy at any age, but they are especially difficult with older generations who can be private to a fault, in denial about their declining health or unwilling to show weakness. Add dementia into the mix, and the resistance to talk about death becomes even greater as a failing mind sees change as a fearful process.

These are broad generalizations, of course, but many adult children in their 40s and 50s now find themselves facing tough decisions — and tough discussions — as they witness signs of their parents’ health failing.

What adds to the challenge is a problem fairly unique to the U.S. and parts of the West: It’s not part of regular conversation. There’s a reluctance to admit that death is an inescapable part of life. The media show us a story of a woman completing a marathon at age 92, and we somehow consider that this achievement is the norm if only we engage in clean living. Unfortunately, this is simply not the case.

Sadly, talking about death and dying with an eye on the sanctity of life rarely happens, even in churches. Without a traditional Christian approach to death (as preparation to meet Jesus) and a willingness to discuss end-of-life issues before the end actually arrives, the stress on the parent-child relationship in those final days can seem overwhelming.

This strain can feel even greater when dealing with family from a distance. When you don’t see parents on a regular basis, you may often wonder, What is really going on? when you hang up the phone.

Even asking parents to consider moving closer is met with resistance when their security in later years is tied to longtime friends, a family home, church community or a network of doctors. If you live in a different part of the country, an occasional trip home — or frequent trips home — may be necessary to glean the full story.

Dr. John Dunlap, a physician specializing in geriatrics and the author of Finishing Well to the Glory of God: Strategies from a Christian Physician, advises adult children to look for these indications that a parent is failing and perhaps end-of-life care is needed: 

  • Level of function: Are they more withdrawn?
  • Are they not eating as well or as much?
  • Are they avoiding social engagements?
  • Are they cutting visits short?
  • Are they withdrawing more from daily life?
  • Are they talking less about the future?
  • Are they less interested in others and more interested in themselves?

If you see these signs, or others such as memory loss and frequent trips to the doctor or hospital (even for minor ailments), it’s important to have a direct conversation. Maintaining a good quality of life to the very end is an important part of the human experience, and it honors God.

The first step, however, is getting everyone on the same page. And it begins with a conversation.


Navigating the emotional and spiritual landscape of end-of-life care can take its toll on loved ones. If you need further guidance and encouragement, Focus on the Family has a staff of licensed, professional Christian counselors available to talk with you at no charge. Just call 800-A-FAMILY (232-6459).

Focus on the Family Store resource:

The Art of Dying: Living Fully Into the Life to Come by Rob Moll