The most important conversations about our health care are often the ones we avoid—until it’s too late.

Yet the evidence is clear: people who take the time to talk about their wishes for future medical care, and put those wishes in writing, are far more likely to receive care that reflects what they truly want. Just as importantly, these conversations lift a tremendous emotional weight from loved ones. In moments of crisis, families are not left guessing, second-guessing, or carrying the burden of uncertainty.

In a perfect world, these discussions would happen early—when we are healthy, clear-headed, and able to thoughtfully consider the “what ifs.” In reality, most families find themselves having these conversations in the middle of illness, when decisions are urgent and the person at the center of it all may no longer be able to participate.

Planning ahead changes that.

Advance care planning is not about giving up control—it is about maintaining it. It allows individuals to define their preferences, choose who will speak for them, and ensure their voice is heard even if they cannot speak for themselves. Through tools like a health care proxy, a nonhospital DNR, or a MOLST, people can document what matters most to them and how they want care to be delivered.

This isn’t just for older adults or those facing serious illness. At any age, an unexpected event can leave someone unable to make their own medical decisions. Having a plan in place brings clarity in moments when clarity is hardest to find. It preserves dignity, reduces conflict, and gives families the confidence that they are honoring—not guessing—the wishes of someone they love.

These conversations are also not meant to happen in isolation. Talking with a healthcare provider can help frame what decisions may lie ahead and what options are available. Medicare recognizes the importance of these discussions and covers advance care planning, making it more accessible for patients and families to take this step.

Still, many families arrive at critical moments without a plan. In those situations, decisions fall to caregivers, family members, or designated surrogates who must work together with healthcare providers to determine what care should look like. Even in the most supportive environments, this can be emotionally complex. It is far easier—and far more compassionate—to have had the conversation earlier.

At its core, this is about a simple but profound question: who will speak for you if you cannot?

Choosing that person, and making sure they understand your values, may be one of the most meaningful decisions you ever make.

At Parker Jewish Institute for Health Care and Rehabilitation, we see every day how powerful these conversations can be when they happen early—and how difficult it can be when they don’t. Through a collaboration between Parker’s Hospice Program and Parker at Your Door, our physicians and social workers help individuals and families navigate these discussions with compassion and clarity. We meet people where they are—at home, in the community, or virtually—providing guidance, education, and support every step of the way.

This work is not about preparing for the end. It is about making sure that, no matter what happens, your care reflects who you are, what you value, and how you want to live.

The best time to have this conversation is before you need it.

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