Decisions about a parent, made with a parent

Standing by the car after a visit, two of you trade worries in low voices: the stairs, the shopping, what next winter might bring. Inside, your parent is folding the tablecloth and putting it back in the drawer. Nobody in that scene has done anything wrong. This is information, not medical or legal advice. It will not tell you who in your family should decide what; that cannot be worked out from outside a family, and this page leaves it where it belongs.

Put plainly, a decision about a parent's life is one they are part of, and guidance written for care professionals in England puts it in much the same way.

The person is at the centre of the decision

NICE guidance for adult social care in England (2018) recommends that practitioners actively involve the person in all decisions that affect them. The same NICE guidance in England asks practitioners to respect people's right to make their own decisions.

That guidance is written for social care practitioners and services in England, not for families, and it is not a rule for anyone's kitchen table. Even so, it puts the centre of a decision in a clear place: with the person the decision is about. A family conversation can borrow that shape without borrowing anything else. The talk by the car is one kind of conversation; the one at the table, with your parent in it, is another.

Family comes in the way the person chooses

NICE guidance in England asks social care practitioners, at first contact, to ask the person whether and how they want family, friends, carers or others of their choosing involved in decisions about their care and support, and to follow their wishes.

The order in that guidance is worth a second look. Family is named, and family is part of it, but in the way NICE describes it for England, the invitation starts with the person. How to bring it up without a fight is about the conversation itself, and Respecting their independence and choices about choice from one day to the next.

Where capacity is in question, there is a formal side

There is a harder edge to all this, and the guidance treats it carefully. NICE guidance in England asks practitioners not to make assumptions about a person's capacity to be in control of their own care and support. Whether a parent is able to make a particular decision for themselves is not something a family is asked to settle on its own; where that is in question, it is for their doctor or care team, and the formal side differs by where your parent lives.

In Ireland, where a person's capacity to decide is in question, the HSE's National Consent Policy (v1.2, 2024) says healthcare workers should support the person to make their own decision, with the support they need to decide for themselves or to take part as fully as possible.

None of this needs settling in one go. The questions that do need a professional have somewhere to go: your parent's doctor or care team, with your parent part of the conversation wherever they want to be.