Don't Be Foolish
First and foremost, don’t be foolish in believing that your family will never face such a situation. Unless there are already legal documents in place, you cannot underestimate how strong of a barrier emotions can be when making a life-changing decision. While this type of discussion should occur in all families, it is definitely a must if your loved one is involved in a new significant relationship or has remarried since your loved one's beliefs regarding long-term care may have changed and relayed only to the new partner.
Don't Be Bashful or Afraid
Beginning such a conversation can be tough and in some cultures it is viewed as taboo. For some, it can even be anxiety-provoking. It is extremely important, however, to check your priorities by weighing your options. Would you rather deal with 15 minutes of fear when bringing up the topic or days of trying to figure out what decision is best for your loved one while you are in the middle of a crisis?
Make Your Intentions Clear
During your discussion, be sure to be upfront about your reason for bringing up this issue. Maybe it's because you want to make sure your loved one’s assets are protected, or ensure his/her wishes are honored, or simply to assure everyone is on the same page about who will be in charge of making decisions. Stating your “agenda” early on can generally alleviate any doubts someone else may have regarding your intention.
Aim to "Plant the Seed"
When planning or having your discussion, don’t expect to leave with everyone in agreement about a plan of action or who will be in charge. Since most people generally do not like to think about their own health deterioration, reluctance or even disagreements between parties is to be expected. As a result, you should aim to “plant the seed” and simply ask your loved one to think about the issues you are discussing. At the very least, you want to be able to get an idea of what your role will be in an emergency situation. Will your loved one’s spouse be in charge or will you? Does your father expect your stepmother to relay his wishes regarding life-sustaining treatments or does he expect you to do it? Getting the answers to such questions can open the door to communication about other issues that most families often don't think about until it is too late. It can also reduce the amount of tension and friction that can result within a stepfamily.
While there are many more recommendations I can list, I would prefer to hear your thoughts regarding what has worked for you. Do you have any recommendations you would like to share?