As we age, being a patient takes on a different meaning than it might have when we were in our 20s or 30s.

Parents who are older have adult children, their children's children - possibly even great grandchildren - who may be involved in their care or the consideration of medical treatment. For everyone, medical decisions can be freighted with a lifetime of emotion, culture, family ritual, and tradition.

A recent article in The New York Times on dialysis in elders brought up making medical decisions and the choices people face when considering various types of dialysis treatment.

Most important is listening to the wishes of the patient. The American Society of Nephrology stated: "Don't initiate chronic dialysis without ensuring a shared decision-making process between patients, their families and their physicians."

This is solid information for any type of medical need. And it all starts with listening to the wishes of the patient.