This article is for informational purposes only and does not constitute medical, legal, or financial advice. Always consult with qualified professionals regarding your specific situation.

Organ and tissue donation — the decision and the conversation

Some people know immediately. They've thought about it already, or they know from their faith tradition that donation is aligned with who they are. They want to give something back, even in death. They want their body to help someone else live.

Some people say no. They want to be whole when they die. They want their body intact. They want to think about being buried or cremated in the way they've imagined. They want what's left of them to be respected in a particular way. That's not selfish. That's integrity.

Most people haven't thought about it at all. And now someone is asking them, or you're asking your parent, or you're thinking about what your parent would have wanted. The conversation doesn't have to be complicated.

What can actually be donated, and by whom

Your parent's age and health determine what could be donated if they chose to be a donor. Organs like the heart, liver, kidneys, lungs, and pancreas can be transplanted. But the person has to be brain dead and on life support when organs are retrieved, and most people don't die that way. Most people die when their heart stops.

Tissues are different. Tissues like corneas, skin, bone, and heart valve can be recovered after death, even if the person has died naturally. Tissue donation is more possible for more people. It has a longer window, with some tissues recoverable up to 24 hours after death.

Age used to be a barrier to donation, but it's not anymore. People in their eighties and nineties can be donors. Health matters more. If someone has had cancer, they might not be able to donate organs, but they might be able to donate tissue. The transplant network makes those decisions, not the person or the family.

This is worth discussing because some people think they're too old to donate and opt out. But your seventy-five-year-old parent might have given the gift of sight to someone else, and they never knew it was possible.

The conversation with your parent: what they believe

If your parent is healthy and able, this is a conversation worth having. Not in the midst of illness, but in ordinary time. At dinner or on a drive. You might start by asking, not by telling.

"I've been thinking about organ donation. Do you know if you want to be a donor? Have you thought about it?"

Then listen. Your parent might say yes immediately. Might say no firmly. Might say they're not sure and want to think about it. All of these are fine. If they're not sure, you might ask what makes them unsure. Is it fear about the recovery process? Is it a religious concern? Is it uncertainty about whether they want their body touched? Different concerns have different answers.

If your parent says they want to be a donor, ask what draws them to it. Is it wanting to help? Is it a religious practice based on believing in organ donation because of their faith? Is it something someone they love needed? Understanding their reason helps you honor it after they've died.

If your parent says no, ask what matters to them. Do they need their body to be whole? Do they worry about the recovery process? Do they fear it affects their funeral? These worries can sometimes be addressed. Organ recovery happens after death, and the body can still have an open casket funeral. Tissue donation is less invasive than organ donation. But if your parent doesn't want to donate, that choice should be respected. It's their body, their death, their values.

The conversation might also be about not knowing. Some people are fine with donation if it happens, but they don't want to have to decide before they're in crisis. They might want to put on their license that they're willing, but make the final decision a family choice, made in the moment. That's allowed too. You can be a donor without being active about it.

If they can't tell you: what their values say

If your parent is in crisis and can't tell you what they want, you're making your best guess about their values. This is where conversations matter that have nothing to do with donation directly.

What kind of person was your parent? Were they generous? Did they give blood? Did they believe that helping others was important? Did they talk about legacy and wanting their life to matter, wanting to have meant something? These beliefs usually point toward whether donation would align with their values.

Were they private? Did they worry about their body being violated or seen by people outside the family? Did they want to be remembered in a particular way, whole and intact? Did they have spiritual practices around the body involving beliefs about what happens after death or what the body means after death? These beliefs usually point toward no.

You might also check if they signed the back of their driver's license. Some people sign it and forget about it. That's a signal they thought about it at some point and said yes. That's worth remembering. But not signing it isn't a signal that they said no. It just means they didn't check the box at the DMV.

If you really can't figure it out, you can ask the transplant coordinators what they'd recommend. They've had these conversations hundreds of times. They can ask you questions about your parent—about their values, their faith, their beliefs about helping others. They can help you think through what your parent would probably want.

After death, if donation happens: the process and the funeral

If your parent dies in a hospital and you choose donation, they will be taken to the operating room. A surgical team will remove the organs or tissues they agreed to donate. This happens with respect. The body is treated with care. Then the body is released to the funeral home, and you proceed with whatever funeral you planned.

The recovery process takes time, sometimes hours. This might delay the funeral slightly, but not usually significantly. It depends on what's being recovered. Families are usually told how long it will take.

After recovery, the funeral happens as planned. If you wanted an open casket, you can usually still have one, though there may be some bandaging or stitching that's visible. Many funeral homes can repair this well enough that it's not noticeable. You can ask your funeral director about this when you're planning.

You won't know where your parent's organs or tissues go. Privacy laws prevent the donation organization from telling you. But they can tell you that recovery was successful, and that your parent's donation helped someone or multiple people. Some people find deep meaning in that. Their parent lived a certain number of years, and then their body gave life to others. It's an extension of the person they were.

Other people struggle with not knowing. They wonder where their parent's corneas are. They think about the person who can now see because of their parent. They imagine stories that might be happening, and these imaginings can be beautiful or haunting, depending on the person.

If your parent died and didn't specify, and you chose donation on their behalf, you might feel uncertain afterward. You might second-guess whether you decided right. This is normal. You made the choice that seemed right in an impossible moment, with imperfect information. You made a choice based on love, on your understanding of your parent, on your best guess at their values. That's all any of us can do.

Some transplant organizations have programs where families can connect, anonymously, with recipients or their families. This is different from organ donation, where privacy is stricter. Some families find healing in knowing how their parent's donation helped. Some families are better served by not knowing. You get to choose how much you want to know.

The choice about donation is individual. It's shaped by faith, by beliefs about the body, by values about helping others. Whether your parent was a donor or not doesn't mean they were selfish or generous. It means they chose the death they believed in.

How To Help Your Elders is an informational resource for families working through aging and elder care. We are not medical professionals, attorneys, or financial advisors. The information provided here is for educational purposes and should not replace professional consultation. Every family's situation is unique, and rules, costs, and availability vary by location and circumstance.