Sooner or later, many adults must help make decisions about aging parents who are becoming too ill or frail to live alone. Sooner is better than later, according to Cammy Seguin, University of Illinois Extension Educator, Family Life. "Many people try to solve this problem by ignoring it," she said. "Then when elderly parents face serious health problems, family members make hasty decisions when they are upset, feeling guilty and scared and are unsure about their options." In some situations, hospitals discharge patients within a day's notice, forcing family members to make an immediate decision about placement.

In an American Association of Retired Persons (AARP) survey from 1997, almost 65 percent of adults said they believed talking with parents about independence issues would be easy. Even so, 68 percent said they had not had this discussion with their parents. The survey also showed that so few had discussed the issue because only a small percentage of adults had experienced health problems that might threaten independent living. In short, most adults are waiting until their parents have health difficulties before discussing what to do.

When that time comes, many often do not know where to turn for information, Seguin said. Families may avoid discussing the issue because the parents or the adult children feel uncomfortable about the topic. Initiating the conversation and talking about independence issues in a general way may encourage family members to consider their views on the matter. The topic may be easier to discuss if a doctor, a clergy person or someone else outside of the family initiates the discussion, Seguin said. "There is never an ideal time for any family to discuss these delicate matters," Seguin said. "But when families plan ahead they will feel more assured that the older person will receive the best care available." The older adult and family members responsible for providing or coordinating the care should be involved in making decisions about medical care options, housing possibilities, financial and legal matters and available resources. The decisions should be made jointly, considering the quality of life, not just the quantity.