Many families find it helpful to have a plan to follow as they make decisions or solve problems for their elderly loved one.

Gather information, the goal is to make an informed decision. The first step is to clearly identify the issue and to gather information. Often, families are so concerned about making a decision that pertinent questions go unasked and unanswered. A professional assessment of the older person's health and ability to function in his or her home also may be needed.

Formulate options, once the issue has been identified, list all possible options to resolve it. Consider the resources of the older person, family and community. Health care and social service professionals can help identify options. This should be the brainstorming portion of decision-making. Keep this step separate from the actual decision step. It tends to take pressure away from people defending their postions.

Evaluate options, after all options have been identified, look at the pluses and minuses of each one. You may want to set up standards for how the options will be evaluated-criteria such as financial constraints and personal preferences. Agreeing on standards makes it easier to pick the best options. A good guideline to follow is, "Be easy on people; be tough on issues." Family members and others involved must be open and honest about their abilities to fulfill responsibilities of the options.

Create a plan, this can be the most difficult aspect of decision-making, especially if there does not seem to be a single best choice. At times, you may feel that there simply is no good choice and that you must select "the best of the worst." You may find that putting a plan in writing and indicating who has agreed to which tasks can reduce disagreements. A written plan can also be useful later when you re-evaluate it.

Act on the plan, a plan should not be considered as "final and forever" things change. Try to establish trial periods, and be flexible.

Last but not least is to reassess the plan and ask how well it is working, then make adjustments accordingly.