When I worked in a hospital as a Case manager, I saw families BEGIN to talk about nursing home placement while their loved one was in the hospital for a 3 day stay.  Families were not prepared and they did not always make the best decisions.  That was probably the beginning of my Eldercoaching career.  I thought if people could plan and discuss how they wanted to be cared for before there was a crisis, then the family could spend more time caring and less time arguing or tending to details instead of their family member.