At 89, and with worsening heart and breathing problems, Chester Albright knows that his days of living alone in his home are probably coming to an end. His son and daughter are both pressuring him to move now, before the inevitable. Chester readily admits that he's vulnerable, so why won't he see reason and move now, before something awful happens?

Chester's son and daughter have talked with him over and over about their concerns: What if he falls and injures himself? What if he has a breathing emergency? What if he has a stroke or a heart attack? He could die alone on the floor and no one would know. It's so obvious that he would be much safer and more comfortable if he would only move somewhere where help is always available. Besides, the house is too hard for him to maintain now, and who's going to see that he eats properly?

Chester sees things differently. He is just as aware as his family that he is an old man with bad health. He knows full well that one of these days he will "go." The only thing he doesn't know is how and when. He chooses to face this at home as long as he can, because one of these days the choice will no longer be his to make.

Chester has already lost more than his adult children can comprehend. His wife is gone. His friends have either passed away or are no longer able to socialize like they once did. His own vitality is severely diminished. He has more days behind him than he has ahead. Where he chooses to spend his remaining time is one of the few things he can still control.

Chester knows that when he is forced to move he will be giving up most of what little control he still has. For him, it is the last downward slide on that final slope that has only one possible outcome. Even knowing the risks, leaving home has a finality about it that Chester is not ready to face.

Chester is more afraid of giving up the last remnants of his independence to a "facility" than he is of dying alone at home.

For Chester, every additional day he can spend at home is a victory.

For his adult children this makes no sense. Accustomed to making "logical" choices and making fast "executive" decisions, we look for practical solutions that will keep our parents "safe." We want to follow the experts' advice to anticipate problems and take steps to avoid emergencies. Not planning ahead means that sooner or later we will have to deal with a crisis. We're already stressed and we'd like to avoid adding to our stress with more worry.

For his children, every additional day he stays "unsafely" at home is a defeat.

Our definition of successful caregiving and Chester's definition of the best life are in conflict. Who will win? In the short term, Chester will. It is his life to live, and as long as he has the mental ability to understand the risks, he can choose to stay at home, even if it does increase those risks.

It's so very frustrating, but our lot is to wait until "it" happens. Chester hopes that "it" means that one day he simply won't wake up. His adult children fear that "it" means that he will lie on the floor for two days before help arrives. They are all three terrified that "it" means Chester will spend his final days in the nursing home he so greatly fears.

Helping Chester clarify what his "it" might be if he is not lucky enough to simply go to sleep forever will be enormously helpful to both Chester and his adult children. By encouraging him to talk about what his personal "triggers" for moving might be, they can help him preserve his sense of independence and control. Using this approach may make Chester more willing to talk about when and why he might eventually be willing to move, and where he would like to go.

In the meantime, all of us with a "Chester" parent have little choice but to wait for that other shoe to drop.