As a home care and hospice consultant, I have written a newspaper column about caregiving in Sarasota County, Florida, a county with a median population age of 55 years (City-Data.com, n.d.) for many years. The following story is one of many I hear about every year. Sarah, an 86-year-old woman, has moved in with her adult daughter and son-in-law. My involvement began with a phone call from this very distraught couple who were trying to do the right thing and bring a family member into their home when it became obvious she was no longer safe on her own. This move did not occur with much forethought or planning; however, it soon became clear that Sarah was very demanding and difficult, and would not follow the doctor's recommendations nor theirs. The son and daughter-in-law work full time and have two children, ages 14 and 18, living at home. They related that, although Sarah had always been “prickly,” her negative behaviors seemed magnified when she moved into their home. The last straw was when Sarah fired the aide they had hired to assist with her personal care. They knew they needed to regroup and develop a long-term plan that would be best for Sarah and her care needs.