In this first of three articles on family decision making and long-term care arrangements, data are presented to indicate the elderly are not abandoned; rather, most home health care is provided primarily by the family. Adult children meet the responsibility toward frail, dependent parents but are facing a difficult situation unique in history. Many factors are attributed to the present cohort of elderly and to the cohort of their adult children which complicate the traditional expectation of caregiving to one's elderly parents. The older person's family needs education and support in making decisions regarding long-term care. Religious organizations have an important role to play in this process.