Chester Berg is a 95-year-old bachelor who lives alone in Ada, Minn., about 45 miles northeast of Fargo.

A few years ago, he bought the house next door. It sits empty, he says, because he didn't want to "put up with any rock and roll music" the new owners might play. Berg says he plans to live in this silent bliss for as long as he's in good health. It could be a while. He still drives, shovels two driveways and mows his two lawns.

His little sister, Laverne, 85, is in a somewhat similar situation. She's a widow who lives in suburban St. Paul, Minn., alone in a house where she raised six children. Like Chester, Laverne also refuses to budge. Unlike Chester, her health comes and goes. And as she put it recently, "I'll die before you drag me out of this house."

Those are 10 words adult children of aging, ailing parents don't necessarily want to hear. They want mom and dad to ease into the most challenging stages of their lives as flawlessly as possible -- to be completely willing to accept health care workers into their home or eager to sell everything and move into assisted living or a nursing home.

It doesn't work like that. In fact, just talking about the subject is a huge first step for most families.

Elinor Ginzler, a housing and health care expert for AARP, said it all starts with an honest conversation, punctuated with "I" statements, as in, "I'm worried about your safety."

"Do it with the frame of care and concern," Ginzler said. "Our suggestion is that people talk early and talk often. In the best of all worlds, talking about how your aging parents want to be cared for … would begin long before there are any problems."

Parents may not like talking about it, but they probably won't be surprised by the issue.

"It is absolutely true that adult children are nervous about raising this topic," Ginzler said. "It's also true that older parents do think about this thing. They do think about their situation changing. They do think about the possibility that they will need some help as they get older. This is not the first time that it's crossed their mind. Is it a difficult conversation? Sure."

Ginzler suggests that the conversation may be easier if the adult children do a little homework first.

"Because then you're talking in real terms and there's nothing vague," she said. "You are really saying, 'I did a little fact-finding and there are seven assisted-living residences within a 20-mile radius of where you're living. I'm thinking we might want to go and see what they look like.'"

Determining The Costs Of Care

Fact-finding also means figuring out how much different options cost -- something Americans are fairly clueless about.

According to a 2006 AARP survey, most Americans over the age of 45 either underestimate or simply don't know the facts about long-term health care costs. The findings show that only 8 percent could correctly estimate the monthly cost of a nursing home -- about $4,700, according to national averages. Less than 25 percent knew the monthly cost of an assisted-living facility ($2,500). Less than 25 percent also knew the cost of an in-home visit from a skilled nurse ($16 per visit).

Ginzler added that there are also plenty of misconceptions on who pays the bills.

"People are walking around with a false sense of security because they think Medicare covers things that Medicare doesn't cover," Ginzler said. "Most of the public thinks that Medicare covers assisted living. Medicare never covers assisted living. Some people think Medicare covers nursing home stays. It's true Medicare covers some short-term nursing home stays, but long-term placement at a nursing home is not covered by Medicare. Well over half of the population thinks that that's true."

Most costs, Ginzler said, are covered privately. If a patient is eligible, Medicaid will cover continued stays in nursing homes. But that funding mechanism requires that the patient be "spent down" to a low asset level first. Again, that's why the initial conversation of "what do we do next" can be a challenge.

"Making a decision to move is a big deal," Ginzler said. "Leaving your home, even if it's going to be good for your safety -- and good for your health -- there's going to be a loss, the loss of leaving something familiar and going to something unfamiliar. That's a transition that's important to recognize.

"This is not about you deciding for them. It's about you sharing with them as a concerned family member that you're worried and that you want the best."