Mom doesn't want to move to a nursing home. Dad doesn't believe he needs someone in the house 24 hours a day if he's going to remain there. Your wife is absolutely set against surgery. Your husband would be crushed if someone took away his driver's license. But these are the steps that the professionals are recommending. What can you do?

The first reaction you may have to such professional recommendations is "This can't be true." This is a natural response. No one wants to hear the bad news that a love one's condition is deteriorating.

It's easy to find excuses: "Mom has always been forgetful." "Dad never had good eyesight." "She was just tired." "He got confused with all those questions." It's tempting, too, to look at this professional, this outsider, as someone who is merely trying to drum up more business. Maybe more than anything else, it simply hurts to hear bad news. It hurts to have someone say a loved one's health is getting worse and something big has to be done.

Regardless of how hard it is to get bad news about your care-receiver, it's important to keep in mind that a health-care professional has the responsibility, the training, and the experience to see the overall picture -- to assess a person's general well-being, and to determine if an older person is receiving the proper care or if that person is safe under his or her present living conditions. A professional assessment is based on a range of abilities -- physical, mental, emotional, and social. Everyone has strengths and weaknesses within that range. Your loved one's doctor isn't testing to see if he or she passes or fails. The goal is to take note of the problem areas so that you can work toward a solution. Remember, too, that a competent professional looks at many, many patients with these issues, whereas the average person often comes in contact with far fewer people in that situation.

If your family has questions about the accuracy of a doctor's assessment, by all means get a second opinion. If the concern is that the doctor is behaving like a salesman going after more business, know that Senior Information and Assistance can provide the names and numbers of professional assessors who are not associated with any nursing home, clinic, or other senior service.

Obviously, the news you don't want to hear can be even more devastating for your loved one. It can immediately bring up tremendous fears and troubling questions. One way you can show you are on his or her side is to help answer those questions and address those fears. Together, you can get more information. You can explore what the realistic options are. You both can join a support group that welcomes your loved one and his or her family members.

 Still, it's important to remember that resisting good professional advice can harm your loved one. Very often, that advice -- though painful to accept -- can enhance the quality of his or her remaining time on earth, and that is what every concerned caregiver wants.