My parents prepared for their old age by doing all the paperwork ie setting up a trust, DPOA, advanced directive etc. But, never did Mom and Dad sit down with my brother and I and discuss what they wanted done when they could no longer live on their own. Did they expect to move in with one of us? Did they want to go to a nursing home? Why did we as a family never discuss this, did we think it would never happen? How much easier it would be on family members if this topic were discussed. Parents and children could plan and unrealistic expectations could be dealt with. Families would no longer be "thrown" into a situation they weren't prepared for. Guilt would be kept to a minimum because everything would have been decided in advance by all involved.
Now, obviously, even the best laid plans can be thrown for a loop but maybe it's time as much emphasis be put on this family discussion as there is to filling out the advanced directive.