With deinstitutionalization, family members, typically parents, have become providers of long-term home care for many patients with schizophrenia. However, caregivers age along with patients and are largely impotent in finding replacements. This chapter combines research findings and clinical reports from families describing home conditions and patient progress. Agreeable patients may be boons to aging parents. More typical are difficult patients who sometimes become angry and threatening , reject medication, and may require police interventions that usually lead to cursory crisis interventions that are countertherapeutic. In the U.S., familial replacement caregivers may be scarce. Research on elderly caregivers indicates little future planning and ignorance of resources. Many fear that patients will fight displacement from the family home and decompensate further. Research on siblings indicates willingness to supply social support, but many report hostility from patients. Research examples of cultural differences in caregiving, largely relate to family structure and available resources. Worldwide solutions and some national attempts to address aging caregiver loss among persons with disabilities are presented. Some helpful planning resources for U.S. caregivers are provided.