The risk of needing help with household tasks or of requiring care in old age increases. Using semi-structured, qualitative interviews, beliefs about the usefulness versus uselessness of planning ahead for future care needs (FCN) were investigated in 23 East German, 10 U.S., and 10 Canadian elderly-community dwelling women (> or= 65 years). Primary reasons in favor of planning for FCN were: gaining a feeling of security regarding the future, avoiding being a burden to potential helpers, and coping with one's present health conditions. Factors that prevent planning for FCN were: the difficulty foreseeing FCN, the lack of resources to plan, and low levels of perceived vulnerability. The women dealt with the contradictions between these factors that promote and prevent preparation by making general plans which could be adapted in the case of needing help by developing alternative plans or by avoidance of thinking about possible future health crises.