This guide is designed to help families identify and explore common questions, concerns, and dilemmas as they consider the advantages and drawbacks of raising a child with severe physical disabilities at home or arranging for care in a residential program. Chapters address: (1) options for the care of children with severe physical disabilities in the past and the present; (2) choosing home care; (3) considerations in choosing residential care including the physical burden of care, the child's age, the parents' ages, the make-up of the family, social isolation, the type of disability, the lack of community services, the need for specialized training, and the financial stress of providing care; (4) the emotional effect of looking for residential care, preparing the child for residential care, and dealing with siblings; (5) benefits and disadvantages of residential care for families and children; (6) choosing a residential program and considering location, staffing, social environment, involvement of parents, and educational programs. A list of family resources on disabilities is provided. (CR)