Seniors or retirees can elect to live by themselves, but individuals orcouples who elect to do so must be active and able to care for themselves. Home health aids are available to assist those in need of their services and hospice workers can come into the home when a senior is in the last stage of life. Many seniors also arrange for live-in help which, although expensive, is often far less in cost than most other choices.

Sunrise Senior Living based in McClean, VA is one of the largest assisted living companies in the U.S (380 communities) and has a home-care division which provides in-home care for the elderly and infirm.

Silverado Senior Living based in San Juan Capistrano operates home-care in CA, TX & UT

Some Jewish Homes for the Elderly like the one in Fairfield, CN offer home-care. Check out your local home to see if they offer this service. www.longtermcare.gov/LTC/Main_Site/index.aspx

National Association of Insurance Commissioners www.naic.org.

1. daily benefit
2. duration of benefit
3. when benefits kick in

Major players that provide long term care insurance include:

John Hancock, MetLife, Prudential, MassMutual, New York Life

Assisted living communities are designed for seniors who are having difficulty managing on their own, but who can provide a basic level of personal care including eating, taking their medication and bathing without assistance.

Continuing care communities usually have facilities for seniors in various stages of the aging process. Many of these communities include independent housing, assisted living facilities and nursing homes as well as rehabilitation care/facilities.

Nursing homes offer a higher level of medical care usually under the supervision of a physician and are designed for seniors who can't care for themselves, suffer from dementia or Alzheimer's or are at the last stages of their lives.

A 2004 study by MetLife Mature Market Institute provides the following information: "The national average monthly cost for assisted living was $2.534. At the high end was Silver Spring, MD at $3718 and at the lower end was $1,340 in Miami. The average cost to stay in a nursing home was $192 per day. The average cost for home health aids was $18 per hour".

There are many different kinds of insurance scams that target seniors. The National Association of Insurance Commissioners http://www.naic.org/ provides information and links to help you avoid being scammed.

Home Health Care and Long Term Care Insurance can pay for nursing home or health-aids at home. The costs of these policies have risen substantially in the past few years. Check out several insurance companies prior to purchasing this kind of insurance and make sure to see if these carriers have raised their rates for existing customers over the past few years.

The cost of the insurance depends on several factors.

1. What is the maximum daily benefit? $100, $150, $200?
2. How long will this benefit be paid 1 year, 2 years 5 years?
3. How long after you are judged in need of nursing home or home health care benefits before the daily benefits kicks in. 30 days, 60 days 90 days? It may take 30 to 90 days before receiving the first benefit payment after submitting a claim. Take this into consideration when choosing an "elimination period".
4. Is the coverage the same if you stay at home as opposed to being admitted to a nursing home?
5. You can also consider depositing a single sum or making deposits over ten years into a special type of annuity that will pay out a percentage of the total value for your care either at home or a nursing home. If the entire fund is not used during your lifetime the balance of the benefits will go to your heirs. Of course it is also important to understand the parameters of what constitutes your need for these benefits and who makes this determination. Your physician? The insurance company? An insurance company approved retirement provider or caregiver?

One of the best ways to save on your premium is the purchase of a policy with a long elimination period. If the period is 90, 120 ,150 days or even a year, the cost of the policy will be a great deal less than if the period is only 30 days or starts right away. However, the cost of care is substantial; often more than $100,000 a year and most seniors simply cannot afford to pay for their care and for out of pocket for more than a month or two.

Stand Alone Home Health Care policies are generally much less expensive than Nursing Home/Home Health Care Policies. They are designed to pay for care at home, not in a nursing home. There are two advantages.

1. The patient can be kept in his/her own comfortable surroundings.
2. The cost of the protection is a great deal less.

Policies can be designed to pay benefits for 1 year up to a lifetime. Benefits can be set to start immediately or put off for up to 365 days. The shorter the benefit period and the longer the elimination period, the lower your cost will be.

For example, a 60 year old, healthy, non-smoking male, using A F & L Insurance Company and starting coverage from day one with benefits extending a lifetime would cost about $830.00 per month. Using Physicians Mutual Insurance with benefits starting after 365 days and extending only one year the cost would be about $157.00 for the year. Of course there are many alternatives between these extremes.

(This information was supplied by Gil Nickelson, CLU, ChFC, SFS and is based on quotes which could increase in subsequent years).

For help in choosing a nursing home, negotiate fees, resolve billing questions or find assisted living quarters, look at Senior CareGuiders http://www.careguiders.com/.

The Medicare Web site http://www.medicare.gov/is a good resource to help you find nursing homes convenient to the location you are looking for.http://myhealthcareadvisor.com/ can assist you choose a hospital and make health care decisions but there is a small charge (at publication time it was $12 for a 6 month subscription) to subscribe and get answers to your questions. Powered by Subimo hospitals are ranked from 1 to 100 based on a number of factors including use of technology and cost. The information provided on the site says "The Healthcare Advisor is a powerful personal health management tool, integrating cost and quality information to help you make better health care decisions. Whether you’re looking for information on a common medical condition or procedure or, where to go for treatment, the Healthcare Advisor empowers you to make the right choice by presenting what you need to know clearly and simply."