There is no doubt that a person's own home provides the most stable and pleasant long-term care environment for the majority of seniors. Most people want to stay in their own home for as long as possible, and home should always be the first consideration if adequate and appropriate care can be provided in that setting. However, necessary care cannot always be provided in the home. In our mobile society, family and friends are sometimes not available to assist those needing complex care, or may not be able to undertake the amount of responsibility and work involved. When that occurs, or when the older person chooses, other options and alternatives must be considered.

If you or your loved one is ill or disabled you may be able to get help from a variety of home service providers that might make moving into a nursing home or other type of facility unnecessary. Home services include Meals on Wheels programs, housekeeping services, shopper services, assistance with medications, and adult day care. These programs are found in most communities.

If you are considering home care, discuss this option with family members to learn if they are able to help provide your care or help arrange for other care providers to come to your home. Because full time care giving can be very demanding, family caregivers may occasionally need time off. Some nursing homes or assisted living facilities provide respite care and admit a person in need of care for a short period of time to give the home caregivers a break. Depending on the individual situation, Medicare, private insurance, and Medicaid may pay some home care costs that are related to medical care.

There are Federal and State programs that help pay for housing for seniors with low to moderate incomes. Some of these subsidized facilities offer assistance to residents who need help with certain tasks, such as shopping and laundry. Residents generally live independently in an apartment within the senior housing complex.

Assisted Living Facilities, or Board and Care homes as they are called in some states, are group living arrangements designed to meet the needs of people who cannot live independently, but do not require nursing home services.

"Assisted living" is a general term for a facility which provides room, meals and a range of services, based on the individual's needs. Services could be as minimal as receiving help with laundry and housekeeping or reminders to take medications, or could be as extensive as receiving help with activities of daily living such as eating, walking, dressing, bathing, and toileting. These services are provided to residents who still live independently within the assisted living complex.

In most cases, assisted living residents pay a regular monthly rent that covers their room and meals, and then pay additional fees for any extra services that they require. In some cases, private long-term care insurance and medical assistance programs will help pay for this type of living arrangement, however assisted living is not covered by Medicare and Medicaid coverage in most states is very limited.

You should also keep in mind that assisted living facilities are not designed to provide the level of medical care provided in a hospital or nursing home and are not monitored or regulated as strictly as nursing homes. Even so, assisted living facilities are an option worth considering.

CCRCs or "life care communities" are senior housing communities that provide different levels of care based on residents' needs. CCRCs offer independent living apartments, assisted living and skilled nursing on the CCRC campus.

Residents move from one setting to another based on their needs, but continue to remain a part of their CCRC community. Be sure to and examine the admission contract closely and check the record of the CCRC's nursing home. Your CCRC contract usually will require you to move into the nursing home when they determine that you can no longer remain in assisted living.

Most CCRCs require a large payment prior to admission and also charge monthly fees. For this reason, many CCRCs may be too expensive for older people with modest incomes.