Decisions about long-term care don’t need to end in “nursing home.” Perhaps what’s needed is more along the lines of assistance with daily activities such as eating, bathing, or dressing. The Centers for Medicare & Medicaid Services (CMS) offers Nursing Home Compare, a detailed Web site on nursing home comparisons. Visit that site and locate the "Learn More" heading on the right side. See the “Alternatives to Nursing Homes” link? Click on that, and you’ll see a number of options to consider:

Community services: These might help you with your personal care and activities. Some services, such as volunteer groups that help with things like shopping or transportation, may be low cost or the group may ask for a voluntary donation. Some services may be available at varied costs, depending on where you live and the services you need. Many communities have adult day care, meal programs (like Meals on Wheels), senior centers, “friendly visitor” programs, help with shopping and transportation, and help with legal questions, bill paying, or other financial matters.

For information about local community services, contact your Area Agency on Aging (call 800-677-1116 to find one near you), the Aging and Disability Resource Center (visit the Eldercare Locator Web site to find one in your area), and the Center for Independent Living (click National Council on Independent Living for a state-by-state directory).

Home care: You may be able to get help with laundry, shopping, cooking, and cleaning from family members, friends, or volunteer groups. Some home health care agencies can also help with nursing or attendant care in your home.

Subsidized senior housing: Residents usually live in their own apartments within a complex. Rent payments are usually a percentage of your income (a sliding scale). Federal and state programs can help pay for housing for those with low to moderate incomes. Some of these housing programs offer help with meals and other activities (e.g., housekeeping, shopping, doing the laundry).

Board and care homes: These are group living arrangements—sometimes called group homes—for people who can’t live independently but don’t need nursing home services. Help is provided for bathing, dressing, and using the bathroom. The monthly charge is usually a percentage of your income and covers rent, meals, and other basic shared services. These aren’t always paid for by Medicare or Medicaid.