As individuals retire or age into Medicare, their insurance situation can change dramatically.

Those eligible for Medicare, or soon to be eligible for Medicare, need some understanding of their insurance options and how it could impact their health and finances.

These questions and answers are meant as a guide to help you understand the complex questions you are now thinking about. Each families specific situation may create a different set of problems and solutions.

Question: If my husband does not need skilled care, but requires more nursing care than I can provide, what are my alternatives for care?

Answer: For services within the home, there are many alternatives. Home care agencies, facilities, private providers (individuals), friends and family are just some of the alternatives.

Skilled nursing home facilities provide 24-hour care to those that require ongoing nursing care, or have a short term need for care due to illness or injury. The individuals who live/stay in a facility require assistance with usually three or more ADLs. ADLs are the activities of daily living.

Included in this list are eating, dressing, transferring - in and out of chair or bed - ambulating (walking), toileting and bathing. Three or more of these activities all the time or occasionally, are indicative of a need in a skilled nursing facility and insurance may pay for the stay. with two or more ADLs an assisted living program may be appropriate.

Keep in mind that not all 24-hour care facilities are not necessarily skilled nursing homes.

Respite care. This is a short-term stay. This stay could be initiated because the primary caregiver is ill, or needs hospitalization themselves, requires a much needed break, is going out of town for a visit or special family event, or any number of reasons. I have found these respite stays to be a very useful tool for caregivers. It allows them to do what they need to do, yet know their loved one is well cared for and safe.

Another alternative for care would be a adult day care program. This alternative would have the person requiring care attend a program of their choice a number of days each week. The day programs usually run from approximately 8 until 5 p.m.

Yet another alternative is the idea of having someone come to your home to provide the help needed in the home setting. This could be a family member, friend, an individual you hire or an agency that provides this help. Usually family and friends are the least expensive options working up to the cost of an agency to provide the help.

If the individual is someone you hire, you are then responsible for scheduling and covering scheduling issues. If you choose an agency, they will schedule their staff according to your needs and desired times.