Thinking about your parent moving into a nursing home is an emotional event that raises many questions. We put together this easy checklist that will help you make the first decision in what's best for your loved one:

• Can your loved one no longer live independently even with assistance?
• Does your loved one require round-the-clock skilled supervision?
• Does your loved one need help with two or more of these activities: bathing, dressing, eating, walking, or going to the bathroom?
• Is your loved one placing difficult demands on your emotional and physical health, as well as your finances?

If you answer "yes" to at least three of these four questions, your loved one will be better off living in a more controlled environment. For most, that means a nursing home. But don't limit your options. There are many alternatives available and choosing the right one for your situation depends on the type of care your loved one needs.

Here are seven nursing home alternatives that provide quality care in a more "homey" environment:

1. Home Health Care: Your Loved One Stays in Familiar Surroundings
Look for a home healthcare agency that offers a wide variety of care, including nursing care, in-home doctor and therapist visits, medical equipment delivery, and assistance with daily activities. There are also other home-care agencies that will do housecleaning and shopping, and deliver ready-to-eat meals (like Meals on Wheels).

Make a list of the types of care your loved one needs and which services you or other friends and family can provide. Remember: The more services that are needed, the more the home health care will cost. At the same time, don't be penny-wise and pound-foolish—you can't take care of everything yourself; you need to have some help.

Medicare, long-term care insurance, and veterans benefits may cover some of the costs for home health care. Also, call your health insurance provider and ask what specific coverage you have.

To help narrow down your search for a qualified home health care agency, we recommend contacting your local branch of the National Association of Area Agencies on Aging. Visit them at www.n4a.org. 

2. Combine Home Health Care with Adult Day Care
These centers combine medical, nursing, therapeutic, and psychiatric services with recreational activities and meal services. You drop off your loved one in the morning and pick him or her up in the evening. You can use these centers daily if you have an outside job or occasionally if you're caring for someone at home but need a day off now and then. Your loved one would still spend nights at home, but would be in a stimulating, protected environment during the day.

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