My mother is in a nursing home right now, so it's something we think about...

Nursing homes in America are mostly privately owned and operated, sometimes by nonprofit charitable organizations, and sometimes by for-profit companies.

In America, everyone over age 65 is covered by Medicare (a government program), which covers basic medical care but NOT the cost of medications (which can be expensive) or nursing home care. In addition, there are private "supplemental" insurance policies available which can cover these things. But of course the premiums are expensive.

My mother has an insurance policy that covers the medication, and I think some other things, but not the nursing home care. The insurance policy is sort of a carry-over benefit that she is eligible for as the widow of a railroad employee. She still has to pay premiums, but I think she gets a good deal. I'm kind of vague on the details.

Her house was sold last year, along with a lifetime accumulation of furniture and miscellaneous household equipment. I kept only a few things that have sentimental (but very little monetary) value. The proceeds, plus her savings, plus her pension and an annuity are all being used up to pay for her care, and I figure they will be gone in about 3 years, if she lives that long.

The good news is, when her money runs out, I will not have to pay anything out of my own pocket. Some government money will come in, and the nursing home, which is a nonprofit organization with an endowment, will make up the difference. My mother will stay in exactly the same place and receive the same level of care. Not even the nurses on her floor know which patients are paying for their own care, and which are receiving General Assistance – only the business office knows. I think that's great, and it's one of the reasons we chose this nursing home, even though it's more expensive than some. Some nursing homes, including the one that would have been our second choice, segregate their patients according to the source of their finances, maybe just to simplify their accounting. That would have meant a move, and when you're old and disabled, even a move to another floor in the same building can be as traumatic as a move a hundred miles away.

And my mother is thriving there. She has a more active social life, and is happier, I think, than when she was living alone. It reminds me of a college dorm (but usually quieter), more than a hospital!

I don't think I will mind being in a nursing home myself, when the time comes, as long as I have an Internet connection!