But even unpaid caregivers need a break from time to time, or have full- or part-time jobs that prevent them from caregiving throughout the day. If you do pay someone to provide assistance with ADLs, the cost of long-term care depends on three factors – the general level of charges in your part of the country, the specific expense rate for the services you need, and how long the need for care lasts.

According to a survey by the MetLife Mature Market Institute (MMI) in August 2005, the average cost for a month in a semiprivate room in a nursing home ranged from a low of $3,000 in Shreveport, LA, to a high of $9,500 in the Stamford, CT, area. (Actually, the average cost for a month in a semiprivate nursing home room was $14,200 statewide in Alaska, but this is a true “outlier.” The next highest cost was in the Stamford CT area.) A year-long stay translates to $36,900 in Shreveport and $115,700 in the Stamford area (and $172,600 in Alaska).

The same survey also covered costs for Home Health Care. In August 2005, the lowest average hourly rate for a home health aide was $12 in Shreveport, and the highest was $28 in Rochester, MN. (Surprisingly, Alaska was not tops in the nation for this service; at $22, it was close to the national average of $19.) If you need a home health aide around the clock, this translates to a daily rate ranging from $288 to $672, or a monthly rate of $8,640 to $20,160.

In October 2004, the MMI surveyed costs of Assisted Living. The lowest average monthly base rate it found was $1,340 in Miami, and the highest was $3,700 in the Washington, D.C. metro area and also statewide in Alaska.

In another study, of people making claims under long-term care insurance policies, roughly one in four claims were for two years or more. One in twelve claims were for four years or more.

Finally, don’t forget that long-term care costs, like most health care costs, are rising faster than the general rate of inflation. The bottom line? A four-year-or-longer stay in a nursing home could cost $300,000 or more – in today’s dollars. If you can’t pay this out of your own pocket and aren’t poor enough to qualify for Medicaid, you should consider buying long-term care insurance.