During an interview on National Public Radio, Chicago Tribune columnist Amy Dickinson said that, "…it really requires 6 to 8 people to keep someone in their home with 24 hour care."

She was discussing the worries and issues she and her sisters had to deal with in caring for their own mother.

Older people rarely want to go into assisted living or nursing homes.

But what are the alternatives if they become bedridden or can no longer cook or keep house?

And for many of us the physical demands of caring for a loved one may be too much, too. Children in their 60's may have health issues that prevent them from being able to care for parents in their 80's.

Many of us work full time, too.

But parents may need help bathing, washing clothing and linens, cleaning the house, doing yard and home maintenance, preparing meals, taking medications, getting to the doctor and the druggist and lots of other things.

Chronic illnesses that people have as they age make everything even more complicated.

Some one also needs to keep an eye on medications and all the doctors that are prescribing them. A combination of drug interactions and poor communication happen and do great harm.

And if an elderly person has any form of dementia they will be unable to live independently or make decisions. They are as defenseless as a toddler.

Even younger people who have health problems may need 24 hour a day care. Many people who are obese have diabetes and heart problems and are in fact elderly even though they shouldn't be so ill.

Many people are determined to avoid nursing care.

It's is not the best option. But for many people who only have Medicare and Medicaid it is the only option if the family can't handle caring for an elderly relative.

A patient needs to be involved in this decision. Anything else is a legal violation of their rights. Making these choices is difficult for everyone.

We are all just trying to do what is best for our elderly relatives.

It may be helpful for families to consult with a patient advocate, minister, social worker or lawyer to help them evaluate their decisions.

Many elderly people want some kind of change when they lose a spouse. Companionship could help them get past the sadness.

Depression and isolation are both problems for the elderly. Activities available in assisted living situations could make all the difference.

Many of us are purchasing insurance to cover the expenses involved in elder care before we need it. This could make all the difference for you in the quality of care you can afford.