(MONEY Magazine) – When his wife died three years ago, Robert Shimmin, called Bob-Bob by his friends and relatives, moved out of his San Diego home and in with his son Phil's family in Woodland Hills, Calif. Reliant on a walker because of a progressive nerve disease, Shimmin, a retired engineering executive, now 78, knew that he wasn't physically or emotionally equipped to live on his own. ''I hadn't made a decision by myself for 49 years,'' he notes. But with the younger Shimmins out all day at work or school, the widower grew increasingly lonely. Says Phil, 47: ''My dad needed companionship as much as a place to live.''

Two years ago, Phil's employer, a movie-chain company, transferred him to Hawaii. Bob-Bob moved too -- not to his son's new home but rather three blocks away to a $1,300-a-month apartment in the Laniolu Good Samaritan, a retirement complex in Waikiki. The facilities include a medical center and nursing home, housekeeping and dining services and, best of all for Bob-Bob, other retirees. ''I'm part of a family, and I have a life of my own too,'' says Shimmin, who now uses a motorized wheelchair to make regular jaunts to his son's house and the fabled Honolulu beach where he and his fellow residents spend much of their time. ''I think I've got it just right.'' The odds that your aging parent will, like Bob-Bob Shimmin, someday need help are overwhelming, given the fact that the majority of Americans age 65 or older suffer from some kind of chronic disability or acute illness. Fortunately, as the Shimmin family has learned, providing your parents with the support they need has in many ways never been easier. Public and private health-care and housing options for the dependent elderly have grown enormously over the past several years, as has the network of community support services. In reviewing the available resources with your parents, make sure you understand what they want. ''Quality of life means different things to the adult child than it does to the parent,'' points out Sandra Howell, an associate professor at MIT who specializes in environments for the elderly. ''The child worries most about the parent's security, the parent about keeping control of his or her life.'' Your parents' choices will be partly limited by their ability (and perhaps yours) to pay for the care they need. Don't count on Medicare to bail them out. Although benefits have been expanded under a law passed last year, substantial holes in coverage remain. Private supplemental insurance, known as Medigap, can help defray the out-of-pocket cost of your parents' care for sickness or accidents. But neither these plans nor Medicare pay for the bulk of costs associated with chronic disability. While long-term-care insurance may fill part of the breach, the stiff premiums and limitations in coverage lead some experts to question its value (see page 166). Your parents' alternatives will be limited as well by how dependent they are. With that in mind, here then is a closer look at the various health-care and housing options available.

YOUR PARENTS' HOME For many older people, attachment to the family home is deeply felt -- even if they have physical disabilities that make it difficult to get around the house or keep up with routine repairs and maintenance. If your parents are determined to stay put, helping them retrofit their house to their new needs may be a solution. For instance, adding a downstairs bathroom or a chairlift, at a typical cost of $5,000 to $10,000, may alleviate the strain for a parent who has trouble climbing stairs. Installing grab bars ($150 each) and ramps ($2,400) can make a big difference to a parent who has trouble getting in or out of bed or requires a wheelchair or walker to get around. Retrofitting the house, however, will not help with the routine daily chores like cleaning, grocery shopping and cooking. If you or your siblings live nearby, you may help out with many of these tasks. But if you live far away or feel drained by the time-consuming, emotional demands of providing this care, you can tap a vast network of community resources. Consider just a sampling of the kinds of help available. Meals-on-Wheels, a service underwritten in nearly every U.S. city and town, will deliver two meals a day to needy seniors, generally for contributions of $5 a day or less. Many communities also sponsor programs in which volunteers help the elderly with home maintenance at low or no cost. For example, minor home repairs are performed free by neighbors in Bergen County, N.J. Most towns also run a companion and phone reassurance program, frequently staffed by other elderly people, that checks on old people living alone to make sure they're all right physically and emotionally. To find out about services in your parents' hometown, phone their state or local agency on aging, generally listed in the Yellow Pages under ''Senior Citizens.'' For a somewhat higher price, you or your parent can also hire a professional from a public or private home health-care agency to perform household chores and services. The typical cost: $7 to $10 an hour. These firms also have staff who can assist your parents with their medical needs. Standard services include routine checkups, changing bandages, bathing and dressing assistance as well as administering medication. Fees vary according to the expertise required. A therapist or nurse may run $30 to $50 an hour, for instance, while a personal-care aide might cost less than $10. (Publicly sponsored programs charge patients according to their ability to pay.) Medicare and private insurance often cover most of the bill but, depending on the frequency of visits, annual benefits can be exhausted within as little as two months. Tips from local senior citizens groups are the best guide to a reliable home health-care agency. Your parents' state home-care association and local health department will also supply names of agencies that meet their quality standards. Conduct personal interviews with the likeliest agencies as well as the aides who will actually be administering the help. If you live too far away to locate, evaluate and supervise such services, you may hire a private geriatric-care manager at roughly $60 an hour to do the tasks for you.

YOUR OWN HOME An estimated 60% of elderly adults who need care move in with their children. Whether love, money, guilt or a combination of all three prompts you and your parents to merge households, the arrangement -- even in the closest families -- is likely to stir ambivalent feelings on both sides. Your parents, for example, may be grateful for your support but bitter about their loss of independence. You, in turn, may enjoy their company and counsel but simultaneously resent their interference in your life. The resumption of old roles can also cause problems. ''Your childhood has deep roots in both you and your parent,'' says Lissy Jarvik, a professor of geriatric psychiatry at UCLA. ''Dependency and living together are apt to awaken some old conflicts.'' Finding a way to preserve some semblance of privacy and autonomy for the various members of your extended family can reduce the friction. One possibility, if space and finances permit: building a self-contained apartment for your parents as an addition to your home. The cost of construction typically ranges from $15,000 to $50,000, according to its design and local labor costs. Depending on the degree of your parents' disability and your own schedule, you may also need to make provisions for their care while you and your spouse are away at work. One solution is adult day care, available in as many as 2,500 locations across the country. Some centers resemble social clubs, providing mostly companionship and recreational activities. Others, usually located in nursing homes, offer more supervision and some medical services like physical therapy and podiatry. The cost of adult day care, which averages $20 to $40 a day, is usually not covered by Medicare. But some private long- term-care policies do pick up the tab, as will Medicaid, if your parents' income and assets make them eligible for coverage (see page 148). When you need to be away from home for longer periods or simply want some time to yourself, home health-care agencies will provide full-time attention to an elderly person in your home for fees starting at $525 a week. About 30% of nursing homes and 10% of hospitals also accept elderly people with chronic health problems for overnight stays. As with other types of custodial care, their daily rates of $65 to $125 are not covered by Medicare. But a few long- term-care insurance policies do pick up this expense.

ELDER-CARE COMMUNITIES If your parents' physical disabilities make living in your house or theirs too difficult or if they simply yearn for the company of peers, a residential home for the elderly may make sense. With major builders, small entrepreneurs and private and public agencies now scrambling to develop housing alternatives for the elderly at the rate of 30 new units a day, the choice of facilities is growing. Although elder-care communities go by a variety of labels, the basic types boil down to a handful, differentiated primarily by the number and kind of support services they provide as well as by how much privacy they offer residents. Making a choice depends mainly on your parents' needs, their preferred life style and their budget. Parents who are in relatively good health and can afford the stiff $20,000 to $100,000 entrance fees plus $600 to $800 monthly charges will probably prefer a continuing-care retirement community. These residences offer all types of elder-care housing and support services: private apartments designed for the convenience of the aged, a home health-care department, an assisted- living facility for people with mobility problems and a nursing home for residents who need round-the-clock supervision. To be admitted to a continuing-care community, your parents must be able to live independently in a private apartment. Once they're in, though, management must provide lifelong care, no matter what degree of help they eventually require.

If your parents are not in robust health but don't need extensive support services and on-site medical care, consider a group home or congregate housing facility. About 400 programs across the country now place elderly adults in private houses with six or seven others with comparable needs at a typical cost of about $500 a month. The arrangement provides them with services like meals and housekeeping or simply with a weekday social worker to help the group fend for itself. Congregate housing is similar, but usually offers more service and supervision for a larger number of residents. In addition to meals and housekeeping, these residences usually provide recreational facilities and access to medical care from affilated health-care agencies, hospitals or nursing homes. Depending on the sponsor and the amenities, congregate living usually costs $500 to $1,200 a month. When retired postal worker Nelson Holmes, 77, was urged by his four children two years ago to sell his house in Yuma, Ariz. because he was alone all day, he wouldn't consider moving in with one of them. Instead, he moved to a nearby group home for the elderly, where he and three other men each have a bedroom and share three bathrooms, a living room, a kitchen and a dining room as well as light chores and entertainment. His cost: $580 a month. Nelson frequently visits his children, who are scattered across the state. ''But I love having my own place to come home to,'' he says. When a parent becomes frail, an assisted-living facility is best. Like most group and all congregate homes, they provide their elderly residents with companionship, meals, housekeeping services and professionally supervised care. But they are designed for people with greater physical dependency. Living units -- either bedrooms or small efficiency apartments with cooking facilities -- are outfitted with such amenities as handrails and emergency call buttons. The most modern even feature color-coded hallways to help residents with poor vision or faulty memory navigate. These residences also provide access to medical care through an affiliated hospital or nursing home, on a fee basis. Costs for such a unit usually range from $800 to $1,800 a ^ month, depending on location and the luxury of the accommodations. No matter what kind of residence your parents are considering, try to visit a few of the facilities with them, comparing costs and asking questions about the services before reaching a decision. Quiz occupants as well as the management.

NURSING HOMES When a parent falls victim to a severe mental or physical impairment, such as advanced Alzheimer's, there usually comes a time when the family can no longer cope. In such cases, a nursing home may be the only viable option. Pam Edens, 35, of Beaverton, Ore. is slowly coming to this conclusion. Pam and her mother Mary Lou McClenaghan, 61, now share responsibilities for the care of her father Jack, 59, who was diagnosed with Alzheimer's five years ago. During the three days a week he spends at her home, she has noted a steady deterioration. ''There's a time bomb ticking for my family,'' says Pam. ''We know that we'll have to make a decision about a nursing home when his condition reaches the point that keeping him at home is no longer healthy for the family -- if my kids are suffering from having Pa around, if they can't have friends over, if his care becomes such that I can't maintain an emotional balance.'' Pam already knows what her breaking point will be. Says she: ''If it comes to having to put him in diapers, I know that I can't handle that.'' Deciding if and when to place a parent in a nursing home is among the most wrenching dilemmas any child can face. As a result, few families discuss it until there's a crisis. Unfortunately, such delays can be costly. Many topnotch facilities have waiting lists, sometimes stretching as long as a year or more. If you haven't planned ahead for the time when your parent may need such care, he or she may be forced to languish in a lesser-quality institution until a spot opens in the home of your choice. Placing your parent's name on its waiting list as soon as his or her eventual need becomes apparent can circumvent the problem. Two of the best indicators of quality in a nursing home are a well- supervised program of activities for residents and broad visiting privileges. A facility that severely restricts when you can see your parent may have something to hide. All nursing homes are expensive, with annual fees of $18,000 to $50,000. Medicare will pay the bill for up to 150 days but only in those rare cases when constant medical care is necessary. And long-term-care insurance usually < defrays only a portion of the cost. In fact, most nursing-home residents end up paying their own way until their assets run out, at which point Medicaid coverage kicks in. Even if their problems are not serious enough to warrant a nursing home, seeing to elderly parents' care is, in many ways, like assuming the role of parent. It won't be easy for either of you, warns Jo Horne, 46, author of The Nursing Home Handbook (Scott Foresman, $9.95), who for three years has cared for her own parents who suffer from stroke-related problems and diabetes. Her advice: ''Take things one step at a time. When you don't know what to do, you just consult your conscience and your heart.''