Most people say no matter how disabled they may become, they never want to leave their homes. But that's not always possible. Even for someone who's still independent, the burden of maintaining a house and yard can be too much.

The elder housing field is vast. Options range from apartments to skilled care nursing homes. A person's choice should be guided by the kind of care he needs.

Rent-Subsidized
The federal government puts money into rental subsidy programs for apartment complexes across the Tampa Bay area. Many of these complexes are exclusively for older people and some offer special services, such as transportation and recreational activities. Whether the elder qualifies and what he pays in rent depends on his income.

In Hillsborough and Polk counties, call the federal Housing and Urban Development office in Tampa, (813) 228-2504; Clearwater Housing Authority, (727) 446-7748; Community Service Foundation (Pinellas), (727) 461-0618; Pinellas County and Dunedin Housing Authorities, (727) 443-7684; Pasco County Housing Authority, (352) 567-0848

Continuing Care Retirement Communities
Sometimes called life-care communities, these facilities offer what they call a continuum of care - independent living to nursing care. A resident moves from one to the next as his health and abilities change. Services include meals, housekeeping, personal assistance and emergency help. Many continuing care communities require a one-time entrance fee and monthly payments thereafter. In some, residents own their units, in others they rent.

The Continuing Care Accreditation Commission, based in Washington, D.C., lists communities across the country that have met its standards. Check its website, www.ccaconline.org

The Florida Department of Insurance produces a consumer guide to CCRCs, which includes tips on how to find one and a listing of CCRCs across Florida. It's called "Options for Lifelong Care." Check the consumer guides section of www.doi.state.fl.us or call 1-800-342-2762. The hearing impaired can use 1-800-640-0886.

Adult Family Care Homes
These are private homes that offer room, board and personal care to frail older people. They're meant for people who need daily help but not 24-hour supervision. If the home has more than two residents, it must be licensed by the state.

The state offers help to low-income people living in adult family-care homes through its "optional state subsidy." All homes are required to designate one of their licensed beds for a resident on OSS, which is about $700 per month. The state Department of Children and Families administers the OSS program. For more information, call the Elder Helpline, 1-800-963-5337.

For a list of homes in Florida, go to the "FacilityLocator" section of www.Floridahealthstat.com and click on "Adult Family Care Home."

Assisted Living
Assisted living refers to a type of elder housing that covers everything from a residential home for five people to a luxury high rise. Charges can range from $700 a month to $3,500, and most take only private payments.

People in assisted living facilities have their own rooms or apartments, often shared, but they can receive help with the basic activities of daily life, such as bathing, dressing and grooming. Aides are required to be there 24-hours a day.

Any place offering care to five or more disabled adults or frail elders is required to be inspected and have a state license. Some ALFs in Florida can get special licenses to offer nursing services and extended care to declining residents who would otherwise have to move to a nursing home. Having one of these special licenses enables the facility to accept Medicaid payments through Florida's Assisted Living Medicaid Waiver. The state's optional state supplement also pays for ALF care for those who qualify. Many facilities don't accept either form of payment.

A complete list of Florida ALFs, by geographic area, can be found at www.floridahealthstat.com under the "FacilityLocator" heading. Inspection reports are public record. For information on viewing, call the Florida Agency for Health Care Administration, 1-888-419-3456.

Services vary from place to place. The Assisted Living Federation of America offers advice on what to consider while looking for an ALF. Check its website, www.alfa.org. The Consumer Consortium on Assisted Living also offers advice, (703) 533-8121, www.ccal.org

Nursing Homes
Nursing homes provide the most intensive type of long-term care available. Some nursing home residents receive short-term rehabilitation after a stroke, fall or accident. Others are there because they are in the final stages of an illness, such as heart disease or Alzheimer's, and need 24-hour-a-day care or supervision.

People often are moved to a nursing home directly from the hospital after a medical crisis. If caregivers or family members aren't prepared to choose a home, the decision is often made by a hospital social worker or discharge planner. If the loved one is on Medicaid, the choices may be limited.

If there's a chance a loved one might need nursing home care soon, be prepared. Learn about the nursing homes in your area.

For a guide to nursing homes in Florida, including payment options and a list of homes, check with the state Agency for Health Care Administration, 1-888-419-3456, www.fdhc.state.fl.us. The agency is reponsible for inspecting all Florida nursing homes annually.

Copies of the inspection reports, called surveys, are kept at the AHCA district offices.
For Hillsborough, Pinellas, Pasco and Polk Counties, call (727) 552-1133.

The federal government offers detailed help to those searching for a nursing home, including its "Nursing Home Compare,'' which lists nursing homes across the country and how they measured up on their most recent inspections. Go to www.medicare.gov/nursing/overview.asp

The Long-Term Care Ombusdman Council is responsible for investigating and resolving complaints about family care homes, assisted living and nursing homes. For southern and central Pinellas, call (727) 588-6912 For northern Pinellas and Pasco, call (727) 834-3127 Hillsborough and Polk, call (813) 871-7185

Other Web resources:
• Coalition to Protect Florida's Elders, www.protectelders.org
• National Citizens Coalition for Nursing Home Reform, www.nccnhr.org
• The Florida Health Care Association, www.fhca.org
• Florida Association of Homes for the Aging, www.faha.org
• American Association for Homes and Services for the Aging. www.aahsa.org
• National Center for Assisted Living, www.ncal.org