Caught in nowheresville -- neither nursing home, ALF or safe home care.  Today we are in a no-man's land of legislative initiatives to keep (or move) seniors at home and out of a shrinking number of nursing homes -- between the CLASS Act, CMS program experiments, PACE program here and Medicaid payment (see Leading Age/CAST report about which states reimburse PERS et al.) -- the only really clarity is that government agencies believe that the costs of care are lower at home.  On the other hand, we are at an amazingly under-deployed stage of the use of technology in delivering home care services (if you have any statistics that prove otherwise, please come forth!) So on the one hand, we chip away at the viability of nursing homes (1000 have closed within the past 10 years), we don't chip away at the cost of assisted living, however, which is financially out of reach when there is no pricey home to sell. Yet 24x7 home care is priced by MetLife at a US-wide average of $183K/year (in comparison to a US-wide average of $40K/year for Assisted Living).  So what are families to do?