For the two-thirds of Americans over 65 who are expected to need some long-term care, the costs are increasingly beyond reach. The cost of staying in a nursing home has climbed at twice the rate of overall inflation over the last five years, according to the insurer Genworth Financial. One year in a private room now runs a median $91,000 a year, while one year of visits from home-health aides runs $45,760.

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