OVER THE PAST TWO

years, Ina Cassano has watched in horror as her formerly vibrant mother, Rebecca Horn, descends into the hellish fog of Alzheimer's. To help pay for her care, Cassano, 40, an only child, has had to contribute $1,800 a month, almost 70% of the salary she earns as a legal secretary. "We have totally altered our lifestyle," says Cassano, who lives with her husband, John, in Oakland, N.J. To help pay for the home health aides who care for Horn, 78, in her Queens, N.Y., apartment, the couple has cut back on vacations, trips to the shopping mall and other expenses. "I'm hoping my company gives me a Christmas bonus this year. I have to give a bonus to the aides."

Afraid for the future, Cassano is applying to get her mom into a top nursing home that has a three-month waiting list. First, she'll have to sell her mother's apartment of 40 years to pay for the $13,000 monthly fees. When that money runs out, Medicaid the public assistance program that foots the bill for 68% of the nation's nursing-home residents will take over. She remains wracked with confusion and regret. "How I wish we had talked about the whole financial situation," says Cassano. "If my mother ever knew I was spending all this, she would go and kill herself. This is something she never wanted."

You probably think of your parents as pretty good planners. After all, they raised you, and maybe even put you through college and paid for your wedding. Now, after a lifetime of careful saving and investing, they have enough set aside for the country club dues, the Florida condo and regular visits to see the grandkids.

Okay. But do they have enough for . . . the 15% increases in prescription-drug costs seniors are facing each year? The rising out-of-pocket bills they'll pay to doctors who are dropping Medicare patients? Average nursing-home rates of $60,000 a year, assisted-living fees of $2,000 a month or home health nurses at almost $40 an hour? In short, do they have enough money to grow old and pay the costs that come with it?

If you're like most Americans, you don't know. While 60% of people over age 75 will need long-term care, supervision and assistance due to illness or frailty, more than half of older adults have never discussed such care with their children, according to a 2002 survey by the GE Center for Financial Learning. It may be the most awkward conversation you've had with your folks since the birds and the bees. But you've got to have it. Their emotional, physical and financial futures are at stake and yours, too.

Family caregivers-sons and daughters, in-laws and grandkids lose thousands of dollars each year in wages in order to take time off work to care for elderly parents. And increasingly, they must provide help while living miles and, sometimes, time zones away. As you'll see in our accompanying story, "The Toughest Thing I've Ever Done," such logistics can produce a whole new set of troubles.

Unfortunately, the recent economic downturn, along with stiffer regulations and more strictly controlled payouts from federal- and state-funded programs, has made it even more difficult to pay for all this care. On top of that, in less than nine years the oldest of the 76 million baby boomers will start turning 65, putting unprecedented pressure on an already strained health care system. "We all pray and hope that we won't need any long-term care," says Lenise Dolen, a Tarrytown, N.Y.-based geriatric-care manager. "But then we run out of both breath and money at the same time."

Sounds dire, but don't give up. In the following pages we'll help you put a strategy in place. First off, think of funding long-term care in the same vein as college planning. Just as you would finance a college education through a combination of family resources, financial aid grants, loans and private scholarship money, you can similarly meet your parents' long-term-care needs through a combination of savings, loans, government aid and private insurance. Specifically, we'll show you what to expect from Medicare as a long-term-care provider (don't expect too much), when and how to select the right long-term-care insurance policy, how to incorporate Medicaid if the need arises and how your folks can use the accumulated wealth in their home to carry some of the load.

All in all, the pieces are there to care for your aging parents. What's often missing? The commitment to prepare now for the help they'll eventually need.