Costs continue to rise for those requiring long-term care in the U.S., with the national average rates for a private nursing home room increasing 4.4% to $239 daily or $87,235 annually, in 2011, according to the 2011 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs released by the MetLife Mature Institute.

Assisted living base rates rose by 5.6% to $3,477 monthly or $41,724 annually; adult day services went up by 4.5% to $70 per day, and health aides and homemaker/companion service rates were unchanged at $21 and $19 per hour, respectively.

The highest average daily rates for nursing homes continue to be in Alaska, where rates decreased slightly to $655 for a private room compared to $687 in 2010. Costs were lowest in Louisiana, outside the Baton Rouge and Shreveport Metropolitan Statistical Areas, at an average of $141 per day for a private room.

For assisted living, Washington, D.C., had the highest average monthly base rate at $5,757, a 10% increase from last year. Arkansas, outside of the Little Rock MSA, had the lowest average monthly rate of $2,156, also an increase.

Sandra Timmermann, Ed.D., director of the MetLife Mature Market Institute which conducts research on aging, longevity and the generations, said this year's increases are greater than in previous years.

Timmermann said the state of the economy, combined with rising health care and energy costs, are having a significant impact on long-term care rates, which continue to outpace the medical inflation rate.

"The result is dramatic, protracted inflation that will impact consumers," Timmermann said. "As the cost of care continues to rise, Americans need to discuss long-term care planning with their families now, to ensure they receive the kind of care they want in the future. This is especially critical at a time when retirement savings rates are low."

MetLife surveyed 2,003 nursing homes, 1,492 assisted living communities, 1,644 home-care agencies and 1,341 adult day services, in all 50 states and the District of Columbia. It was conducted by telephone between April and August 2011, by LifePlans, Inc., a risk management and consulting firm, for the MetLife Mature Market Institute.

The states were divided into three groups by population: under three million, three to 10 million and over 10 million. These groupings were determined using data from the 2000 U.S. Census and updates.

The MetLife Market Survey and accompanying report provide additional information regarding various types of long-term care available in the U.S. and a detailed breakdown of costs by region.

Nursing Homes

According to the U.S. Census Bureau, in 2010, 66% of nursing home residents were women. The median age of residents was 82.7 years.

Fifteen percent of nursing homes surveyed have an associated assisted living unit or wing; 11% are part of a continuing care retirement community (CCRC).

A small percentage (10%) of nursing homes surveyed provide adult day services.

The majority (87%) of nursing homes surveyed provide Alzheimer's or dementia care; of those, 80% charge the same rate for care.

Assisted Living

Current estimates from the American Seniors Housing Association indicate that the average age of an assisted living resident is 86.9 years old, and the median length of stay in assisted living is 25.6 months.

Oversight of assisted living communities rests primarily with state governments rather than federal regulation. In 2007, several states strengthened existing standards or implemented new standards for communities with residents with Alzheimer's disease or other forms of dementia.

Almost three-quarters (72%) of assisted living communities surveyed provide Alzheimer's and dementia care, 50% of which charge an additional fee for the service.

Home Health Care

The majority (79%) of the home health care agencies surveyed provide Alzheimer's training to their employees, and almost all (99%) agencies surveyed do not charge an additional fee for patients with Alzheimer's.

While most home care agencies surveyed provide an hourly rate, 81% of the agencies require a minimum number of hours per day ranging from 30 minutes to eight hours with three hours being the average. Small percentages (3%) provide a daily rate. About 32% of those surveyed have a 24-hour or live-in rate. The average daily live-in rate for a home health aide is $258 and $255 for a homemaker/companion.

Adult Day Services Centers

More than three-quarters of adult day services centers surveyed are open Monday through Friday; 6% are also open Saturdays and 13% are open seven days per week. For those open 24 hours, 67% provide full adult day services for all 24 hours. Seven in ten centers provide transportation services to and from the center. Of these, 47% do not charge a fee for these services. Of those that charge for transportation, the average one-way fee is about $8.

Almost all (98%) of the centers surveyed provide services for those with Alzheimer's disease, with 2% of these charging an additional fee.

-Jim McConville