Shoshana Krupp’s informative article about home care seems to indicate that recipients do not need to meet medical eligibility requirements to receive home care (“Health At Home,” May 31). In fact, recipients must prove medical necessity if their care is funded via long-term care insurance or veterans’ benefits. While home care is an optimal approach, there are instances when an institution is more appropriate. Unless recipients are extremely wealthy, they may not have the means to have semi-skilled or skilled care around the clock. Often both spouses are very old and extremely frail and the “healthy” one cannot lift or care of the one in need or deal with the emotional stress. Finally, rather than moving directly from home to skilled nursing care, there may exist the less expensive alternatives of assisted living and day care. So much depends upon each individual’s and couple’s circumstances.