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ByMatthewCraft The Associated Press NEW YORK Doris Ran- zman had followed the ex- pert advice, planning ahead in case she wound up un- able to care for herself one day. But when a nursing- home bill tops $14,000 a month, the best-laid plans get tossed aside. Even with insurance and her Social Security check, Ranzman still had to come up with around $4,000 ev- ery month to cover her care in the Amsterdam Nursing Home in Manhattan. "An awful situation," said her daughter, Sharon Goldblum. Like others faced with the stunning cost of elderly care in the U.S., Goldblum did the math and realized that her mother could easily outlive her savings. So she pulled her out of the home. For the two-thirds of Americans over 65 who are expected to need some long- term care, the costs are in- creasingly 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 in- surer Genworth Financial. One year in a private room now runs a median $91,000 a year, while one year of vis- its from home-health aides runs $45,760. Goldblum estimates that she and her mother spent at least $300,000 over the last two years for care that in- surance didn't cover. "If you have any money, you're going to use all of that money," Goldblum said. "Just watch how fast it goes." How do people manage the widening gap between their savings and the high cost of caring for the el- derly? Medicare doesn't cover long-term stays, so a large swath of elderly peo- ple wind up on the govern- ment's health insurance program for the poor, Med- icaid. For those solidly in the middle class, however, the answer isn't so simple. They have too much money to apply for Medicaid but not enough to cover the typ- ical three years of care. Some 60 percent of Americans nearing retire- ment — those between the ages of 55 and 64 — have re- tirement accounts, accord- ing to the Employee Benefit Research Institute. The me- dian balance is $104,000. Combined with other savings and income, that amount might provide some retirees with all they need for decades. But everything changes when, for instance, an aging father struggling with dementia requires more help than his wife and children can manage. Plans that looked solid on paper are no match for their bills. "Withinthefirstyearmost people are tapped out," said JoeCaldwell,directoroflong- term services at the National Council on Aging. "Middle- class families just aren't pre- pared for these costs." Many who can afford it buy insurance to help pay for long-term care years in advance, when insurers are less likely to reject them. But even those with insur- ance, like Ranzman, come up short. Forced to impro- vise, they sell the house and lean on family. They move in with their adult children, or arrange for their children to move in with them. Some can save money by switching to different facil- ities. On average, a shared room in a nursing home runs nearly $11,000 a year less than a private room, and a room in an adult-fam- ily home runs cheaper still. 'AWFUL SITUATION' Familiesfacetoughdecisions as cost of elder care increases TEDS.WARREN—THEASSOCIATEDPRESS Roslyn Duffy holds two photos of her late mother, Evelyn Nappa, at her home in Seattle. Duffy had to scramble to find a home willing to take Medicaid payments a er her mother was evicted from a Seattle assisted-living facility. COURTESY OF ROSLYN DUFFY The stress and the change of surroundings strained her mother's health, Duffy said, and six weeks a er moving, she was dead. By Robert Burns The Associated Press HUSSEIN LOOKOUT, ISRAEL On a hilltop lookout near Israel's border with Leba- non, U.S. Defense Secre- tary Ash Carter offered personal assurances Mon- day that the U.S. will help Israel counter Iranian sup- port for the militant group Hezbollah. He called it one example of how the U.S. can support the Jewish state in the aftermath of the Iran nuclear deal. Carter visited Hussein Lookout, with a sweep- ing view of the border as well as the Golan Heights, in an effort to emphasize U.S. concern about a range of threats that face Israel. These include tens of thou- sands of short-, medium- and longer-range Hezbol- lah rockets and missiles in southern Lebanon that could hit Israeli villages and cities. "Hezbollah is sponsored of course by Iran, which is why the United States will continuetohelpIsraelcoun- ter Iranian malign influ- ence in the region," Carter told reporters after receiv- ing an Israeli security brief- ing in the area. Carter hit the same theme later at a joint news conference in Tel Aviv with Israeli Defense Minister Moshe Yaalon. They used the appearance to make a public show of unity at a low point in U.S.-Israeli re- lations heavily strained by Israeli's opposition to the Iran deal. The agreement, reached betweenU.S.-ledworldpow- ers and Iran, puts limits on Iran's nuclear program in exchange for lifting crip- pling economic sanctions on the Islamic Republic. Israeli leaders have com- plained that the deal does nothing to address Iran's support for hostile anti-Is- rael groups like Hezbollah in Lebanon and Hamas in the Gaza Strip. They also say the deal does not have sufficient safeguards to pre- vent Iran from reaching the capability to make nuclear weapons. Yaalon warmly praised Carter's track record of support for Israel, while ac- knowledging the split over the Iran deal. "We greatly disagree when it comes to the agree- ment with Iran and fear for the future in the aftermath of its signing," Yaalon said. "Yet we discuss this issue in a fully open manner, along- side many other issues of great importance." He called the relation- ship with the United States a "core pillar" of Israel's de- fense, and Carter promised thattheObamaadministra- tion would not waver from an "ironclad commitment" to ensuring Israel's military edge in the region. He said that next year Israel will be- come the first U.S. ally to fly the new U.S. F-35 warplane. Carter said Israel can count on the U.S. to do whatever is necessary to ensure its security, and he ticked off a list of areas in which the two countries are cooperating, including mis- sile defense. PERSONAL ASSURANCES US Pentagon chief tries to assure Israel a er the Iran deal CAROLYN KASTER — THE ASSOCIATED PRESS Israeli Defense Minister Moshe Ya'alon, third from le , and U.S. Defense Secretary Ash Carter, second from right, walk from viewing Hula Valley on Monday. By Desmond Butler The Associated Press ISTANBUL Authorities sus- pected the Islamic State group was behind an ap- parent suicide bombing Monday in southeastern Turkey that killed 31 peo- ple and wounded nearly 100 — a development that could represent a major ex- pansion by the extremists at a time when the govern- ment is stepping up efforts against them. Turkish officials vowed to strike back at those behind the attack in the city of Su- ruc targeting a group of po- litical activists who wanted to help the shattered Syrian city of Kobani, a bombing that turned a moment of hope into a scene of horror. "We are face to face with a terrorism incident," Prime Minister Ahmet Davuto- glu said. "We have the will- power to find and certainly punish those who are re- sponsible." There was no immedi- ate claim of responsibility, but a senior government official told The Associated Press that Turkey suspected the IS group was behind the blast as retaliation for Tur- key's steps against the mil- itants. The midday explosion took place as the Federa- tion of Socialist Youths was wrapping up a news con- ference on plans to help re- build Kobani, a witness said. Suruc is just across the border from Kobani, the town that was the site of fierce battles between Kurdish groups and Islamic State fighters. The fall of Kobani, heav- ily populated by Syrian Kurds, was the biggest de- feat last year for the mili- tants since they established control over large parts of Iraq and Syria. Its ruins have become a symbol of Kurdish resistance. If IS was indeed behind the bombing, it would rep- resent the group's most se- rious attack inside Turkey. A female suicide bomber with suspected ties to IS blew herself up in a tourist district of Istanbul in Jan- uary, killing a police officer and wounding another. In recent weeks, Turkey has taken new steps against IS, blocking websites and arresting suspected follow- ers in the country, officials said. Witnesses of Monday's blast described scenes of carnage and shock. Because the activists' news confer- ence was being recorded, the attack and its imme- diate aftermath were cap- tured in widely circulated video. Fatma Edemen said the federation of about 200 youths had been pressing for more access to Kobani to help with reconstruction. The group was chanting "Long live the resistance of Kobani!" when the ex- plosion tore through the crowd, she said. IS militants carried out surprise attacks in Kobani last month that killed more than 200 people. 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