Few Americans have talked to their family about how to pay for their care during the twilight years, according to Genworth Financial's 2011 Financial Reality Check Study.

Three-quarters of Americans have never had that basic conversation with loved ones. Another 70 percent say they don't know what they would do if someone in their family needed long-term assistance, according to the study.

As you age and need help with your daily activities, neither Medicare nor standard health insurance coverage will pay for the cost of home care or assisted living. Moreover, the Obama administration has dropped plans for a federal long-term care insurance plan.

Planning early is crucial. If you are already having trouble getting around, it's probably too late to buy long-term care insurance.

The best way to secure good long-term care is to start planning for that seemingly distant day long before trouble hits. To avoid getting caught in the long-term care crunch:

  • Buy early: The best time to buy a long-term care policy is when you are still in your 50s, or even 40s. You may not need the policy for decades, but the premiums could be half what you will end up paying if you wait until you are in your 60s.
  • Don't procrastinate: New research by the Michael Finke, an associate professor in Texas Tech University's Division of Personal Financial Planning, finds that your ability to make financial decisions steadily declines after age 60.
  • Face the facts: Americans don't seem to mind talking about their finances. To the contrary, 89 percent of those surveyed by Genworth had a discussion about their family's financial goals in the past year. And it's hard to find a family today not grappling with how to pay for health insurance, or buy more affordable health insurance. But facing up to the realities of aging can be difficult, with a common temptation being to think that it won't happen to you.