To the Editor:

''The Middle Class Struggles in the Medicaid Maze'' (news article, July 9) demonstrates the complexities of coping with the emotional and financial considerations confronting our aging population.

As an elder-care specialist, I am aware of the challenges that long-term care presents and the overwhelming costs to meet that need.

The Depression-era elderly and their baby boomer children face the labyrinth of regulations while still trying to preserve their right to self-determination, independence and control.

Our health care system is in crisis, and the government must redirect policy to efficiently meet the increasing demands to provide affordable and safe long-term care. 

Teri Koff 
New York, July 9, 2005 

The writer, a social worker, is an elder-care specialist.