"What keeps me going, I have to tell you, is my faith," Silva said, glancing at her daughter, now 54.

The national debate over Terri Schiavo, a brain-damaged Florida woman who died after her feeding tube was removed, forced many people to think about end-of-life choices. While much of the attention was on the importance of living wills, since Schiavo's husband and parents fought over whether she would have wanted the tube removed, a larger fear for many was the potential financial burden when a loved one gets sick.

"Financially, we make do," Silva said. "But it can be expensive."

Gov. Linda Lingle and several Democrats in the state Legislature want to offer a tax credit for people who buy long-term care insurance and for companies that purchase the insurance for workers. The credit has not received the same amount of focus as other tax-relief ideas this session, and may not move out of House and Senate conference committee, but it appears to have appeal because so many people can personally relate.

"This is a situation that affects a lot of us," said Kurt Kawafuchi, the state's tax director, who has been caring for his father, Roy Shigeyoshi, a 442nd Regimental Combat Team veteran of World War II. "Until you go through it you don't realize how challenging it is."

With the elderly population expected to increase in Hawai'i over the next two decades, raising the demand for long-term care services, more people who buy their own insurance could take some pressure off state and federal health programs and give people more of a safety net beyond traditional healthcare coverage.

The Chamber of Commerce of Hawai'i, healthcare providers and insurers have told state lawmakers they support the credit, but its fate may depend on whether lawmakers also find enough money in the state budget for tax relief for lower- and middle-income workers.

Some lawmakers have called for long-term-care assistance for years, so even if a tax credit does not pass this session, the issue is not likely to go away. Lingle vetoed a bill in 2003 that would have charged taxpayers $10 a month to pay for a state long-term-care program that would have provided people who qualified for care with up to a year in cash benefits. The governor argued that a year of coverage was not sufficient but supported another part of the bill that would have provided a tax credit.

"This might encourage a few more people to consider long-term-care insurance that might not be able to afford it," said state Sen. Suzanne Chun Oakland, D-13th (Kalihi, Nu'uanu), the chairwoman of the Senate Human Services Committee.

Private insurance could also give families some comfort financially and help them better manage the psychological impact of caring for a spouse or relative, which can be draining.

Deborah Jackson, who owns Eldercare Hawai'i, which offers advice and counseling to families, said she returned to Hawai'i from the Mainland in 2000 to care for her mother and stepfather before they passed away.

"The pressure was that they did not want to leave their homes. Frankly, there are not a lot of options," Jackson said. "This is something that catches people off guard."

The cost of long-term-care insurance can vary widely depending on age and health, with premiums for basic coverage at about $1,000 a year, jumping higher for more comprehensive coverage. People who are older or who have chronic health problems generally are more likely to apply for the coverage than people who are younger and healthy, although the insurance becomes more expensive as people get older.

The insurance typically covers people, such as Silva's daughter, who have lost the ability to care for themselves and can no longer do routine daily activities. The options are usually some type of home care or nursing home. The costs to stay in a nursing home in Hawai'i are about $84,000 a year, while adult residential care homes cost about $24,000 a year.

Silva, a retiree and volunteer with the AARP, had the double blow of caring for both her daughter and her husband before he died in January. She said long-term-care insurance may have helped but, like many people, she did not even think about it until it was too late and much too expensive given her family's circumstances.

Claudia fell into a coma shortly after she was born and struggled with developmental disabilities all of her life, although Silva said she played sports and was able to graduate from high school. About a decade ago, Claudia began to lose her motor functions. "You forget how to eat. Your forget how to talk. You forget how to walk," she said.

Silva was deeply upset by Schiavo's death — "That was like my daughter," she said — and worries about her ability to care for Claudia as she gets older.

Silva's younger daughter has agreed to take care of Claudia if something were to happen. "I feel guilty that the burden is going to be on her," Silva said. "But at least Claudia will be taken care of."