Long-Term Care Planning: Who Will Take Care of You?

May 14
4 min read

https://www.youtube.com/watch?v=AploCFDJsXQ

Many years ago, my parents sat my brothers and me down and told us they had purchased long-term care insurance. They explained what it was and why they chose it. But what I remember most is something my mom said: “We don’t want you kids changing our diapers.” She said it laughing. But she meant it.

At the time, I didn’t think much about the conversation. It wasn’t until years later that I really understood what they were telling us: They had a plan. They wanted support if they ever needed care. They wanted to stay independent as long as possible. And they didn’t want that responsibility to fall on us.

Because they had that conversation with us, I knew what long-term care insurance was. Most people don’t. Most people don’t think about any of this until something happens. And by that point, everything is urgent. Decisions get made quickly. And families are left trying to figure it out in real time. I’m not trying to scare anyone. Before I became an end-of-life doula, I hadn’t seen the reality of what care costs in this country, or how little help most people get from insurance. It is disappointing, and I’ve learned that in the land of “GoFundMe”, help is rarely available.

What happens when there is no plan

In the United States, care at home or in a residential setting can cost between $7,000 and $12,000 a month. And that doesn’t include room and board. Most people can’t pay for that for long. So, family steps in. A husband or wife takes over. A son or daughter starts helping, then helping more, then eventually becomes the full-time caregiver. And that usually means cutting back at work or leaving a job entirely. Some states will pay family members to provide care. But the pay is often far below what that person was earning before. So now you have two pressures at once. The cost of care and the loss of income. And that’s where the real strain begins. So what can you actually do about this?

7 Practical Steps to Protect Yourself and Your Family

1. Understand what long-term care actually is

Most people hear “long-term care” and think of a nursing home. But it’s much broader than that. It can mean help with everyday things like bathing, getting dressed, preparing meals, or getting in and out of bed. It can happen at home, in assisted living, or in a care facility. And it’s not always short-term. For many people, it lasts for years. If you don’t understand what long-term care actually is, it’s hard to plan for it.

2. Learn what insurance does and does not cover

This is where many people are caught off guard. Medicare and standard health insurance do not cover long-term care the way most people think. They may cover short-term rehab or limited services, but not ongoing daily support. That means help with bathing, dressing, or full-time care often falls outside of what’s covered. It’s worth taking the time to understand this now, before you’re in a situation where you’re relying on it.

3. Get clear on the real cost of care

The numbers are not small. Care at home or in a facility can run between $7,000 and $12,000 a month, sometimes more, depending on where you live and the level of care needed. And this can go on for years. Even national data shows how quickly these costs add up. The Genworth Cost of Care Survey reports that a home health aide averages around $30 an hour, and assisted living averages over $6,000 a month. And those are median numbers. In many areas, especially higher-cost states, it’s much more. If someone needs full-time or more advanced care, costs can easily reach six figures per year.

For many people, this isn’t a short-term thing. According to the U.S. Department of Health and Human Services, someone turning 65 today has almost a 70% chance of needing long-term care, and about 1 in 5 will need it for more than 5 years.

4. Talk to your family early about long-term care planning

This is one of the hardest and most important steps. Don’t wait for a crisis. Have the conversation while everyone is calm and able to think clearly. Talk about what you would want. Ask your parents what they would want. Where would you want care? Who would you trust to help make decisions? What would feel acceptable, and what wouldn’t? These conversations can feel uncomfortable. But they prevent much harder situations later.

5. Be honest about caregiving

Many people assume their spouse or children will step in. And sometimes they do. But caregiving changes relationships. A husband becomes a caregiver. A daughter becomes responsible for very personal, demanding care. It’s exhausting. It affects work, income, and mental health. If someone is willing to help, that’s a gift. But it shouldn’t be the only plan.

6. Think about how you will pay for care

There is no single right answer here. Some people look into long-term care insurance. Others plan to use savings, assets, or a combination of options. Some families share the responsibility. The point is not to have a perfect plan. It’s to have some idea of where the support will come from. Even a partial plan is better than none.

7. Write it down and make it accessible

It’s one thing to think about your preferences. It’s another to make sure people can actually follow them. Write down what you want. Where would you prefer to receive care? Who should be involved in decisions? Document key contacts, financial info, and wishes. And then tell the right people where to find it.

Planning for long-term care isn’t something most people want to think about. But avoiding it doesn’t make it go away. Some basic planning and a few honest conversations can protect your independence and make a difficult situation much easier on the people who care about you.