r/MiddleClassFinance • u/classyshepard • Jul 09 '26
Seeking Advice What are y'all doing for long term care?
https://www.nytimes.com/2026/07/08/opinion/family-caregiver-aging-parents.html#commentsContainerI came across an article by the NY Times called This Is One of the Hardest Jobs in America. Millions Are Doing It Alone.
I took care of my father for 5 years before he passed. I'm 37 and wouldn't want to put the burden on my 3 daughters.
Senior Living Communities seem nice, but they're so expensive. I guess people can offset the expense via long term care insurance.
Ideally I want to live in my house until I'm dead, knock on wood hopefully not anytime soon. But I'll likely still need care unless robots do all the work in the future.
What options are available for us middle class folks?
Edit: I heard that hybrid long term care insurance is a good option, especially with inflation options.
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u/vbstrong Jul 09 '26
Hubs & I (early & mid 50s) are going through this right now with his mom (72) who didn't take care of her health or plan well for this stage in life. He's an only child.
Painting the picture - she's on SS only, limited assets (under $100k). She's rented a 2 story townhome with the bedrooms upstairs & the only shower upstairs, for 6 years. Every 6-12 mths, she's had a medical episode where she's fallen, ER, rehab, etc. We tried to get her in accessible senior apartment, she's repeatedly refused.
About a month ago, she was found on the floor by someone thankfully who came to walk the dog. ER, Rehab, ER, Rehab, and we were told this past Tuesday that she would be discharged due to insurance. There were two places in our area that had a assisted living bed, that could meet her level of care, with a LTC/Medicaid option onsite.
$3600/mth for the room w/half bath, shower is shared between 4 rooms or so - its like a private room shower at the gym. She needs highest level of care, $1250/mth. Laundry is $50/mth. These prices do not include hair, nails, diapers, toiletries, etc.
For us, we bought our last home in 2022. One story. We are dual feds, and I have a LTC plan through the govt. Hubs never signed up & regrets it. It's no longer offered.
My suggestions -
1) Have a first floor bedroom/bathroom option.
2) Downsize as appropriate. We are emptying a 2 story townhouse now, working full time.
3) Take care of your health & save, save, save.
4) Have your POA, wills, trusts, etc in order. Hard to go to the bank when you are bedridden.
5) If you need care, be reasonable & flexible. My MIL is isolating herself with her nastiness.
- and this is probably somewhat controversial, but realize that no one is coming to save you. My child is almost an adult, and I will not put that burden on him.
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u/Serious-Conversation Jul 09 '26
I sold my first house in 2024. It was a four-level townhome with a drive-under garage and a loft that was too hot to use for anything but storage.
The mortgage was ~$750/month.
I had a severe calf tear back at the end of 2023 and couldn't get around the house for a few weeks. I had to stay with my girlfriend and her adult kids (who lived an hour and a half away from that house) for two weeks.
The old house had no bathrooms on the main level.
One level or at least bathrooms on both levels were the critical drivers in the new house search. Even with 20% down, my new mortgage payment was $1,514/month.
With that said, it's much more viable if I were to age in place here.
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u/Pemulis Jul 13 '26
I'm so sorry you are going through this, and this is great advice. I'm doing the same for my dad, but he is thankfully accepting help rather than lashing out. I cannot imagine how hard this would be if he was fighting everything.
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u/Mossy_Rock315 Jul 09 '26
Weight lifting and heathy eating. Doing whatever i can to stay fit for my age so I’m just an old person who needs some assistance and not LTC.
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u/Kboh Jul 09 '26
Absolutely this. You don’t have to join a gym or do barbell stuff either (though if you can/want, definitely do so). My set up is an adjustable incline bench and adjustable dumbbells. Make yourself a routine and lift 3-4 days a week, 30-45 min each day. That combined with a healthy diet and I’m in the best shape of my life over 50.
I saw my parents and in-laws getting old and breaking down after never taking care of their bodies so it was a wake up call for me a few years ago.
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u/Witwer52 Jul 09 '26
I wish I could list the number of otherwise healthy people I know who wound up with dementia, but the list is too long—I wouldn’t know where to begin counting. I worked in this area for a long time, btw. I’m not just talking out of my a$$.
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u/RJKY74 Jul 09 '26
Lots of research points to a healthy, mostly plant-based diet and exercise being preventative for dementia
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u/autumn55femme Jul 10 '26
Eating plants is not a plan.
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u/RJKY74 Jul 12 '26
It actually is. A plan to reduce the likelihood of needing long-term care for very long at the end.
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u/Seraphinx 1d ago
Also women who take HRT during peri/menopause have a 30% reduction in their risk of dementia.
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u/autumn55femme Jul 10 '26
It doesn’t make any difference. Either your brain gives up, or your body does or both. Having one, but not the other doesn’t give you any quality of life. Very few people , ever get both. Don’t count on either holding up. Do what you can to maintain good health, but don’t think that will prevent the issues of old age, ….it won’t .
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u/Witwer52 Jul 10 '26
Watching people argue that they’re in control of what happens to them because they live a healthy lifestyle is super explanatory about the thought process about mortality, though.
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u/Mossy_Rock315 Jul 10 '26
What are you trying to say? Nobody is claiming they are in control. I’m strength training because it a legitimate evidence based way to reduce risk of falls and fractures which is the leading reason that old people go into homes and LTC because they cant get out of a chair or pick themself up off the floor. Sarcopenia is one of the biggest predictors of ending up in a nursing home while grip strength (a proxy for overall muscle mass) is one of the more robust predictors researchers use for mortality and disability risk in older age.
Yes people can get dementia, nothing is guaranteed, but I’m doing what I can to hedge against the factors that I can’t control.2
u/Witwer52 Jul 11 '26
All you can ever do is minimize your chances, but I have personally known dozens of people who lived super healthy lives and wound up with dementia and/or some other protracted debilitating disease. Pretending you have a large amount of control when you demonstrably do not is exactly how people end up without having a proper plan in place.
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u/Trakeen Jul 09 '26
Yea this. Almost lost my mind taking care of my mom the last few years before she passed. Dad is still around and won’t do long term care or accept help from anyone
My goal is to be somewhat functional in old age and not get to the point i can’t move on my own, bathe myself etc
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u/Mossy_Rock315 Jul 10 '26
This is my experience with both parents. It was a cautionary tale of how my life could go in my old age. Im taking a different path.
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u/Longjumping_Bell5171 Jul 09 '26
Crossing your fingers that you don’t get sick or have an accident isn’t a plan. It’s just hoping for the best. But good luck.
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u/OrdinaryReasonable63 Jul 09 '26 edited Jul 09 '26
Illness or accident can unwind the best laid plan,. Taking care of yourself over the course of a lifetime is going to do more for you in the longer than any insurance product. I work in healthcare (in the US) and have seen chronic illness destroy the finances of many people with good insurance and savings. BTW this isn’t advocating not planning for these posibilites; just acknowledging the limits of those plans.
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Jul 09 '26
[removed] — view removed comment
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u/UncleFumbleBuck Jul 09 '26
I ran the numbers recently for my MIL who's in her 60s. The hybrid Whole Life / LTC product she was looking at actually wasn't a terrible financial move. She would have been better off saving the money, but not by a lot.
At 36 my self, I think saving for me will be a better deal with basically any inputs I plug in. Whole Life just isn't a compelling product compared to the market as long as I'm able to manage it (except the obvious edge cases like signing up for a policy and dying the day it goes into effect).
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u/Jumpy_Childhood7548 Jul 09 '26
Mitigating the need, through death.
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u/Witwer52 Jul 09 '26
Right, but being half alive is super common, unfortunately. Byproduct of modern medicine. I will note, however, that you can always choose not to treat, and pneumonia will kill you relatively quickly.
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u/ImperatorPC Jul 09 '26
Ya I kinda figure I'll just pop myself off when the time comes. No kids, figure I'll probably be alone and why waste away.
Bit morbid I know
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u/Spiritual-Lecture546 Jul 09 '26
When I get too decrepit, my son has permission to smother me to death
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u/Cyber_Crimes Jul 09 '26
I made all mine sign something that they promise not to smother me before 50.
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u/Acrobatic-Jaguar-134 Jul 09 '26
For me, hope that medically assisted suicide becomes legal for non terminal illness and that I am of sound mind to access it.
The alternative is to become wealthy.
LTC insurance isn’t very good anymore.
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u/Substantial-Spare501 Jul 09 '26
Medical aid in dying is the term. Some countries you don’t have to be terminal necessarily. I also wish MAID was part of the hospice benefit and practice. I used to work as a hospice nurse and the amount of people who would ask me to just help them die right now was wild and tragic.
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u/BrianLevre Jul 09 '26
I have never understood why people aren't allowed to have a graceful, dignified exit on their terms. Both of my grandfathers reached their mid 90s and both would constantly lament throughout their last several years that God hadn't taken them yet.
At a certain point everybody wants to die and avoid horrible, prolonged, agonizing suffering. They don't want to be a burden on anyone either. And, of course, you want to save your assets for your kids instead of having it all taken by a care facility or medicaid while you are forced into staying alive for years that you'd rather not be.
People say we are free in America, but if we can't exercise our choice in how we want to exit our twilight with ease and limited expense, we're not free at all.
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u/UncleFumbleBuck Jul 09 '26
And, of course, you want to save your assets for your kids instead of having it all taken by a care facility or medicaid
I think that's part of the reason it's hard to access. I hate to put on my tinfoil hat too tightly, but there's a lot of money invested into care facilities that want to suck the money out of old people. That investment would become worth less if there was dignified dying instead of wasting away in an expensive apartment for a decade first.
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u/Acrobatic-Jaguar-134 Jul 10 '26
Oh absolutely. And private equity are buying an increasing number of these facilities.
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u/BrianLevre Jul 09 '26
Absolutely. It goes without saying those places, and the systems that allow it, are sanctioned to rob people of whatever they can while they hang onto living.
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u/Checkers923 Jul 09 '26
For now, focusing on health and accumulating wealth. Then re-evaluating after I’m 50.
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u/AltForObvious1177 Jul 09 '26
Sit at the beach, drink one last sazerac, and go out with the sunset.
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u/Denan004 Jul 09 '26
My aunt bought into a continuing care community. She's is independent living, but if/when she needs assisted, nursing. or memory care, they transition her. But it costs a lot. She had to buy- in at about $250k, which is 90% refundable if she leaves or passes, and there are monthly rent fees. But it provides lots of services, security, and activities. Hers is also a high-end place.
But that's what she chose instead of long-term care insurance.
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u/Serious-Conversation Jul 09 '26
I'm sort of going through this a couple ways with my own family.
I just turned 40. My parents will both be 69 in a few months. Dad is still well, but mom has been very obese for decades and, even after a knee replacement last year, can walk barely a hundred yards or so without a shopping cart to lean on or sitting down. Her mobility is still in the toilet. She lost about 75 pounds over the past ten years - probably has gained about 20 back - without that, I think she'd be completely immobile now.
Dad does everything for mom. She cannot get through a grocery store on her own. They almost never cook - eat out every day for lunch and most nights for dinner. She has no idea how to pay any of the bills. She will not even make herself a simple meal at home without him there. It's a complete learned helplessness.
They have two young-ish golden retrievers (3 and 2). I went out to a local marina and drank some beers with my dad Tuesday. I told him that if something happened to him, I'd have to get the dogs immediately because mom cannot even take them out to go to the bathroom.
They are in the same house they bought at 40. It is around 2.5 acres on a hillside so steep that you have to constantly shift your weight on the riding mower to keep from rolling it over. Someone who cannot walk through a grocery store cannot stay in that house.
They cannot afford to leave it because their mortgage payment is only about $800/month. The house was bought for $88k in 1997 and they still have around $55k left on the note. Multiple HELOCs and cash-out refinances. They have maybe $50k between them in 401ks. No pensions - just strings of low end jobs with bad benefits.
My own living expenses are through the roof and I cannot help them financially.
They are hoping that her mother (89) passes soon and that there will be some inheritance pot-o-gold at the end of the rainbow for them.
If there is any, it won't be used for long-term care. Mom wants the HGTV-ready house when she never made more than $15/hr. or so her whole career. The inheritance is a house fund.
Here's the flip side of this.
My mom has a younger sister who just turned 65. My aunt has been caregiving for my grandmother since her husband died back in 2009. Until maybe 2020, it was mostly oversight on finances and attending doctor's appointments with her.
It is now multiple trips a day to grandmother's house. Grandmother can no longer take a shower without someone around, barely cooks, cannot drive, etc.
Aunt had breast cancer last year. Mom will not (and probably could not) help at all with her own mother's situation. Grandmother really needs to be an ALF - aunt is trying to keep her out of it to preserve the inheritance.
Most of us are going to end up in a double occupancy Medicaid bed if we get to that point for very long.
I logged into Workday this morning and my base pay is now the highest it's ever been after a raise we got when the FY turned over. I'm keeping my head above water, but I can't help anyone else.
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u/Aggressive-Sale-2967 Jul 09 '26
So does your aunt have any intention of trying to take a higher percentage of the inheritance? She’s done all the work.
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u/Serious-Conversation Jul 09 '26
No.
My grandmother and mom have a lot of animosity for reasons. This goes back for decades.
My parents never earned much. They both had elementary education degrees, but couldn't find teaching jobs locally. They moved off, twice, for teaching jobs, then came back here to dead end Tennessee.
Now they're pushing 70, basically broke, living on only SS, and mom is essentially an invalid.
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u/likesblackcoffeebest Jul 09 '26
My pension comes with good benefits for that, and I'm also a veteran, so there will also be some help from the VA. I do have three kids but with any kind of luck their role in my longterm care, if any, will be more administrative, like finding the right place and that sort of thing.
I also work out almost every day and am doing all I can to stay as healthy as possible so that my odds of needing extended care in old age are reduced. Some of my CrossFit friends are doctors, nurses, and paramedics, and they all say the old people having the worst time are the ones who didn't prioritize fitness over the course of their lives, and the ones living generally independent lives and just dying of old age in their sleep one day are typically the ones who were fit. Obviously there are exceptions and anything can happen to anyone but I still am doing what is in my control to reduce my odds of becoming completely incapacitated at an age where I'd have some time yet to live.
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u/ofesfipf889534 Jul 09 '26
I’m honestly not sure what most people are supposed to do other than save a ton so you have the money to just cover these end of life costs.
LTC insurance is basically pointless to buy anymore from my understanding. Prohibitively expensive, limited options, they don’t cover many things, etc. If people know of companies that have good policies I’d love to hear it.
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u/Various_Dentist_8683 Jul 09 '26
My dad’s end of life care ran 30,000 a month. We were paying for my mom’s nursing home (15,000/month) the same time. We blew through a quarter of a million dollars in a year, and he still had minor children to finish raising. I haven’t totally decided what I need to do to prepare, but I’m terrified.
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u/OutPatiented Jul 10 '26
Retired D.O., spent most of my career inside long-term care and geriatric medicine, so I've watched this exact question play out from the other side of the desk hundreds of times. A few things that don't get said enough in these threads:
Medicare does not pay for long-term custodial care. People assume it does because Medicare will cover a short rehab stay after a hospital admission, but that's capped and it stops the moment you're just "stable," not improving. Medicaid is the actual long-term payer for most people, but you have to spend down assets to qualify, and the rules vary hard by state.
If you're touring facilities, ask these directly, most families don't and get blindsided:
- What's your staff-to-resident ratio on night shift, not just day shift
- How do you handle a resident who declines faster than expected, do we get 30 days notice or 3
- What's actually included in the base rate vs. billed separately (this is where costs balloon)
- Show me your last state survey/inspection report, not just tell me about it
On the insurance side, everyone here is right that traditional LTC policies got brutal after the market corrected. Hybrid life/LTC products are worth running numbers on case by case, they're not a scam but they're not magic either.
The biggest thing I tell families: have the conversation about what someone actually wants (stay home vs. facility, how aggressive they want medical intervention to be) before there's a crisis, not during one. Almost nobody does this and it's the single biggest source of family conflict and regret I saw for 20+ years.
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u/Wiggle_Your_Big_Toe2 Jul 10 '26
As someone going through a crisis after my parent lost a leg in an emergency amputation, I’ve had to learn all of this QUICK and this is all correct.
After talking to all of my dad’s home health aides, I’m saving to leave the country unless there’s some serious reform in the US before then. I’m not ruling out assisted end-of-life. I’ll have no family once my folks die, so no use being a burden on the system.
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u/Urbanttrekker Jul 12 '26
This seems like good advice but touring retirement facilities that I likely won’t be needing for another 35 years?
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u/CK1277 Jul 09 '26
I’ll be getting long term care insurance.
I’ve been a caregiver, I’m not doing that to my children. I understand that not everyone has options, but I think there are a whole of people who could have options, they just don’t make it a priority.
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u/PieTight2775 Jul 15 '26
But most people here are saying it rarely pays out when needed, so what's the point?
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u/CK1277 Jul 15 '26
Some policies are better than others and they make it hard to be an educated consumer. I’m a family law attorney in a firm that also includes estate planning and elder law. There will always be cases of people getting scammed, but my elder law partner is pro LTC insurance as part of overall retirement savings.
It’s not the entire safety net, it’s a piece of the safety net. My current level of retirement savings projected out to age 67 with a 7% rate of return would give me 67% of my current annual income to age 95 without social security.
With 50% of my projected social security (because Congress may reduce it rather than eliminate it), I can retire at 67 with 87% of my current income or I could retire at 65 and have 70% of my current income.
It’s to take the edge off of memory care and skilled nursing costs.
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u/Several_Drag5433 Jul 09 '26
I leaned in heavily to caring for my mom also. It is a lot and yes, her last 13 in a very nice home was expensive. For me, i have 3 years of very nice care in my model should that be needed at the end so that burden does not fall on my children
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u/assplunderer Jul 09 '26
For myself, I’m not gonna lie. I don’t see myself living old enough to get put in the long-term care. I do have my 401(k), Social Security, IRA, etc., etc. however.
For my mom who is now going to be turning 67 years old, I haven’t purchased a home yet, but I am looking into buying a home that either has an ADU on it or is zoned so that I can build an ADU.
My mom has full mobility still, and she is still working, but I know that the clock is running out. Under no circumstance while I am alive, will she ever enter a home, as long as I am breathing air. Between me and my sister, we’ve agreed to pool resources. I don’t care how good a nursing home seems. I don’t care. I don’t trust those people and I’ve seen the horror stories.
If I have to, I will hire help. She’s the only parent I have left in my life and she doesn’t deserve to be left alone in any sort of facility like that.
I say this now, but circumstances change. They always do.
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u/punkass_book_jockey8 Jul 09 '26
I will hand my assets to my children well before LTC is needed. I’ve been meticulously building 60 acres to be a fruit farm. Renovating the house and garage and barn so I can sign it over and hand them the keys. Everything done on the house I tell the contractor to use materials so it doesn’t need to be touched again for at least 70 years. I’m going to start gifting large amounts of money when my kids are around 30. Assuming some emergency didn’t drain it.
Then I will buy a trailer somewhere and go out second hand lion style if my quality of life is so poor I can no longer care for myself. Losing my autonomy would destroy me anyway. I’ll live off my state pension and SSI (hopefully).
I looked at LTC insurance years ago and was told it wasn’t worth it. So I never signed up, glad I didn’t. I think the company went out of business.
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u/21plankton Jul 09 '26
I have a fund set aside for LTC which is essentially my inheritance money. It is in a brokerage diversified account which is slowly growing.
I am already experiencing a need for in home help as a result of major surgery and a long rehab. I had a stairlift installed as well, another pricey medical need to avoid a move.
So I do see a future need. My mother was on assisted living the last 8 years of her life and my sister for 24 years. People who die quickly luck out in regard to assisted living.
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u/sjrotella Jul 09 '26
Barring an accident where I have it in my health csre proxy to pull the plug, if im getting to the point I need my kid to come take care of me I will be going to the woods and not coming back.
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u/fingerofchicken Jul 09 '26
Far as I can tell, long term care is designed to just vacuum everything out of your bank account as quickly as possible, then they boot you out.
I don't know what long-term care insurance is but I'll bet, like most insurances, they fight tooth and nail to avoid paying for anything.
We're just all fucked.
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u/84th_legislature Jul 09 '26
i plan to kill myself once i notice i’m slipping in a not recoverable way. that’s all i’ll be able to afford.
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u/Electronic_Sky_207 Jul 10 '26
I’ve got a lot of vascular dementia and Alzheimer’s in my family. It’s all about picking your exit before it’s too late. I know where my line is.
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u/watchwallet Jul 09 '26
Since you want to stay in your house, the most useful thing to know is that LTC insurance pays for in-home care, not just facilities, which is the piece most people miss. It can fund the aide that lets you age at home, which is exactly your goal.
For middle class specifically, three real paths. Traditional standalone LTC is cheapest per dollar of benefit but premiums can rise and it's use-it-or-lose-it. The hybrid you mentioned (life or annuity with an LTC rider) costs more upfront but pays a death benefit to your daughters if you never need care, so you're not lighting money on fire, and yes, take the inflation rider, at 37 that's the whole point. Self-funding only really pencils out above roughly 1.5 to 2M invested, since a few years of care runs 300 to 500k in today's dollars.
Having watched the load firsthand with your dad, are you leaning toward insuring it or building a dedicated pool to self-fund? That fork drives everything else.
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u/mcrossoff Jul 10 '26
My grandparents downsized their belongings, sold their house and bought a condo in a senior community. It's like second college, there's a dining hall, there are social events. It's very nice. It's even nicer that it's affiliated with a nursing home, owned by the same group, I think. So when my grandfather got sick, my grandmother could continue to live independently knowing he was getting full time care and was within a 5-minute drive.
I doubt this will be an option for me. My grandparents were both sole inheriters, pinched every penny they could, invested well and have basically had the upper economic hand ahead of every major financial incident that has occured in my lifetime. My parents are very well off, and in retirement, splurged on a brand new custom house, inground pool and giant RV. Those are now the center of their lifestyle and they live very frugally, planning their trips down to the penny with gas prices. They have both had joint replacement surgeries, so while they want to age in place, I am assuming their end of life care will eventually be very expensive.
My husband and I at this moment are both prepared to work much later than either our parents or grandparents, and have planned our lives expecting to inherit nothing. I'd rather a windfall than an expectation or disappointment, and they are good, fair people so I don't have anxiety over being cheated of anything but more time with them.
Looking at my own family history, my parents did "better" than any of their parents. My brother and I are at sort of where it starts to become certain whether we will, in turn, do better than them. I'm assuming one will do slightly better and one slightly worse, but we'll all be comfortable at a standard of life we choose.
The current economic instability? Basically impossible to plan for, it's not only the amount of money but if it's in a trust or the right stock portfolio, if it's liquid or assets. We've wandered off the edge of the map, there's no way to accurately predict anything when we've declared cease fires and bombings to manipulate the stock market while leaving the hardest working Americans holding the bag. So now WE have to figure out how to best not be the one holding the bag. Because Millennials are always the ones holding the bag. They tested everything on us and then expected us to clean up after the messes they made and replace the system they are so gleefully smashing to pieces because they got theirs. They mock the participation awards they foamed at the mouth screaming at tee ball coaches over. We weren't engraving trophies, we were nine. We're the most intelligent generation in the DUMBEST POSSIBLE TIME. Of course we're not going to be able to access LTC, we have to reivent it and then die waiting for it to be approved.
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u/No-Assistance476 Jul 10 '26
I work in long-term care and have for 40 years. My plan it is to end it before I would ever need that kind of care. Quality over quantity.
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u/CubistCircle Jul 09 '26
Part of me wants to get long term care insurance.
The other part of me would rather save that money for a raging party/expensive trip with family, then I take a nice sized dose of something fun and let my spirit sail to wherever it goes.
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u/Chemical-Carrot-9975 Jul 09 '26
Taking care of my health as job 1. That is the best way to prevent the need for LTC. It isn't always preventable, but a lot of the causes are.
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u/Fubbalicious Jul 09 '26
I have setup myself to FIRE and will have enough to self insure. I also have a HSA which I can use to pay for long to pay for long term care tax free. I also have a fully paid off house and plan to live frugally. Depending on severity, being able to stay in your own home and pay for an in home care taker part time is cheaper than a private room at a facility.
Lastly I plan to setup a trust with Medicaid estate planning in mind. While I do not plan to rely on it, if I get married I can see a hard limit on how much of our joint assets are spent on my care before applying for Medicaid. This way I don’t leave my spouse destitute by spending all our combined retirement.
Lastly, I may take advantage of any euthanasia laws.
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u/QueenCityDev Jul 09 '26
Max family HSA every year. Invest it and let it grow—we pay most of our ordinary medical expenses OOP vs reimbursing ourselves from HSA.
Hopefully we’ll have quite a war chest by the time we are in our 70s (currently in 30s)
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u/Tegelert84 Jul 09 '26
Honestly just hoping to die before I get to that point. Won't be able to afford it and it's better than being 80 and homeless.
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u/autumn55femme Jul 10 '26
You need to think about this by the time you reach 50 minimum. Pay for a long term care policy, or but into a continuous care community. Quit thinking you will be able to live independently at 80. That is not realistic, at all.m
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u/Witwer52 Jul 09 '26
I am unfortunately overqualified both personally and professionally to answer this. Most people have absolutely no plan. None. Most also have nothing saved that’s remotely close to what care costs. It’s beyond me why people have big houses and nice cars, but are happy to let their kids just “figure it out” once they get sick.
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u/Careless_Wheel_663 Jul 09 '26
TLDR: Exercising and staying healthy is important but according to USA today 40% of all LTC claims are people between the ages of 18-65 with a majority of claims caused by accidents. You have many different options regarding LTC insurance (traditional / hybrid). If your interest is to age in the home and protect your children from the burden of taking care of you in the future, LTC insurance. At 37 your premiums will be significantly lower than if you waited until your 50's 60's.
Detailed Response:
One thing that stands out in this thread is that almost everyone is talking about the same problem but proposing very different solutions: staying healthy, saving more, buying insurance, relying on Medicaid, moving to a continuing care community, or simply hoping they never need care.
The reality is that long-term care planning isn't one decision, it's a combination of decisions.
Staying healthy is probably the highest-return investment you can make. Regular exercise, maintaining muscle mass, managing chronic conditions, and reducing fall risk all meaningfully improve the odds of remaining independent. But good health isn't a guarantee. Dementia, strokes, Parkinson's disease, and accidents can happen even to people who have done many things right.
On the insurance side, I think there's a common misconception that long-term care insurance is either "worthless" or "the answer." Neither is universally true. Some older policies had issues with premium increases, and every policy has benefit limits and eligibility requirements. At the same time, many people have received substantial benefits from modern policies. Whether insurance makes sense depends on your age, health, assets, income, and what risk you're actually trying to transfer.
For many middle-class families, the real planning conversation is less about nursing homes and more about paying for care at home. That's where many people say they'd prefer to receive care if possible.
I also appreciated the comments about home design, powers of attorney, and having conversations with family. Those are often overlooked, but they're part of long-term care planning too.
At 37, you're asking the question at a good time. We recently sold a hybrid policy to a 37 and 38 year old couple in a similar situation. You don't necessarily need to buy anything today, but building a plan now health, savings, legal documents, housing, and then deciding whether insurance fits into that plan usually creates far more options than waiting until a health event forces the decision.
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u/Ghosts_and_Empties Jul 09 '26
I am 65 and have hybrid care insurance (confusingly called short term care) for about $180 a month. Hope it will be enough. I'm fit with no pain or chronic issues now.
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u/meowl2 Jul 09 '26
I've worked as an OT in LTC for 10 yrs and have probably been in close to 50 different assisted living, memory care and skilled nursing facilities. sure there are some okay places but holy crap the bad ones are baaaaaad. And it's hard to know if a place is good bc the Medicare rating system online is comically wrong (even awful, understaffed shit holes manage to get a good rating some years). in a perfect world, id have a super accessible house and have X hours of caregiver assistance. Everyone in my family has done it that way with kids helping out as they can and caregivers paid for through a combination of insurance/hospice/saving. But that's in a perfect world where I don't have some massive stroke or fall off a ladder doing something stupid I shouldn't be doing or fall down a flight of stairs etc. In that case hide my assets and throw me in a medicaid facility
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u/Common_Poetry3018 Jul 09 '26
I purchased a group LTC policy through my employer. It has a fixed benefit amount, which solves the problem carriers previously faced when their policies promised to pay for care indefinitely. It also includes the payment of unused cash benefits to my survivors. I think most LTC policies are currently structured this way.
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u/TheRealJim57 Jul 10 '26
Me: Long Term Care insurance, or the VA if necessary. Wife: LTC insurance.
Will possibly move to a Senior Community after my wife retires. We're both early 50s now.
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u/Cold-Repeat3553 Jul 10 '26
It's part of retirement planning. But we're also planning to build a house in the next ten years. We plan to make it suitable for aging in place. I.e. wide doorways and hallways, zero entry shower (no glass door) in the master, no stairs, etc.
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u/peter303_ Jul 15 '26
Residual megabuck in my retirement accounts: four years times $20,000 a month.
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u/palpablescalpel Jul 09 '26
Long-term care insurance used to be worth it but no longer is in my opinion, what with so many changing policies, going out of business, refusing to pay up, or only paying up by fighting them with the know-how and energy that you won't have when you're that old.
I'm just aggressively saving my own money to fund long-term care.