According to the U.S. Department of Health and Human Services (HHS) Administration on Aging, about 70 percent of people over age 65 will need long-term care services at some point. Needing long-term care generally means requiring assistance with at least two activities of daily living (ADLs) such as eating, dressing, or bathing; some individuals will require more intensive skilled nursing care.
One common question is, “How long will I need long-term care?” While no one can predict individual futures, available research offers useful averages and ranges to help with planning. Below we examine both the likely duration of care and the costs you may face.
How long will I need long-term care?
HHS data indicate that the average woman requires long-term care for about 3.7 years, while the average man requires about 2.2 years. These figures include a mix of in-home care (family or paid caregivers), assisted living, and stays in skilled nursing facilities.
A 2009 report from the American Health Care Association and the National Center for Assisted Living found that the average assisted living stay is roughly 28 months, with a median stay of 22 months. About 60 percent of assisted living residents later require a higher level of care, often moving to a skilled nursing facility.
HHS reporting on nursing home residents from 2015–2016 found an average nursing home length of stay of 485 days. Of the 1,347,600 residents identified in 2016, approximately 43 percent had stays of less than 100 days (short stays) and about 57 percent had stays of 100 days or more (long stays).
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The cost of long-term care
Cost estimates vary widely depending on the type and duration of care. PricewaterhouseCoopers research from 2017 estimated an average lifetime long-term care cost of about $172,000. That figure can include paid in-home care, assisted living, and nursing home stays, but averages hide significant variation.
According to the same analysis, 25 percent of long-term care episodes last about eight months or less, costing under $26,000. Conversely, another 25 percent of cases exceed $240,000 in lifetime costs. In 8 percent of cases, care lasts more than eight years; in 7 percent of cases costs exceed $500,000; and in about 1 percent of cases costs exceed $949,000. With care costs rising over time, more recent estimates would likely be higher than those historical figures.
For a sense of current pricing, Genworth’s Cost of Care Survey reports national 2020 averages of approximately $4,300 per month for assisted living, $7,756 per month for a semi-private nursing home room, and $8,821 per month for a private nursing home room.
>> Related: Inflection Point: Our Nation’s Ever-Growing Long-Term Care Crisis
What about long-term care insurance?
Long-term care insurance (LTCi) can help cover some or all care costs. Typical policies might offer monthly benefits in the range of several thousand dollars, with inflation protection that increases benefits annually, and a benefit period measured in years. However, LTCi premiums can be expensive and have risen in recent years as insurers adjust pricing to reflect rising claims and care costs.
Policies also often include eligibility requirements that must be met before benefits begin, such as having a cognitive impairment or needing help with at least two ADLs. Many policies have an elimination period—commonly 30 to 90 days—that requires you to pay out of pocket before benefits start. Most policies also impose a lifetime maximum benefit. If you exhaust that maximum, remaining costs fall to you or your family.
For those who need only limited care, the policy may cover most needs; for those who require extensive care, the protection can preserve assets and reduce the likelihood of relying on Medicaid. Understanding exclusions, waiting periods, inflation protection, and lifetime limits is critical when evaluating policies.
>> Related: Examining Key Figures on Long-Term Care Insurance
CCRCs and long-term planning
Facing these uncertainties can be stressful for individuals and families. Decisions about caregiving have emotional and financial consequences: a family member providing in-home care may need to reduce work hours or take on additional responsibilities, and savings may be strained if a move to assisted living or skilled nursing care becomes necessary.
Some people choose to move to a continuing care retirement community (CCRC), also called a life plan community, to gain peace of mind. CCRCs offer a continuum of care—independent living, assisted living, and skilled nursing—often on the same campus. That continuity allows residents to remain close to partners and friends as care needs change.
CCRC costs vary widely and many communities require an entry fee, which in some contracts is refundable to some degree. Prospective residents should review contract terms carefully, especially refund provisions and what services are included. Learn more about CCRCs in the community resources section.
Long-term care planning involves weighing probabilities, costs, and personal priorities. Reviewing available data, exploring insurance and community options, and having candid family conversations can help you create a plan that balances care needs with financial security and peace of mind.