How to Talk to Your Loved Ones About Long-Term Care Planning

Sooner or later, most of us will need some long-term care. That might mean help getting to appointments or cooking meals; it could mean help with bathing and dressing from a family member or a paid aide at home; it could mean months or years in an assisted living facility or nursing home.

“We plan for retirement, but we don’t necessarily plan for the older adult years in an aging body,” says Jennifer Crowley, a registered nurse who is a life care planner in Kalispell, Montana, and author of Seven Steps to Long-Term Care Planning.

Just 28 percent of adults over 50 say they’ve given a lot of thought to how they could continue to live independently if they needed help with daily activities, according to an AARP survey, yet 1 in 5 of us will need significant long-term care, according to the Department of Health and Human Services.

How much that care will cost varies widely across the United States. In 2023, the median monthly cost was $6,292 for a home health aide, $5,350 for an assisted living facility and $9,733 for a private room in a nursing home, according to a survey by Genworth.

Denial can persist even after people become ill or disabled. They may not consider how livable their homes will be, or they may make faulty assumptions about who will care for them. There are consequences to not acknowledging the importance of legal, financial and care planning.

The result can be fewer options when needs arise. “If you wait too long,” Crowley says, “decisions are more likely to become someone else’s decisions, not your own.”

Denial plays a role

Frank discussions about long-term care “are hard conversations that, as human beings, we don’t enjoy having,” says Ailene Gerhardt, a patient advocate in Brookline, Massachusetts. She says some older adults who try to start such conversations with their grown children find that it’s the kids who are in denial.

Often they can’t face the fact that “their parents will someday not be there,” says Joy Loverde, a Chicago eldercare consultant and author of Who Will Take Care of Me When I’m Old?

Underlying much of the denial is the idea that “if I don’t plan, then that’s not going to happen to me,” says clinical social worker Debra Feldman, a Chicago-based care manager who is past president of the board of directors of the Aging Life Care Association.