One of the most important—and often avoided—conversations we need to have as we age is about long-term care.
I see it all the time. Families are caught off guard, not because they didn’t care, but because they didn’t realize how quickly needs can change… or how expensive care can become.
Planning ahead isn’t just about finances. It’s about protecting your independence, easing the burden on your family, and giving yourself more say in how and where you live.
The Reality of Long-Term Care
Long-term care isn’t about medical treatment—it’s about support with everyday life.
At some point, many of us will need help with things like bathing, dressing, preparing meals, getting around safely, or simply having someone there for supervision and peace of mind.
That care might happen at home, in an assisted living community, or in a skilled nursing setting. And while each situation is different, one thing is consistent: the costs can add up quickly.
In-home care or assisted living can cost several thousand dollars per month, and more advanced care can exceed $10,000 monthly. Without a plan, those numbers can feel overwhelming.
What Many People Get Wrong
One of the biggest misconceptions I hear is: “Medicare will cover it.”
Unfortunately, that’s not the case.
Medicare is designed for short-term medical needs—like rehabilitation after a hospital stay—not ongoing custodial care. Medicaid can help, but only if you meet strict income and asset requirements.
This is where planning ahead really matters.
How Do People Pay for Care?
There’s no one-size-fits-all answer. Most people use a combination of resources, including:
- Savings and retirement income
- Home equity (through downsizing or selling)
- Long-term care insurance
- Veterans benefits, such as Aid & Attendance
- Medicaid, when appropriate
The key is understanding your options before you’re in a position where decisions have to be made quickly.
Where to Start
If this all feels like a lot, you’re not alone. The good news is—you don’t have to figure it all out at once.
Start by thinking about what you would want. If you needed help, would you prefer to stay at home? Move to a community? Be closer to family?
Take a look at your financial picture so you understand what resources are available to you.
If long-term care insurance is something you want to explore, it’s worth looking into sooner rather than later, while you have more options.
Make sure your legal documents are in place—things like a Power of Attorney and Healthcare Directive can make a difficult time much easier for your family.
And most importantly, have the conversation. Let your family know your wishes. It’s one of the greatest gifts you can give them.
Terri Dimond is a Certified Senior Housing Professional with Berkshire Hathaway HomeServices California Properties and founder of the “Empowerment Through Education” seminar series in Santa Barbara. To learn more about upcoming seminars and access additional resources, visit www.TerriDimond.com.
