Americans Fear Navigating Long-Term Care Alone More Than Affording It

Americans Fear Navigating Long-Term Care Alone More Than Affording It

Nationwide study finds concerns about advocacy, caregiving and support outweigh cost concerns, even as few families have made plans for future care

Columbus, Ohio - For decades, conversations about long-term care (LTC) have centered on the question about how people will pay for it. But new research from Nationwide shows many fear something far more personal: who will be there to help them navigate care when they need it most?

According to Nationwide Retirement Institute's 2026 Long-Term Care survey, Americans are more likely to say they would be concerned about not having someone to advocate for them if they were facing LTC needs alone (84%) than they are to worry about affording care itself if they were living alone (71%). They are similarly concerned about not having help coordinating care (81%) and receiving lower-quality care (81%) if they were living alone.

The findings suggest that many Americans are starting to view long-term care as more than a financial consideration, shaped by questions about caregiving, advocacy, and who will help navigate difficult healthcare decisions later in life.

"Americans are realizing that long-term care planning is about far more than finances," said Holly Snyder, president of Nationwide's life insurance business. "People want to age with dignity, maintain their independence and know someone they trust will be there to help make decisions on their behalf. The challenge is that many families haven't had those conversations or made those plans."

Most Americans envision receiving care in familiar surroundings rather than in a facility. Nearly three-quarters (73%) said they would prefer to receive LTC in their own home or a loved one's home, and many expect to rely on their partner (50%) or children (40%) to provide care.

But few have taken steps to make that preference a reality. Among those who prefer to receive care at home:

• Just 37% have created a savings or investment plan to cover LTC expenses
• Only 27% have identified who their future caregivers may be
• Less than one quarter (22%) have modified their homes to support aging in place.

The disconnect highlights a growing gap between how Americans want to age and how prepared they are to do so.

Caregiving Changes How Americans Think About Their Own Futures

For many Americans, the realities of long-term care only become clear after stepping into the role of caregiver themselves. Caregivers report spending an average of 22 hours each week providing care - the equivalent of a part-time job - and an average of $382 per month in non-reimbursed expenses, including transportation, prescriptions and household needs. Among primary decision-makers for LTC, those expenses rise to $445 per month.

The financial pressure is especially intense among Millennials, many of whom are simultaneously supporting children, aging parents, and their own career ambitions.

Among Millennial caregivers:

• Nearly three-quarters (73%) said they are willing to take a loan from their retirement account to provide care for a family member
• Near six in 10 (59%) believe caregiving responsibilities will likely use up money originally intended for their children (e.g., education, inheritance)
• Almost the same amount (58%) fear caregiving expenses will keep them from ever retiring

The silver lining? Caregiving often becomes a wake-up call that motivates Americans to prepare for their own future care needs. Caregivers are significantly more likely than non-caregivers to say they are knowledgeable about LTC (82% vs. 59%), have identified their future caregivers (34% vs. 20%), and have created a savings or investment plan for future care costs (40% vs. 31%).

Financial Advisors Can Help Families Turn Anxiety Into Action

Among those who have served as caregivers, 90% say it would have been valuable to discuss who would provide long-term care before a need arises, while 92% say clear conversations about how to pay for care would have helped.

Yet despite recognizing the importance of planning, many Americans are still delaying conversations about caregiving responsibilities, care preferences and future care costs. As a result, families often find themselves making complex financial and healthcare decisions during a crisis rather than preparing for them in advance.

One factor that helps families move from awareness to action is working with a financial advisor. The survey found that people who work with an advisor are more knowledgeable about LTC compared to those without an advisor (84% vs. 62%). They are also more likely to have already identified future caregivers (39% vs. 18%) and discussed care costs with family members (72% vs. 51%).

"Too often, families wait until a health event or caregiving crisis forces these conversations," Snyder said. "Having a plan in place can help people protect their finances, reduce stress on loved ones and create more confidence about how they want to age and receive care. Whether that means preparing financially, documenting care preferences or identifying who can step in as an advocate, taking action earlier can make a meaningful difference for families navigating LTC decisions."

To learn more about the 2026 Nationwide Retirement Institute Long-term Care survey, visit nationwide.com/SimplifyLTC and click here to read Snyder's blog.

Methodology

The research was conducted online in the United States by The Harris Poll on behalf of Nationwide among 1,208 adults aged 30+ who were the primary or shared financial decision-makers for their household. Respondents also had a household income of $75K+. The survey was conducted April 11-29, 2026.

Data are weighted where necessary by age by gender, race/ethnicity, region, education, marital status, household size, household income, and political party affiliation to bring them in line with their actual proportions in the population.

Respondents for this survey were selected from among those who have agreed to participate in our surveys. The sampling precision of Harris online polls is measured by using a Bayesian credible interval. For this study, the sample data is accurate to within ± 3.9 percentage points using a 95% confidence level. This credible interval will be wider among subsets of the surveyed population of interest.

All sample surveys and polls, whether or not they use probability sampling, are subject to other multiple sources of error which are most often not possible to quantify or estimate, including, but not limited to coverage error, error associated with nonresponse, error associated with question wording and response options, and post-survey.

About The Harris Poll

The Harris Poll is one of the longest running surveys in the U.S. tracking public opinion, motivations and social sentiment since 1963 and is now part of Harris Insights & Analytics, a global consulting and market research firm that delivers social intelligence for transformational times. We work with clients in three primary areas; building twenty-first-century corporate reputation, crafting brand strategy and performance tracking, and earning organic media through public relations research. Our mission is to provide insights and advisory to help leaders make the best decisions possible. To learn more, please visit www.theharrispoll.com.