02.06.25

Do households have a good sense of their long-term care risks?

Executive Summary
Insights Report
Research Dialogue

Many older adults will require some long-term care later in life, with over half needing intensive support, often for an extended period.

Summary

The resources required to meet high-intensity, long-duration care needs can be substantial. Yet, little research has focused on whether people have a good sense of how much help they may need with daily activities as they age. This paper compares two measures of self-assessed long-term care risks with objective probabilities of needing high-intensity care and whether the accuracy of people’s perceptions varies by socioeconomic characteristics.

Key Insights

  • On average, older adults have accurate long-term care risks (LTC)—whether it be nursing home use or serious cognitive limitations.
  • Blacks and women, however, consistently underestimate their risks of needing LTC. These groups also have a higher probability of high-intensity care needs and the fewest resources to provide for their care—potentially resulting in unmet needs.
  • While being aware of long-term care risks doesn’t equate to being financially prepared to pay for long-term care, awareness of the risks is the first step in being prepared.

Those who overestimate long-term care risk could unnecessarily restrict their consumption in retirement, while those who underestimate the risk could experience unmet needs or have to spend down to qualify for Medicaid.

Methodology

The researchers analyzed data from the 1998–2020 waves of the Health and Retirement Study, a nationally representative biennial longitudinal survey of U.S. adults ages 51 and older and their partners. To predict long-term care needs for current 65-year-olds, the study includes data on the number of daily activities with which people need assistance and sociodemographic characteristics.  

Percentage of total caregiving hours provided to individuals ages 65+, by source

Authors

Anqi Chen

Boston College

Alicia H. Munnell

Boston College

Nilufer Gok

Boston College