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Eight out of 10 Older Adults Unable to Afford 4 Years Of Assisted Living

47 million Americans don’t have the financial resources to cover the care they may need down the road.


A new analysis by the National Council on Aging and the LeadingAge LTSS Center @UMass Boston of data from the Health and Retirement Study compared the cost of long-term care services and supports with the total net value of all assets of people aged 60 or more years. The study finds 80% of Older Adults are unable to Afford 4 Years Of Assisted Living. The analysis found that on top of lacking the resources to pay for long-term care, 60% of older adults would be unable to afford two years of in-home LTSS.


“It is unacceptable that nearly all older Americans are one crisis away from plunging into poverty after working their entire lives and often saving a nest egg that is then wiped out by the cost of care,” NCOA Senior Director of Research & Evaluation Susan Silberman, PhD, said in a statement. “This is a snowballing crisis given that the older population is growing rapidly. The cost of care is staggering, and older adults’ resources are insufficient.”


The report noted a misconception that older adults are asset rich, but a vast majority are financially struggling or at risk of falling into economic insecurity as they age — and it may be getting worse. According to the report authors, 90% of older adult households saw decreases in income and net value of wealth between 2014 and 2016.


Longevity and lower savings are fueling a retirement security crisis that has been exacerbated by inflation, rising healthcare costs and the fact that someone turning 65 today has a 70% chance of needing LTSS at some point in their lifetime, according to the authors.

“When you think about these potential costs, and then look at the entire picture of what is available to people, in terms of their own resources and government assistance, you realize that the most vulnerable here are middle-income Americans who have the most to lose,” said LeadingAge LTSS Center @UMass Boston Co-Director Marc Cohen, PhD.


The NCOA is advocating for public policy solutions to address the crisis, including improving affordability and access to home- and community-based services under Medicaid. Some assisted living providers offer HCBS through Medicaid waivers. Congress and the Biden administration, according to the organization, must “put Medicaid HCBS on equal footing with institutional services,” eliminate HCBS waiting lists and address the growing direct care workforce shortage.


Other public policy solutions being advocated for by the NCOA include providing additional assistance to family caregivers, and promoting saving for retirement among lower- and middle-income workers.

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