Long-Term Care Planning: What Families Often Get Wrong

There's a version of this conversation we hear often: “We're fortunate - we can cover the cost of care if we ever needed it, so we don’t need to focus on a long-term care plan.”

It's an understandable assumption, but one we caution against as dollars and cents are only one part of a long-term care plan. Long-term care planning isn’t just about whether you can afford care - it's about what happens to your family, your choices, and your plan if you don't have one in place before you need it.

Some numbers worth knowing

Nearly 70% of adults over age 65 will need some form of long-term care in their lifetime - whether that's in-home support, assisted living, or skilled nursing (Source: US Department of Health & Human Services). And, according to multiple reports, the average cost for adults 65 and older runs between $100,000 - $130,000 for just under a year of care - a figure that climbs quickly for longer stays or higher levels of care. 

The real risk isn't cost, it's being unprepared

For most families we work with, the ability to pay isn't the concern. What's often missing is a plan for how that money gets deployed - and who's making the decisions when it does. According to a recent study led by Nationwide, a majority of respondents said they were more worried about not having someone to advocate for them during a care need than they were about the cost of care itself.

That means the fear for many - including our high-net-worth clients - isn't the bill; it's being unprepared, with no one positioned and ready to make decisions, coordinate care, and speak on your behalf. Without a plan, that responsibility tends to fall - informally, and often suddenly - on family. And the impact isn't limited to one adult child stepping back from a career. It can mean a spouse making high-stakes medical and financial decisions alone, siblings disagreeing over what mom or dad would have wanted, a family scrambling to coordinate care across different cities, or years of unspoken tension because no one was ever clearly designated to lead. 

For families focused on multigenerational wellbeing, that's the real stakes of skipping this conversation: not whether the money is there, but whether the people you love are left to sort out decisions, roles, and expectations in real time, under pressure, without ever having talked it through.

Why the planning is just as important as the policy you end up with

This is the part that's easy to overlook: the greatest value of long-term care planning isn't just the actual policy you end up with - it's the conversation that happens to get there. Sitting down as a family to talk through preferences, who's willing and able to take on what, and what "good care" actually looks like to you, does something a spreadsheet can't. It gets everyone on the same page while there's no pressure and no crisis - so if the moment ever comes, your family isn't improvising, guessing, or disagreeing. They're executing a plan you built together.

We've seen this firsthand: Families who go through this process, even informally, tend to handle a care event with far less conflict and far more confidence than families who never had the conversation - regardless of which policy (if any) they ultimately chose.

The risk of "self-insuring"

Many high-net-worth families default to "self-insuring" - the assumption that they can simply use their assets to pay for care as needed. That can work, but it's rarely examined the way it should be. Self-insuring without a structure means care costs come directly out of a portfolio, potentially at the worst possible time to be selling assets, and without any coordination against the rest of the estate and tax plan. It's not so much a real strategy as it is a hope that things work out. And, it still leaves the advocacy and decision-making question unanswered.

Additionally, the long-term care market has gotten more complicated to navigate on your own. Pricing varies more than most people expect - a recent industry price index by AALTCI found that two people with nearly identical age and health profiles could see annual premium quotes differing by more than 50% depending on the insurer. Traditional standalone policies have also become less common, with more families now considering hybrid life insurance or annuity products that include a long-term care benefit. That complexity is exactly why "we'll figure it out with our assets" deserves the same scrutiny as any other part of your plan.

Why long-term care planning belongs in the same conversation as your estate and tax plans

In our experience, long-term care decisions rarely stay contained to long-term care. They touch your estate plan, your liquidity strategy, your tax picture, and the expectations your family has about who steps in and when. Treating it as a standalone insurance decision, disconnected from the rest of your plan, is exactly how families end up with gaps.

This is where a coordinated team matters more than a single policy. The right approach isn't just "get a policy" - it's understanding how a long-term care strategy fits alongside your investments, your estate documents, and the conversations you've already had, or haven't had, with your family.

Too often, long-term care planning tends to get pushed off because it doesn't feel urgent - until it very suddenly does. If it's been a while since this was part of your plan, or it's never come up at all, let's change that.

Reach out to your Entrust Wealth Partners advisor, or call us at (860) 838-3730, and we'll help you look at where you stand and what's worth adjusting.

This material was prepared by Growth Minded Strategy.

This material was created to provide accurate and reliable information on the subjects covered but should not be regarded as a complete analysis of these subjects. It is not intended to provide specific legal, tax or other professional advice. The services of an appropriate professional should be sought regarding your individual situation.