Everything You Didn't Want To Know About Long Term Care, But Probably Should!
If you’re like me, you’re looking at the title and thinking “what does that even mean?” Long Term Care is the industry term dealing with care for older Americans. I guess it’s the most concise term that isn’t possibly offensive. Elderly Care sounds too clinical to me and the word “elderly” offends most folks that it would apply to. Older Ages Non-Medical Assistance seems way too long. I guess Long Term Care is acceptable.
Long Term Care involves all levels of assistance we will all likely need in our later years. And over the last forty years or so, we’ve come a long way in the levels of care.
Back in the late 70s, when my great-grandfather was in his late 80’s, there were literally the only two choices: He sat in a rocking chair until he couldn’t anymore. Then he was moved to a nursing home.
But today? The landscape is very different. And it’s confusing.
That’s why I wanted to write this, not as a checklist, but as a guide to how elder care really works in 2025. If you’re helping aging parents or thinking about your own future (even if you’re only in your 50s), this is for you.
Level 1: Home Care (The DIY Start Line)
Home care isn’t just medical aides and visiting nurses. It starts with basic stuff; housecleaning, meal delivery, and light companionship. If you’ve got someone coming in to vacuum, help you cook, or drive you to appointments, that’s home care.
And it can scale up. You can hire professional caregivers. You can even get skilled nurses to come to your home. But it gets expensive fast:
💰 Expect $100–$300 for a 4-8 hour shift. That’s $36K–$100K per year.
💡 Most providers require a four-hour minimum per visit.
Still, for a lot of folks, this is the most comfortable and least disruptive path, especially if you build in support before things get critical.
Level 2: Senior Living (Freedom with a Safety Net)
This is an option most people don’t consider until they’ve exhausted themselves trying to keep up. I’m watching my own parents explore this right now.
Senior living is not a nursing home. It isn’t even Assisted Living (more on that soon). Think of it like a condo with food, activities, and a little extra watchfulness. You keep your independence, but the key difference is this: someone’s always nearby.
- You get meals, fitness centers, trips, events, and social connections.
- Some places offer multiple restaurants instead of cafeterias.
- You still drive your own car, come and go as you please.
💰 Expect to pay $5,000–$10,000/month
🔁 Some require big upfront buy-ins ($300K+), read the fine print!
What senior living really buys you is time. It delays the need for more intensive care by helping you stay active, fed, and engaged.
Level 3: Assisted Living (Help Where You Need It)
Remember Green Grove from The Sopranos? Despite Tony’s mom’s insistence, it was NOT a nursing home. (“It’s a retirement community” Tony would scream.)
Assisted living is for people who need help with daily tasks: getting dressed, bathing, remembering meds, etc. You still have your own space, but there’s help on hand for the stuff that’s becoming too difficult.
💰 Typically $8,000–$13,000/month
👥 You can pay more for more care up to $20K+ in some cases
For people with dementia or cognitive issues, there are special memory care units designed to keep them safe without stripping away dignity but costs rise quickly.
Level 4: Nursing Homes (Full-Time Medical + Custodial Care)
This is the level everyone dreads. But the truth is, nursing homes serve a vital role for those who truly need round-the-clock medical and physical care.
Think bedridden, limited mobility, or major health complications. It’s not glamorous, and it’s definitely not cheap.
💰 $12,000–$16,000/month or more
❗ Medicaid will only cover this level, not assisted living, not home care
So many options. While this brings us flexibility, it can be overwhelming. Here are 4 tips to help you plan for your future needs, whatever they may be:
- Medicaid isn’t the safety net you think it is.
It only covers nursing homes, and qualifying can force you to spend down assets in ways that might bankrupt your spouse. - Long-term care costs real money.
Don’t assume you’ll “figure it out later.” The earlier you start planning, the more control you’ll have over your options. - You can’t plan everything.
Medical needs will dictate care. Be open to flexibility. - Ask yourself: Is your goal to preserve money for your kids or to get the best care for yourself?
There’s no wrong answer. But you do need to be clear on what you value most. Are your assets for you first, with whatever’s left for your children or are you willing to accept a lesser quality of life in order to preserve a legacy for the next generation?
Need help thinking this through?
This is one of the biggest financial and emotional planning conversations you’ll ever have. And I’ve been guiding families through it for 30+ years. For more details and insight, check out our recent podcast on this topic:
🎧Listen on Apple Podcasts: LINK
🔊Stream on Spotify: LINK
📺Watch on YouTube: YT LINK