“If I’d known I was going to live this long, I would have taken better care of myself.”
— Attributed to 70-year-old editorial columnist Billy Noonan

This old joke has been used by many over the years, including composer Eubie Blake, baseball legend Mickey Mantle, Hollywood producer Adolph Zukor and others.

Regardless of who first said it, it can hit close to home as we age. Planning for the future and adapting to unexpected health or memory changes comes with the territory and can give you and your family a lot to think about.

Sadly, many folks prefer not to deal with this topic. Over the years, I had good clients/friends actually yell at me for bringing it up.

But back then, and now, I feel it’s my responsibility to talk about “what-if” planning. I’m hoping you’ll take the time to read this, and talk about it with your family/friends.

Just three years ago, the first baby-boomers (born from 1946-1964) started turning 75, and every boomer will be 65 or older by 2030.

Fortunately, baby-boomers are arguably the healthiest — and wealthiest — generation in history.

Increasing life expectancy has made it likely that boomers will spend more time in retirement than their parents did.

Many of the roughly 73 million boomers are still physically active, playing tennis, golf, pickleball, biking, hiking, etc. So, as the bartender said to the horse at the bar, “why the long face”?

Well, those potential long years in retirement come with two big issues:

• How to fund spending needs that could last 10, 20, 30 years or more
• The potential need for help with daily living due to declining physical and/or mental health

My previous columns have discussed funding retirement income needs, with perhaps more down the road. So, this column will deal with issues surrounding the potential need for long-term care.

What kinds of issues create the need for long-term care? People can need help to function in daily life.

Medicare defines the Activities of Daily Living (ADLs) to include bathing, dressing, getting in and out of bed or a chair, walking, using the toilet and eating.

It can also include managing finances, handling transportation, shopping, doing laundry, preparing meals, household and basic home maintenance, using the telephone and computer, etc.

Being unable to perform these tasks will leave you needing help.  

What if you or your spouse/partner need some type of help with the activities of daily life? Of course, this couldn’t happen to you, right?

But just in case, let’s look at some statistics. I chose a 2023 Morningstar study because it appears to provide objective data not a “sales pitch.”

According to Morningstar:

• 70% of people turning age 65 will develop a severe long-term care need in their lifetimes
• 48% of people turning age 65 will need some type of paid long-term care services in their lifetimes
• 24% of people turning age 65 will require paid long-term care for more than two years
• 15% of people turning age 65 will spend more than two years in a nursing home
• 3.7 years is the average duration of long-term care needed by women, it’s 2.2 years on average for men
• 67.9% of people staying in long-stay nursing facilities are women

Most folks would like to “age in place” to stay in their homes. Home- and community-based services can provide services and support that help older adults to do just that.

But while the majority of people would prefer to age in place in their own homes, this isn’t always feasible for safety and/or financial reasons.

And caring for someone in their own home can be the most expensive option, especially if 24/7 care is needed.

Alternatives include independent retirement housing, assisted living, skilled nursing and continuing care retirement communities.

Adult day programs can be a great choice for families who choose to keep a loved one at home, providing life enrichment, social engagement and a respite for family caregivers.

The Morningstar statistics show that Alzheimer’s or other forms of dementia are a leading cause of the need for long-term care, with nearly half of nursing home residents having this diagnosis.

And the study noted an average life expectancy of 5.8 years following an Alzheimer’s diagnosis.

Then there is the cost of care. Morningstar estimated the lifetime cost of home-based care for someone with dementia is $321,000, or $195,000 for someone with dementia living in a nursing home.

The median annual cost for an assisted living facility in 2021 was $54,000; the median annual cost for adult day care (five days per week) was $20,000; and the median annual nursing home cost was $108,000.

Bottom line: These potential costs can be significant. 

Costs of this magnitude should clearly be considered in retirement planning. Vanguard offers an online cost estimator.

I ran an example for a 70-year-old male who is in excellent health. It shows expected annual Medicare costs of $11,000 and long-term care costs of $120,000 (75th percentile), $337,000 (90th percentile) and $510,000 (95th percentile).

Of course, you may be lucky enough not to have any long-term care costs, but costs could also be higher than these projections, too.

It would be wise to plug these kinds of estimated costs into your financial projections.

A couple more words of advice I’ve given to clients over the many years:

Long-Term Facilities

Check out long-term care facilities before you need one. It’s kind of like having a parachute on — it’s a little too late when the plane starts going down. I know this sounds morbid, but it is sensible advice.

You can look at options firsthand to see which ones you like more than others (not necessarily which ones you absolutely love).

And because it can take up to five years or longer to actually get into a place, get on a waiting list now. For many facilities, when you get to the top of the list, you can delay if you’re not ready to move-in but still stay next-in-line for the next opening if/when you’re ready.

With the growing number of baby-boomers who will likely need long-term care, you can think of this as “insurance,” hoping you won’t need it but having options if you do.

On a personal note, I had to work hard to convince my wife to do this, but we did, and have a “Plan B” just in case.

Professional Advice

Get advice from professionals. This would include your estate attorney to make sure plans are in good order, your financial adviser to see how secure your retirement looks with these potential costs, your doctor regularly to stay on-top of health issues, and even consulting firms that specialize in elder care/long-term care issues.

A good source for expert consulting help for you, or a family member/friend, is the Aging Life Care Association.

Aging is just part of life. It seems smart to enjoy each and every day, hoping for the best life has to offer while planning for what just might be ahead.