Most Americans approaching retirement age are more anxious about lacking a support network during long-term care than about the associated costs, according to a new survey from the Nationwide Retirement Institute. The 2026 Long-Term Care Survey, conducted by The Harris Poll among 1,208 adults aged 30 and older, found that 84% of respondents would be worried about having no one to advocate for them if they faced care needs alone.
By comparison, 71% said they would be concerned about affording care, while 81% cited fears about a lack of help coordinating care and receiving lower-quality services. The findings suggest that financial advisors may need to address emotional and logistical planning alongside traditional retirement savings strategies.
“Americans are realizing that long-term care planning is about far more than finances,” said Holly Snyder, president of Nationwide’s life insurance business. “People want to age with dignity, maintain their independence and know someone they trust will be there to help make decisions on their behalf. The challenge is that many families haven’t had those conversations or made those plans.”
Nearly three-quarters of respondents said they would prefer to receive care at home or at a family member’s home, with partners (50%) and children (40%) topping the list of expected caregivers. However, only 37% of those favoring home-based care have set up a savings or investment plan to cover future costs. Fewer than three in ten have identified potential caregivers, and less than a quarter have made home modifications to support aging in place.
The survey also highlighted the financial toll on current caregivers, who reported spending an average of 22 hours per week providing care and absorbing roughly $382 per month in out-of-pocket expenses. For those serving as primary decision-makers, that figure climbs to $445 per month. These costs can strain retirement savings, especially as many Americans already worry about Social Security insolvency and outliving their assets.
Generational pressure is particularly acute for Millennials: nearly three-quarters said they would be willing to draw from their retirement savings to care for a family member, while close to six in ten worry that caregiving costs will prevent them from ever retiring. This aligns with broader concerns about outliving savings that many retirees already face.
Caregiving experience appears to sharpen planning instincts. Those who have served as caregivers are more likely to consider themselves knowledgeable about long-term care (82% vs. 59% for non-caregivers), more likely to have identified future caregivers (34% vs. 20%), and more likely to have built a savings plan for their own future care needs (40% vs. 31%).
Working with a financial advisor also makes a measurable difference. Clients with an advisor are significantly more likely to feel informed about long-term care (84% vs. 62%) and to have discussed care costs with family members (72% vs. 51%) compared to those without one. Advisors may want to incorporate these conversations into retirement planning, especially as the RIA M&A pipeline grows and more advisors focus on holistic wealth management.
“Too often, families wait until a health event or caregiving crisis forces these conversations,” Snyder said. “Having a plan in place can help people protect their finances, reduce stress on loved ones and create more confidence about how they want to age and receive care. Whether that means preparing financially, documenting care preferences or identifying who can step in as an advocate, taking action earlier can make a meaningful difference for families navigating LTC decisions.”
