A new national survey underscores a persistent disconnect between how Americans expect to age and how they are financing that future, a gap that wealth managers say represents a critical planning opportunity. The 2026 Planning & Progress Study from Northwestern Mutual, fielded by The Harris Poll among 4,375 U.S. adults in January 2026, found that 73% of respondents would choose in-home care over a nursing facility if a health event required long-term support. That preference is strongest among older cohorts: 83% of Boomers and the Silent Generation favor home care, versus 61% of Gen Z.
Yet the financial scaffolding to support that choice is largely missing. The study found that 54% of Americans have not financially planned for their own potential long-term care needs, and 60% have made no financial preparations for the possibility of caring for a loved one. This gap is particularly pronounced among younger generations, who are already stepping into caregiving roles at higher rates than their predecessors.
The advisor effect
The research reveals a sharp divergence between advised and unadvised households. Among those who work with a financial advisor, 66% have planned for their own long-term care and 58% for a loved one's care. In contrast, only 34% and 29% of those without an advisor have done the same. John Roberts, chief field officer at Northwestern Mutual, said in the company's Oct. 5, 2026 release that many Americans are unaware that Medicare generally does not cover long-term care services, a blind spot advisors can help uncover and integrate into a broader financial plan.
Advisors are increasingly being called on to address the intersection of health, longevity, and wealth management, a challenge that is becoming a defining issue for the next decade. The cost of long-term care is substantial and rising. According to the 2025 Northwestern Mutual Cost of Care Study, published in March 2026 by illumifin Corporation, the annual cost of a home health aide providing eight hours of daily care was $99,280 in 2025. If costs continue to climb at roughly 5% annually, that same level of care could exceed $500,000 per year by 2058.
That projection is not a distant hypothetical. Many clients in their 40s and 50s today could face those costs within their lifetimes, making long-term care planning a core component of retirement strategy rather than a niche add-on. Roberts emphasized that long-term care can be one of the largest and most personal expenses a family faces, affecting where people can age gracefully and the legacy they leave behind.
Younger generations already caregiving
The study also highlights the caregiving burden on younger adults. Twenty percent of Gen Z and 21% of Millennials currently identify as caregivers, compared with 15% of Gen X and 10% of Boomers. The financial impact is immediate: among current and former caregivers, 32% have reduced spending, 25% have dipped into personal savings or emergency funds, 21% have worked longer hours or taken a second job, and 20% have accumulated credit card debt to cover care-related costs.
Looking ahead, 66% of Gen Z and 67% of Millennials expect to provide long-term care for a loved one someday, yet financial preparation among these groups remains low. This represents a significant opportunity for advisors to initiate conversations with younger clients about caregiving costs and planning strategies. Roberts noted that while caregiving is a meaningful way to support loved ones, no one should have to sacrifice their own financial security to provide it.
The study reinforces a broader theme: long-term care planning should begin earlier, ideally in a client's 50s, before a health event forces the issue. With 61% of Americans believing they are likely to need long-term care at some point, yet more than half having taken no financial steps to prepare, the gap between expectation and action is where advisors can deliver the most value. For more on related retirement planning challenges, see estate planning gaps and fears about spending retirement savings. Additionally, retirement optimism versus financial health and household costs reshaping retirement saving offer further context.
