The trend has left many families facing difficult choices between paying for care, relying on unpaid relatives, or exhausting lifetime savings before qualifying for public assistance. The issue is affecting both those receiving care and the family members who often step in to fill the gaps.
Older adults who require ongoing assistance frequently prefer to remain in their homes rather than move into institutional settings. According to the AARP Public Policy Institute, that preference has become increasingly difficult to afford as the private-pay cost of long-term services and supports has climbed sharply since 2019.
Long-Term Care Costs Are Rising Faster Than Many Retirees’ Incomes
The financial challenges facing older Americans are illustrated by Ken and Ronnie Sternfeld, a retired New York couple featured by CBS News. Ken Sternfeld, a 71-year-old former pharmacist who uses a wheelchair, and his wife both have significant medical needs and receive approximately 10 hours of in-home assistance each day, including meal preparation and household support.
Ken Sternfeld told CBS News that obtaining coverage required roughly a year and a half of applications, denials, appeals, and hearings before the couple gained access to Medicaid. Before qualifying, they said they spent their retirement savings and other financial resources paying for care themselves. Today, they say Social Security is their only source of income, covering rent with little remaining for other expenses.
According to the AARP Public Policy Institute, the private-pay cost of home health care and assisted living increased by nearly 50% between 2019 and 2024. During the same period, adult day services rose by 33%, while nursing home costs increased between 23% and 25%. Median income for households headed by someone age 65 or older increased by 22%, leaving home and community-based care substantially less affordable than it had been earlier in the decade.
The report also found considerable differences among states, with the cost of every category of long-term care reaching at least twice as much in the most expensive states as in the least expensive ones.
Families Are Filling the Gaps as Demand for Care Grows
The rising cost of care is affecting not only older adults but also relatives who increasingly provide unpaid assistance. According to CBS News, AARP estimates that family caregivers delivered nearly 50 billion hours of unpaid care during 2024, work valued at more than $1 trillion.
AARP President Dr. Myechia Minter-Jordan said many caregivers are balancing full-time employment while simultaneously caring for family members, describing the situation as unsustainable for many households. She also said families are often forced into one of two paths: going without needed care or piecing together services while steadily depleting their savings.
According to the U.S. Department of Health and Human Services, nearly 70% of Americans will require some form of long-term care after turning 65. CBS News also reported that AARP has advocated for a family caregiver tax credit for about a decade, although the proposal remains stalled.
Despite the financial strain, the Sternfelds told CBS News they are trying to focus on daily life rather than the uncertainty ahead. Reflecting on his circumstances, Ken Sternfeld said he believes each day is an opportunity to make life better for someone else.
