08/20/2025
NO ONE WANTS TO GO TO A NURSING HOME!!
I always ask my clients, “Would you rather have your wife/daughter/son give you a sponge bath and dress you, or pick up the phone to make sure the home health aide is scheduled for the week?
The vast majority of LTC services — even in nursing homes — are “custodial care,” which is help with daily activities like bathing and dressing, or supervision because of a cognitive impairment. This type of care can be provided at home in many, if not most, cases. The downside, unfortunately, is that in the absence of a formal care plan, the vast majority of these services are provided by informal, unpaid caregivers — almost always family members. And while the financial impact is a concern, it’s not the biggest concern. Much more important are the physical and emotional consequences to their loved ones.
There are roughly 1.2 million people in nursing homes in the U.S., but more than 6 million receive care at home. Did you know that, as of May 2024, home health and personal care aides made up the largest single occupation in the U.S., with 4 million workers?
Be sure your estate planning or elder law attorney knows your wishes, and helps you with any legal maneuvering, such as advance directives, healthcare, and financial powers of attorney, etc. A change in health may leave you unable to do this.
Endnotes
1. 1 https://www.statista.com/statistics/1168843/number-residents-certified-nursing-facilities-state/
2 https://www.kff.org/medicaid/issue-brief/10-things-about-long-term-services-and-supports-ltss/
3. OEWS Chart
4. The Retirement Outlook of the American Middle Class | 24th Annual Transamerica Retirement Survey 2024
5. Advisor's Perspective 8.13.25