Are Americans financially prepared to age where and how they want?

Although most Americans want to age at home, many lack the financial resources to pay for long-term care — and their family members may be equally unprepared for the financial and caregiving burdens that can follow.

According to Northwestern Mutual's 2026 Planning & Progress Study, nearly three-quarters of Americans (73%) say they would prefer to receive in-home care if a health event required long-term support. More than half (54%) of Americans, however, haven’t planned financially for their own potential long-term care needs, and 60% haven’t planned for the possibility of caring for a loved one.

The preference to receive care at home grows with age: 83% of boomers and 78% of Gen X would choose in-home care, compared with 67% of millennials and 61% of Gen Z.

“The most significant finding is the disconnect between what people want for the future and how they’ve prepared for it,” said Dan Schiffman, founder and wealth management advisor, at Capital River Wealth Management, a Northwestern Mutual office.

Schiffman’s family is currently dealing with this situation with his aging mother.

“I can say that even with prior planning, it’s tough to describe how impactful this situation can be, both financially and emotionally," he said.

Most expect needing long-term care

The study revealed that 61% of Americans say they are likely to need long-term care, and 56% expect to provide it for a loved one. Younger adults are especially likely to foresee caregiving responsibilities: 67% of Gen Z and 66% of millennials say they will likely provide long-term care for someone they love.

Despite knowing they may need care or to be a caregiver, the majority have not put a financial plan in place. Fifty-four percent of Americans have not planned financially for their own potential long-term care needs, and 60% have not planned for the possibility of caring for a loved one.

“It’s about acknowledgment, identification and then action,” Schiffman said. He recommends starting with a plan looking at things like who can provide care, whether paid or unpaid, what changes will be needed to make the home safe, how needs could change over time, and what the financial costs are.

“You also need to plan for what’s next as needs will evolve over time,” he adds. “Even when looking at at-home care, you need to evaluate what that will look like. Will the person need help eight hours a day or just a few hours a day. Will someone need skilled nursing help or help with household chores. All these will impact the cost.”

Financial professionals can help

The study found that Americans who work with a financial advisor are substantially more likely to report planning for long-term care needs: 66% have planned for their own care and 58% for a loved one, compared to 34% and 29% respectively among those who do not have an advisor.

“A financial advisor can help with identifying financially and emotionally viable options,” Schiffman said. “They can help with both the quantifiable things like costs, but also can facilitate the conversation around things like what role people will play in the care plan.”

Having been an advisor for several decades, Schiffman finds this is a bigger topic of conversation than when he first started in the industry.

“Long-term care planning can have a significant financial impact, as well as impacting the family members. If people can work on the financial part with a financial advisor, it can make it a lot less scary,” he said. “Preference on its own is not a plan.”

Schiffman noted that talking about potential long-term care needs tends to be a tough conversation, particularly if done in a vacuum.

“It should really be part of an overall plan. If it’s part of an overall retirement plan, it makes the conversation easier,” he said.

Schiffman also recommends planning early and modeling different scenarios, such as at-home care versus in a skilled nursing facility.

“You need to look at the financial, emotional impacts as well as the available support networks,” he said.

Caregivers may face financial struggles

Thirty-nine percent of Americans say they currently provide care or have done so in the past. Among current and former caregivers, nearly seven in 10 (69%) have taken at least one step to absorb the financial impact.

For many families, the financial strain is already here. Nearly 7 in 10 current or former caregivers have taken at least one step to address the financial impact of caregiving,

Nearly one-third (32%) of current/former caregivers have reduced spending, one in four (25%) have drawn from personal savings or emergency funds and one in five (21%) have worked longer hours or taken on a second job.

Schiffman said it’s important for family members to have conversations about long-term care needs before the care is needed.

“It’s better to negotiate from a position of strength versus weakness,” he said. It’s important to ask questions like: ‘Who can help with financial decisions? Who should be involved in the care plan? Who will be the decision maker? Who is closest in terms of location?’”

“Planning should involve identification of financial and emotional solutions and getting them in place before the needs arise."

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Brooke E. Lacey has more than 20 years of experience writing about the financial services industry. Contact her at brooke.lacey@innfeedback.com