3 in 4 Americans prefer receiving long-term care at home

MILWAUKEE, October 7, 2025 – As people live longer, their likelihood of experiencing a long-term care event is increasing – and more than six in 10 (61%) U.S. adults predict that it will happen to them. Should that occur, a resounding 74% of Americans say they want to remain in their house and receive in-home care – while just 11% say they would prefer to live in a nursing home. These are the latest findings from Northwestern Mutual’s 2025 Planning & Progress Study, which examines Americans’ latest attitudes, behaviors and beliefs related to financial planning and financial security.

People want to stay at home

Long-term care is the assistance provided to someone who has a chronic condition that is progressive in nature, gets worse as time goes on and generally has no cure. Someone who needs long-term care requires help because they are unable to perform at least two activities of daily living, including eating, bathing or showering, getting dressed, using the bathroom and getting in and out of bed or a chair – or they need supervision for a cognitive impairment. Typically, long-term care does not include medical care or treatment of the underlying illness or injury.

According to Northwestern Mutual’s 2025 Planning & Progress Study, across all generations and genders, a vast majority of Americans (74%) would prefer to age gracefully at home if they experienced a long-term care event.

The results are remarkably consistent across race and incomes, too.

Most Americans expect to need care and be a caregiver

Nearly six in ten (59%) U.S. adults believe their retirement will last longer than their parents’ “golden years.” One-third (32%) expect 10 or more extra years in retirement than their parents – and among Boomers+, the proportion is even higher (43%).

Perhaps considering their extra longevity, most Americans (61%) say it’s likely that they’ll need long-term care services for themselves at some point. A similar proportion (58%) believe it’s likely they will need to provide these services for a loved one at some point in their life. According to data from the U.S. Department of the Treasury, they may be right: approximately half of Americans turning age 65 today will need some type of long-term care in their lives.

However, just 42% of Boomers+ and 35% of Gen X’ers say they have planned financially for the possibility that they’ll need long-term care for themselves – and less than one-third (32%) of both groups have planned for the possibility they will need to provide these services for a loved one.

“Long-term care is a common financial blind spot – something that individuals and families think they can deal with in the moment if it happens,” said Kamilah Williams-Kemp, Northwestern Mutual chief product officer. “The truth is this: long-term care events happen frequently, and if people plan proactively, they will have more good options for care to choose from. This is where a trusted financial advisor is absolutely critical, helping assess each person’s unique financial situation and creating a customized plan to help them navigate these complex decisions.”

Cost of at-home care could soar to a half-million dollars

Despite Americans’ wishes to remain at home, the cost of providing long-term care could make it very difficult. According to the 2024 Illumifin Cost of Care Study, the annual cost of a home health aide providing only eight hours of care per day is $96,360. If those costs hypothetically increase by just 5% over the coming years, potential out-of-pocket costs could exceed half a million dollars by the year 2058 – a time when many of today’s working adults may need care.

Many people also think that the costs of long-term care will be completely covered by health insurance or Medicare—but they're typically not. Medicare pays for doctors, hospitals, medication and short-term rehab after hospitalization—but not for independent or assisted living.

“Planning ahead for long-term care can help people age gracefully according to their wishes, protect loved ones from having to make difficult decisions, and safeguard the legacy they hope to leave behind,” said Williams-Kemp. "That’s why a comprehensive financial plan is so critical. A holistic plan combining risk products with investments can help people create wealth, protect what they’ve already built, and achieve their greatest goals in life.”

To see what care costs are and how much they’re projected to change over time for your area and across the country, visit https://www.whatcarecosts.com/NorthwesternMutual.

The impact on caregivers if plans are not fully funded

About half of Americans have been a caregiver at some point in their life. Two in ten Americans (20%) say they are currently providing care – including 28% of Gen Z and 27% of Millennials. Meanwhile, almost three in ten Americans (28%) say they have provided care for someone in the past.

These opportunities to support a loved one in a significant time of need often come with a cost. Caregivers report having to cut back on spending, raid their personal savings, work more than expected, accumulate more debt, or even pull from their retirement funds.

“Caregiving is one of the most selfless acts – but it can take an emotional, physical and financial toll,” said Williams-Kemp. “Through proactive planning, people can shield their loved ones from having to shoulder the full financial weight of a long-term care event. Done well, proactive planning can help to free families from financial anxiety and enable them to focus their attention on their loved ones.”

About the 2025 Northwestern Mutual Planning & Progress Study

The 2025 Planning & Progress Study was conducted by The Harris Poll on behalf of Northwestern Mutual among 4,626 U.S. adults aged 18 or older. The survey was conducted online between January 2 and January 19, 2025. Data are weighted where necessary by age, gender, race/ethnicity, region, education, marital status, household size, household income, and propensity to be online to bring them in line with their actual proportions in the population. A complete survey methodology is available.