Long-term care has quickly become one of the greatest financial and emotional pressures facing American families. Rising costs, longer life expectancy, and limited insurance coverage have created a situation few retirees are prepared for. On today’s episode of Faith and Finance, Harlan Accola joins us to explore this issue. He leads the reverse mortgage team at Movement Mortgage and works closely with families navigating long-term care decisions.
Accola describes long-term care as “the elephant in the room.” As Baby Boomers age and care needs rise, families are trying to balance support for aging parents with raising children and managing their own financial responsibilities. Many households avoid discussing care needs until a crisis forces difficult decisions.
The numbers reveal why planning is essential. Studies estimate that between 50% and 70% of retirees will require some level of long-term care during their lives. Yet more than 90% of those individuals have not purchased long-term care insurance—and many assume Medicare will cover the cost of nursing or assisted living facilities. In reality, Medicare provides limited short-term rehabilitation benefits, while long-term care typically falls under Medicaid, which only applies once a person has depleted most of their financial assets.
Costs vary widely by region, but nursing facilities can range from $80,000 to $120,000 per year, and in-home care providers may charge $30–$40 per hour. Just one or two years of intensive care can rapidly deplete savings intended to last decades in retirement.
One of the most overlooked financial risks is the well-being of the surviving spouse. Accola notes that husbands often require extensive care first, and the assets used to pay for their care can leave their wives financially vulnerable after their passing. Without adequate planning, the surviving spouse may face an underfunded retirement and fewer choices for her own care needs.
To address this gap, families are encouraged to expand their planning tools. One strategy Accola highlights is to tap housing wealth through reverse mortgages. Because many retirees have significant equity tied up in their homes, a reverse mortgage can unlock funds without requiring monthly payments. These tax-free dollars can be used to pay for in-home care, cover long-term care insurance premiums, or bridge the gap between retirement income and care costs. It also allows individuals to remain at home longer—often delaying or avoiding the need for costly facility care—and preserves retirement accounts for the surviving spouse.
Accola emphasizes that reverse mortgages are not a universal solution, but they should be included in the suite of planning options that families evaluate, alongside insurance, savings strategies, and Medicaid planning. Far too many households ignore the issue entirely or assume Medicare will handle it.
As long-term care needs continue to rise, proactive planning is no longer optional. Exploring the full range of financial tools available can reduce stress, protect surviving spouses, and provide dignity and stability during the later stages of life.
On Today’s Program, Rob Answers Listener Questions:
- I’m 66 and plan to retire at 70. I can take full Social Security at 66 and 10 months. Should I start benefits now while continuing to work full-time, or wait? If I take it now, should I place the funds in an IUL, an IBC strategy, or invest through my Edward Jones account?
- I’ve borrowed from my 401(k) several times over the past decade and paid myself interest. Since I hate paying interest on loans like auto loans, is borrowing from my 401(k) a better option than t
