Older Adults Struggle to Afford Housing and Long-Term Care

Many older adults assume that if they can afford to stay in their homes, they will be able to manage their care needs as they age. In reality, housing costs and long-term care expenses often collide, creating financial pressure that few families anticipate. As care needs increase, many seniors find themselves struggling to afford both—forcing difficult choices about independence, safety, and stability.

This growing challenge is often referred to as the “dual burden” of housing and care. It reflects a reality where older adults may have a place to live, but not the financial flexibility to pay for the support they need to remain healthy and secure. As longevity increases and costs continue to rise, this issue is affecting more families every year.

The Growing Need for Long-Term Care

After years of managing daily tasks independently, it is easy to take those abilities for granted. Yet as people age, many will eventually need help with activities such as bathing, dressing, cooking, managing medications, or getting around safely.

Research consistently shows that nearly 70% of people age 65 and older will develop difficulty performing certain daily activities, requiring some level of long-term care support. For many, this need lasts several years, not just a short recovery period.

Long-term care services may include hands-on personal care, help with medical routines, or assistance with household tasks. These services often allow older adults to remain in their homes longer and delay or avoid nursing home placement.

The Dual Burden of Housing and Care

A recent study from Harvard University’s Joint Center for Housing Studies highlights how difficult it is for many older adults to afford long-term care once housing costs are paid. The study found that only a small percentage of older households can cover housing, basic living expenses, and paid daily care at the same time.

In households with at least one person age 75 or older, only about one-quarter could afford a single daily visit from a paid home health aide after accounting for housing and basic costs. This means that many families rely heavily on unpaid care from spouses, children, or friends.

In fact, unpaid caregivers provide roughly 70% of all care for older adults with significant needs. While family support is invaluable, it often comes with emotional, physical, and financial strain—especially when caregivers are themselves aging or working.

Affordability Gaps Across Households

The ability to manage housing and care costs varies widely depending on housing status and demographics.

Homeowners vs. Renters

Homeownership plays a significant role in affordability. Fewer than 10% of older renters can afford housing, basic expenses, and paid daily care, compared with roughly 30% of older homeowners. Without home equity or stable housing costs, renters often have fewer financial options.

Racial and Wealth Disparities

The study also highlights disparities across racial and ethnic groups. A smaller percentage of Black and Hispanic households are able to afford long-term care services compared with white households. These gaps are closely tied to long-standing wealth inequality and differences in homeownership and savings.

Why the Costs Are So Hard to Manage

Several factors contribute to the growing strain older adults face.

Rising Housing Costs

Millions of older adults now spend more than 30% of their income on housing. As the number of households headed by adults over age 80 increases, housing affordability challenges are expected to grow.

High Costs of Long-Term Care

The cost of care continues to rise. Annual expenses for part-time home care can approach $50,000, assisted living can exceed $70,000 per year, and nursing home care can cost well over $100,000 annually. These figures are difficult to sustain when layered on top of everyday living expenses.

Limited Insurance Coverage

Most health insurance, including Medicare, does not cover ongoing long-term care needs. Private long-term care insurance is relatively uncommon, and Medicaid home- and community-based services are limited in availability and capacity.

Increasing Care Needs With Age

Care needs tend to increase sharply after age 80, particularly for mobility, self-care, and cognitive support. This makes independent living more difficult without reliable assistance.

Persistent Wealth Inequality

Wealth disparities compound these challenges. Older renters generally have far less net worth than homeowners, and households of color often have significantly less wealth and home equity to draw upon when care needs arise.

Why This Matters for Families

When older adults cannot afford adequate care, difficult tradeoffs follow. Some may remain at home without sufficient support, risking safety and health. Others may enter institutional care sooner than desired. Family caregivers often step in, absorbing financial strain and emotional stress.

These challenges underscore the importance of planning ahead. While no plan can eliminate rising costs, thoughtful legal and financial planning can help families preserve options, coordinate care, and avoid last-minute decisions made under pressure.

Conclusion

The dual burden of housing and long-term care is a growing reality for older adults and their families. As costs rise and needs increase, planning becomes less about perfection and more about preparedness. Understanding the landscape early can help families protect stability, dignity, and choice as they age.

This information is general education and is not legal advice. You may need to speak with an attorney to understand how these issues apply to your specific situation.