You planned for everything. Except this. Discover what long-term care can do to even the best-designed estate.
Teri had done everything right.
Her estate plan was meticulous. She had worked closely with her advisors to build a multi-generational strategy: trusts, tax optimization, charitable intent, carefully managed liquidity. Everything was in order.
Until it wasn’t.
A stroke changed the trajectory of her retirement, and while she survived, her recovery was incomplete. She needed daily support, first at home then in a private care facility.
And just like that, the plan everyone thought was “done” was back on the table.
Her adult children, acting with care and urgency, began making decisions they never anticipated:
These weren’t financial problems in the traditional sense. They were planning gaps that created tension, uncertainty, and unexpected trade-offs.
On paper, Teri’s estate plan covered all the major points: taxes, transfers, succession, legacy. It had all the elements of a well-constructed high-net-worth strategy.
But what it didn’t account for was care.
Among wealthy households, long-term care planning is often assumed rather than modeled. It’s viewed as a personal or logistical issue, not a financial or strategic one. And yet, few things can derail a well-structured estate faster or more quietly than the need for prolonged care.
In 2024, the average cost of 24/7 in-home care surpassed $77,000 per year.1 A private nursing home room? More than $127,000.1 These aren’t extreme cases—they’re national averages, and they continue to rise faster than most inflation benchmarks.
And those rising costs aren’t just theoretical. They’re relevant for the majority of older Americans: about 70% of individuals turning 65 today will require some form of long-term care.2 Meanwhile, more than 20% of those individuals will need care for five years or longer.2
Yet, despite the likelihood and cost, care often remains the least-defined part of an otherwise well-structured wealth plan.
When care does become part of the picture, the impact is rarely isolated to a single line item. It affects how assets are used, how decisions are made, and how families experience the planning you’ve put in place.
For example:
And in the background, the original intent of the plan (whether it was to protect a business, pass along specific assets, or support a charitable cause) starts to blur.
The truth is, the most meaningful plans aren’t just technically sound. They’re human. They prepare for the emotional complexity of life, not just the tax consequences of death.
So, what can be done to protect a well-designed estate plan from being compromised by unplanned care needs?
For many high-net-worth households, the answer lies in building structure around the uncertainty. That may include setting aside dedicated liquidity, clearly documenting care preferences, or—in some cases—incorporating long-term care insurance (LTCI) as part of the overall strategy.
Today’s LTCI options are more flexible than ever. They’ve evolved well beyond traditional “use it or lose it” policies. When used strategically, LTCI can:
It can also play an important role in protecting the financial security of a surviving spouse. In many high-net-worth households, one partner often sees themselves as the family’s financial steward: the person who ensures everything is planned for and protected. If that person experiences a long-term care event, the cost of care can rapidly draw down shared assets or force liquidity decisions that affect the other spouse’s lifestyle and long-term security.
LTCI creates a dedicated pool of funds, preserving the remaining estate and shielding a spouse from having to make difficult trade-offs in an already challenging time. Therefore, for many couples, this isn’t just a funding strategy. It can be an act of protection.
However, it’s important to note that LTCI isn’t a one-size-fits-all solution and shouldn’t be treated as one. It's a potential planning tool, not a mandate.
For other well-off families, self-insuring may be the more appropriate path.
Some clients prefer the flexibility of modeling care scenarios using internal capital. Others may be philosophically opposed to transferring risk they feel they can comfortably manage. In either case, self-funding can be just as strategic as using insurance when planned intentionally.
The key is not whether care is insured, but whether it's addressed. Without a plan—be it through insurance, self-funding, or a combination—families are left to improvise, often at the exact moment when clarity is most needed.
Teri’s family had the financial means to support her. But the process of making care decisions without clear guidance left a lasting impact. Not just on their finances, but on their confidence in the plan she’d worked so hard to build.
And that’s the part many people overlook.
The real cost of unplanned care isn’t always measured in dollars. It’s measured in doubt, in second-guessing, and in the slow unraveling of a strategy that once felt complete. Without a clear care component, even the most well-structured estate can leave families wondering, What would she have wanted? Are we doing the right thing?
Estate planning is about more than distributing assets. It’s about protecting clarity. It’s about giving your family the tools, not just the funds, to make decisions with confidence.
That’s why care deserves to be part of the conversation. And like most planning decisions, timing matters. When you address these questions early and before options narrow and emotions rise, you preserve flexibility. You stay in control.
Whether your path involves long-term care insurance, self-funding, or a hybrid approach, the goal should be the same: to make your plan resilient. To ensure it holds up under pressure. And to give your family the peace of mind that everything—the finances, the logistics, and the intent—is already in place.
If your current strategy hasn’t yet addressed long-term care, our in-house team can help you explore your options and create a plan that fits seamlessly into your broader estate and wealth strategy. Thoughtfully. Strategically. And with a clear understanding of what matters most.
1 https://www.businesswire.com/news/home/20250301584443/en/Genworth-and-CareScout-Release-Cost-of-Care-Survey-Results-for-2024
2 https://www.aplaceformom.com/senior-living-data/articles/long-term-care-statistics
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