Medicare News and Healthcare Updates

What are the Chances That You’ll Need Long-Term Care?

by Alli Thomas

Aug 4, 2021

New research from Boston College’s Center for Retirement Research shows that not all retirees will require long-term care — especially those who are married, have at least some college education, and who are white.

According to the paper, there are three data measurements that can be used to assess which Americans over age 65 will require long-term care. These involve intensity of care, duration of care, and what the researchers call a two-dimensional matrix of the first two measures that determine whether the long-term support and services needed are minimal, moderate, or severe.

Researchers have categorized two types of daily activities:

  • Instrumental activities of daily living (or IADLs), which include shopping and household chores.
  • Activities of daily living (ADLs), which comprise everyday essential tasks, such as bathing, using the bathroom and eating.


Intensity of care: High, medium, and low

The paper identifies three kinds of seniors: those who need help with only IADLs, categorized as low intensity; those who need help with one ADL, which is considered medium intensity; and those who needs help with two or more ADLs (or who have dementia) – which are considered high intensity.

Seniors who are high intensity require more than twice the monthly hours of support from an informal caregiver than those who are low intensity.


Duration of care: Short, medium, and long-term

This one is largely self-explanatory. Short-term care lasts up to one year; medium-term lasts from one year to three years and long-term lasts over three years.


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Long-term services and support needs: Minimal, moderate, and severe

The authors of the study built a chart using the first two measures of long-term services and support intensity and duration to come up with the level of needs of such services.

Duration Intensity
Low Medium High
Up to 1 year Minimal Minimal Moderate
1-3 years Minimal Moderate Moderate
Over 3 years Minimal Severe Severe


The results

According to the study, the breakdown of long-term care needs in 65-year-olds are as follows:

No LTSS required at all: 20%

Minimal LTSS: 22%

Moderate LTSS: 38%

Severe LTSS: 25%


Further, married people are more likely than unmarried people to have no (or few) LTSS needs because they tend to be wealthier and have more support. Among college attendees and graduates, 22% are likely to have no or few LTSS needs, compared to only 9% of those who never graduated from high school. White people have fewer LTSS needs than both Hispanic and black people.

The report notes that those respondents who said they are in excellent or very good health at ages 65 to 70 have much fewer LTSS needs (or even none) than those in the same age range who merely reported their health as being “good,” “fair,” or “bad.”

The authors of the research will be releasing two more briefs in the future regarding caregiver and financial resources for those seniors who will require long-term care.

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Alli Thomas

Alli Thomas has worked in the financial services industry for nearly 20 years, with a focus on retirement-related investing. She began her career as a FINRA-licensed participant-services call-center associate at Vanguard, and then moved to Principal Financial Group, where she worked closely with employers, assisting with retirement plan set-up and design, selecting appropriate plan investment offerings, and maximizing employee participation through targeted education campaigns and enrollment meetings. Alli has also worked as a qualified 401(k) administrator and registered investment advisor for several small investment firms. She now writes about all things investment- and finance-related, leveraging her extensive experience and passion for retirement planning to help investors make well-informed financial decisions.

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