Why can't seniors afford long-term care?

AISHA ADKINS' MOTHER ROSETTA WAS ADAMANT THAT she wanted to age at home. So when Rosetta's dementia started worsening at age 59, Aisha started looking around for options.

- BY ALANA SEMUELS

She quickly found that round-the-clock at-home care was extremely costly, and that her mother didn't qualify for government assistance because of her father's income. Stuck in the middle, Aisha, who was 29 at the time, ended up quitting her job to take care of her mother herself until Rosetta qualified for Medicaid through a complicated process called spousal impoverishment protection, which allowed her father to keep some assets.

“It was really a struggle,” says Adkins. She cared for her mother for a decade until Rosetta’s death in 2023.

As the U.S. population ages, more families are facing the same challenges. Long-term care, which is assistance with the activities of daily living either in a person's home or in a facility, is expensive. Most people pay for it either out of their savings or by spending down those savings until they qualify for Medicaid, the government payer of last resort, which is for low-income seniors or people who have spent down their savings. (Medicare does not cover senior housing or long-term care.)