Long-term care is no longer a “someday” concern — it is an immediate financial, legal, and emotional challenge for families across North Carolina and South Carolina. Yet few people are truly prepared for what these costs can mean for their independence, savings, and legacy.
According to the U.S. Department of Health and Human Services, 70% of Americans over age 65 will require some form of long-term care in their lifetime. The Alzheimer’s Association further reports that 1 in 3 seniors dies with Alzheimer’s or another form of dementia, while the Family Caregiver Alliance estimates that another third will need functional assistance with three or more activities of daily living.
Behind every statistic is a family making difficult choices —
how to afford care, how to protect what has been built,
and how to preserve dignity along the way.
The Rising Cost of Care
The cost of long-term care can exceed $90,000 per year and prices continue to rise. Home health aides now cost $30–$45 per hour. Over time, even modest care needs can drain retirement savings faster than most families expect. Without a plan in place, the financial impact can be devastating, eroding both security and peace of mind.
Why Waiting Costs More
Early action gives families flexibility, time, and peace of mind. However, every month you delay planning, the options narrow and the risks grow:
- Insurance premiums increase with age and health conditions.
- Asset transfers made too close to Medicaid applications can trigger costly penalties.
- Cognitive decline can eliminate the ability to sign new legal documents or make critical decisions.
A proactive legal plan not only preserves options —
it protects dignity, independence, and can reduce family conflict.
Misconceptions
One of the greatest misunderstandings is believing that Medicare will pay for long-term care. In reality, Medicare only covers short-term rehabilitation following a qualifying hospital stay. It does not cover ongoing personal care such as bathing, dressing, or assistance with eating. Medicaid, the joint federal and state program for those with limited income and assets, is the primary government program that applies to cover ongoing care. However, qualifying for Medicaid in either requires meeting strict financial eligibility limits. An individual may retain no more than $2,000 in countable assets. Without careful planning, families often spend down savings, sell property, or cash in investments to qualify for Medicaid — leaving little or nothing to pass on to loved ones.
4 Steps Families Can Take Now
The good news? Thoughtful, proactive legal estate planning can prevent these outcomes and ensure that care decisions reflect the elder’s own wishes, not the family’s panic.
- Develop a Comprehensive Legal Framework
- Durable Power of Attorney – Grants a trusted person authority to manage finances if the elder becomes incapacitated.
- Healthcare Power of Attorney & Advance Directive – Clearly defines who can make medical decisions and what treatments align with the elder’s values.
- Revocable Living Trust – Avoids probate and allows ongoing management of assets with transparency and oversight.
- Irrevocable Trust – A tool that can preserve family assets while positioning a client to qualify for Medicaid later, if care is needed. These trusts allow elders to retain income and control over certain assets while protecting the principal from being counted toward Medicaid eligibility after the five-year lookback period. These trusts can mean the difference between losing a lifetime of savings to care costs — or preserving a home and inheritance for the next generation.
Together, these strategies create a smoother transition for families and ensure continuity for theirs.
2. Explore Long-Term Care Insurance and Hybrid Options
Traditional long-term care insurance remains an effective tool, but premiums increase significantly with age. Many families are turning to hybrid solutions, such as life insurance or annuities with long-term care riders. These provide flexibility — paying for care if needed, or passing remaining value to heirs if not.
3. Include Care Coordination in the Plan
Legal planning should go hand in hand with care advocacy and coordination. Partnering with elder care coordinators, geriatric care managers, or social workers can help families identify quality care options, navigate facility admissions, and monitor ongoing care and prevent neglect or exploitation.
4. Prepare for Cognitive and Functional Decline
Families should discuss how cognitive decline or dementia might change daily life. Who will manage bills? Who will monitor caregivers or financial accounts? By planning for how incapacity will be handled, families protect not only assets — but relationships. For entrepreneurs, a business succession plan is vital to maintain operations if the owner becomes incapacitated. Identifying successors, creating buy-sell agreements, and aligning the business plan with the estate plan ensures the company’s stability and reduces conflict among family members and partners. Incorporating life and disability insurance can also provide needed liquidity for estate taxes or ownership buyouts.
Together, these legal tools create continuity, protect family relationships, and safeguard the legacy of a lifetime’s work.
Comprehensive Long-Term Care Planning
Long-term care planning is best approached holistically. In Genesis, Joseph’s foresight during seven years of abundance prepared Egypt for seven years of famine — a lasting example of stewardship and faithfulness. By storing grain during times of plenty, Joseph ensured that Egypt, his family, and neighboring nations were sustained when hardship came. His preparation was not driven by fear, but by faith.
That same principle applies today. Thoughtful long-term care planning reflects faith-filled wisdom — preserving dignity, protecting what God has entrusted to us, and easing the burden on those we love. Like Joseph, we can prepare out of faithfulness, not anxiety, by valuing prudent stewardship of resources with legal planning.
Taking the Next Step
Every family deserves peace of mind about the future. The right legal plan ensures that your wishes are honored, your resources are protected, and your loved ones are supported. While delaying action often limits options — early planning opens doors for creative, protective strategies that preserve flexibility and independence.
Proverbs 21:20 reminds us, “The wise store up choice food and olive oil, but fools gulp theirs down.”
If you have questions about how to begin, schedule a consultation today to review your options and take the next step toward a future built on wisdom, preparation, and peace. Planning ahead is not about expecting the worst — it is about creating stability and confidence for whatever life may bring. With the right legal framework, you can focus on what truly matters: living fully, caring deeply, and leaving a legacy of wisdom and love.
If you are in need of assistance, the attorneys at Collins Family & Elder Law Group can help.
