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Long-Term Care: Which Retirees Will Need It, and How Much?

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What You Need to Know

  • Only about a quarter of those 65 or older will need three years or more of medium- or high-intensity care.
  • The study breaks down care needs by both the duration and intensity of care required.
  • Black people are the most likely to need the highest level of care.

It may seem that getting older means living in long-term care is a certainty, but that isn’t necessarily the case. A new paper from the Center for Retirement Research at Boston College found that roughly a quarter of retirees will need a high level of long-term services and support (LTSS), but 20% of retirees won’t need any support.

Further, the paper also found 22% of retirees will have low LTSS needs, while 38% will have moderate needs.

The purpose of the study was to understand the future health needs of retirees. It states that a recent study estimated that a 65-year-old has a 7 in 10 chance of developing a “severe” need for LTSS, but that “masks tremendous variation in the duration and intensity of the required support,” it stated.

The study used two decades of data on actual LTSS experiences by Health and Retirement Study participants. It broke the level of care needed into four levels — none, low, moderate and severe — accounting for both the intensity of care and the time the care was needed.

This first part of a three-part study released in June described the risks of support for health issues retirees will need, breaking down their findings by marital status, education, race and by self-reported health status. Severe disabilities — as defined from an HRS survey of Americans over age 50 to determine LTSS care needs — required three years of more of medium- or high-intensity care.

A Closer Look

The paper found that married people who tended to be wealthier and “enjoy the support of a spouse” were less likely to need LTSS, and “less likely to experience severe needs than unmarried individuals,” although not by much.

Men 65 years old — both married and unmarried — had a 23% probability of severe LTSS needs, while 17% of married and 13% of unmarried men had no need of LTSS.

Married women across the board did better than unmarried women, with 22% of married vs. 27% of unmarried women having severe LTSS needs. Nineteen percent of married and 14% of unmarried women had no need of LTSS.

Education also made a difference: 20% of those with some college education had severe LTSS needs, while that jumped to 28% of those with some high school or a high school education. Indeed, 22% of those with college education had no need of LTSS, while that dropped to 9% of those with some high school.

Race, too, made a difference in severity. Blacks had a 33% rate of severe LTSS needs, while that dropped to 23% for both Hispanics and whites. Blacks also had the lowest level of no use of LTSS: 9%, which was similar to that of Hispanics. For whites, that climbed to 18%.

Finally, it also made a difference on how people ages 65 to 70 described their health. Those who said they were in fair/poor condition had a 32% severity need of LTSS, while that fell to 23% to those with “good” health and 18% for those with “excellent/very good” health. Only 5% of those with poor health didn’t need LTSS, while that jumped to 18% for those with good health and 30% to those with excellent health.

The paper noted that “the patterns across sociodemographic groups are as one would expect.” But the question was whether those who need help “have resources available either in terms of family or friends to receive informal support or sufficient finances to pay for formal support.” This will be reviewed in the next report.