Almost half of spousal caregivers are 75 or older, says new report. How to ensure long-term care costs don't turn your retirement into financial risk

It’s a shift that’s reshaping what retirement can look like for Americans across all income levels. Here’s how caregiving can impact your budget, and what you can do to prepare for it.

How caregiving hits the budget

Many of these caregivers are providing hands-on, round-the-clock care, even while they might be battling their own health problems and are living on retirement income.

Gonzalez told The Washington Post she has health issues of her own, including severe spinal stenosis that causes constant pain. She also faces the harsh reality that her husband’s needs will only increase, along with the costs.

Along with the physical demands of being a caregiver, there’s a hefty price tag to taking care of your elderly loved one. In-home help, medical equipment and medications all add up quickly. Many spouses end up dipping into personal savings or retirement nest eggs to cover expenses like these (3).

Spousal caregivers tend to be more deeply involved than adult children who typically help from a distance. They’re more likely to be on call 24/7, providing intimate care and losing sleep in the process. That physical toll coupled with the financial one can be a hard burden to bear.

Brian Haaser, 69, moved his wife into a long-term care facility after her Alzheimer’s made it unsafe for her to live at home. The cost was about $8,485 a month.

Her long-term care insurance will run out in about 16 months. After that, Haaser expects to rely on investments that he once thought would support his own retirement and provide an inheritance for his kids.

“I’m going to be in a quandary in 2027,” he told The Washington Post (1). It’s a situation that financial planners are seeing more of, where one partner’s illness quietly eats away at savings meant to last both lifetimes.

A part of the problem is what people think will be covered. Medicare generally doesn’t pay for long-term custodial care, extended nursing home stays or most in-home caregiving. Medicaid does, but only after many households spend down their assets to qualify (4).

That leaves many middle-class retirees stuck in the middle: having too much savings for Medicaid, but not enough to comfortably cover years of care.

While the physical and monetary demands can be draining, caring for a spouse (especially one with dementia) can result in anticipatory grief, where the spouse grieves the person they’re losing while they’re still alive (5).

Managing this emotional weight can mean planning is a challenge, and decisions and important conversations either get delayed or just don’t happen. Then, when a crisis hits, families can be forced into making choices quickly that end up being expensive.

Virginia resident Judith Nagle shared her story with The Washington Post about having complicated emotions while caring for her husband who died in 2023, “Be prepared to be angry. Be prepared to feel guilty because you’re angry. Be prepared to be sad.” (1).

How to prepare for caregiving

Caregivers and couples should prepare before a healthcare crisis crops up by taking some time to review finances, have tough conversations, and get organized: