Long-Term Care Statistics 

With age comes increasing healthcare needs. And as the number of older adults continues to skyrocket, the nature of long-term care services designed to support this group is changing. Because most older adults prefer to age in place, the need for accessible and comprehensive home care services is stronger than ever. 

Below, we outline some of the most telling statistics that paint a picture of a more diverse, personalized future for long-term care options.

Key Takeaways

• Long-term care services can include anything that helps a person improve their physical functioning and quality of life.
• More Americans are old enough to need consistent care, and the size of this population will only continue to increase.
• Residential care options like nursing homes and home-based care options are popular for older adults, but most people prefer to age at home with loved ones rather than strangers. 
• Medicaid and Medicare help make home- and community-based care options more accessible.

What Is Long-Term Care?

Long-term care includes services that assist recipients with:

• activities of daily living (ADLs), such as bathing or dressing;
• instrumental activities of daily living (IADLs) like medication management; and 
• health maintenance tasks. 

Put simply, long-term care services help people improve levels of physical functioning and achieve an optimal quality of life.

The need for long-term care services is usually determined by a person’s functional limitations. These are defined as needing assistance with ADLs and IADLs like those listed above. Regardless of their age, background, or the type of assistance needed, any person can qualify for either paid or unpaid long-term care services.

Who Needs Long-Term Care?

While anyone can obtain and access long-term care services, most of those who do are aged 65 or older. And as the number of American adults aged 65 or older continues to grow, so does the number of people who need long-term care.

• Pew Research Center population estimates from 2010 predict that by 2030 when all members of the Baby Boomer generation will have reached age 65, around 18% of the U.S. population will be 65 or older.

• Figures from a comprehensive report by the Centers for Disease Control and Prevention (CDC) estimate that around 50% of Americans aged 65 or older will need long-term care services. (2022)
• Current overall estimates for long-term care costs fall around $138,000 on average. (2022)

• The average projected time most people receive long-term care services is two years, including one year of paid long-term care services. (2022)
• Around one-third of people aged 65 or older will need long-term care services for over two years. This population is predicted to incur higher-than-average long-term care service costs. (2022)

The need for long-term care services is relatively consistent across people of different sexes, though women are generally more likely to utilize them than men:

• Most people using long-term care services were women. (2017-18)
• Long-term care hospitals were the primary exception to this trend, hosting patient populations of 51.8% men. (2017-18)
• Residential care communities held the highest percentage of female users (67.4%). (2017-18)
• Around 59% of short-stay nursing home residents and 66.6% of long-stay residents were women. (2017-18)

Institutional Care

Institutional care facilities include options like nursing homes, adult day care facilities, assisted living facilities, and residential care communities. These long-term care services offer support to users in an environment outside the home, but their costs can be significant.

• The CDC estimates that 1,197,600 licensed beds are available for long-term care in nursing homes, assisted living facilities, and residential care communities. (2020)
• Over 800,000 residents visited institutional care facilities in 2018, and given recent trends, it’s not unreasonable to suggest this figure has continued to grow with time.
• In the United States, as of 2018, there were 15,600 nursing homes, 31,400 residential care communities, 1,200 inpatient rehabilitation facilities, and 400 long-term care hospitals.

• Facilities that receive Medicare certification, including most long-term care providers, except nursing homes, offer social work services. However, just 63.8% of nursing homes met this criteria. (2017-18)
• Mental health or counseling services were offered by most nursing homes (63.6%) and residential care communities (62.0%). (2017-18)
• Around 70-98% of facilities offered therapeutic services. (2017-18)
• About 71.6% of nursing home care offered access to a skilled nursing facility or services. Around 70.8% of residential care communities also provided this service. (2017-18)
• The majority of residential care communities, nursing homes, and long-term care hospitals offered pharmacy or pharmacist services. (2017-18)

• Most facilities offered specialized services like dementia care units and dietary or nutritional services to meet residents’ care needs. (2017-18)
• In 2020, nearly 9 in 10 (88%) institutional/residential care community residents were non-Hispanic White individuals. (2017-18)

• In nursing homes, 73.3% of short-stay and 74.4% of long-stay residents were non-Hispanic White. The second most common ethnic or racial group was non-Hispanic Black individuals, who comprised 14.6% and 15.2% of short- and long-stay residents, respectively. (2017-18)
• Estimates for the average monthly cost of care at a nursing home or assisted living facility range from around $4,000 to $10,000, depending on the region and services needed. (2021)

Home-Based Care

An alternative way to receive long-term care is at home rather than in a residential or community facility. Home-based care usually requires the support of a caregiver or a home health aide who ensures a person’s needs and safety are considered despite their limitations. The demand for this sort of care grows as the number of older adults increases.

• According to a recent survey by The American Association of Retired Persons (AARP), 77% of adults 50 and older prefer to age in place. (2021)
• The same survey found that around a third of all poll participants would need to modify their current home so they or a loved one could continue to live there for long-term care. (2021)
• Around half of all participants said they would need access to resources like emergency response systems or smart-home devices to assist them at home. (2021)
• Most people 65 or older either live alone or with other family members (11%), such as children, siblings, or extended relatives. (2018)
• The number of older adults living in group facilities has fallen in recent decades as home- and community-based services have grown to offer more long-term support. (2018)

Home Health Care

For those who prefer to live and age in place, finding ways to bring long-term care services home is vital. Home health agencies are the primary option people rely on to make services approachable, affordable, and accessible.

• As of 2017, 4.9 million Americans received any or some kind of home health care.
• Around 82.7% of those individuals were patients of a home health agency, which provides services and professional care to recipients in their homes. (2017)
• Recent projections suggest that social workers and home health or personal care aides are some of the fastest-growing occupations within the long-term care industry. (2018)
• As of 2019, some 10,591 Medicare-certified home health agencies were found throughout the United States. A total of 5,266,931 beneficiaries were served through these agencies.
• Of those beneficiaries, around 8.4% receive at least partial payment via Medicaid. 31.2% were covered at least partially by Medicare Advantage, and Medicare FFS covered 60.4%. (2019)

Informal Caregiving

Traditional family caregivers or caregiving performed by loved ones is often known as “informal caregiving.” No formal training or education is needed for informal caregiving, but like other long-term services, costs associated with this form of support can be tough to navigate.

This type of care allows many to continue living at home, but it also has potential downsides for residents and caregivers alike.

• As of 2019, 22.3% of adults reported providing care or assistance to a friend or family member in the past 30 days.
• One in four (25.4%) women are informal or family caregivers, compared to one in five (18.9%) men. (2019)

• The long-term strain of informal caregiving can pose health consequences. For instance, 36.7% of caregivers reported getting insufficient sleep. (2019)
• Many caregivers can benefit from support services themselves. Around 33.0% of caregivers reported having a disability in 2019.
• Around 17.2% of middle–aged and older adults who are not currently caregivers expect to provide care to a friend or family member in the next two years. (2019)

Medicaid and Long-Term Care

Whether for a semi-private room in a nursing home or quality home care, receiving support through Medicaid helps many seeking long-term care find ways to finance services.

• In 2018, around 32% of all Medicaid expenditures, which accounts for $129 billion, were spent on long-term care services.
• The majority of long-term care facilities were Medicare-certified in 2018. Only about 5% or lower did not meet this mark.
• Some 18% of residential care community facility residents were Medicaid beneficiaries as of 2018.
• The larger a facility was, the less likely it was to host Medicaid recipients. At least 24% of residents in communities with 4-25 beds had at least some medical care services paid for by Medicaid. (2018)
• Most Medicaid-supported long-term care services come from smaller-scale residential communities and home health care options. (2018)

Emerging Long-Term Care Trends

Overall, the growing need for long-term care, decreased availability of informal care options, and the shrinking number of accessible formal care options pose a true challenge. 

More people need long-term care that fits their needs, but fewer people than ever are available to provide it. As a result, solutions that consider long-term care needs and help people receive support from wherever they are will likely become a major priority for policymakers nationwide.

• The high annual costs of residential care services motivate more people to shift to community-and home-based care options. (2018)
• More people may feel obligated to pay for services and needs out-of-pocket instead of turning to long-term care insurance due to the format of their care (at home). A lack of knowledge about how to receive financial support for these services can drive this truth. (2022)

• Demographic factors like a rising life expectancy and decreasing average family size drive higher demand for accessible home care options (such as utilizing a home health aide). (2014)
• Increasing employment rates among women and changing social expectations will likely reduce the pool of traditional family caregivers. (2022)

Figures show that most older adults prefer to receive long-term care from the comfort of home. But the number of informal caregivers available is shrinking, and the burden these caregivers carry can be significant. As a result, more home-based and Medicaid-backed care options, like home health aides and support, are likely the future of long-term care.