By Jeremy A. Wechsler, Esq.
Investment Advisor Representative
[email protected]
This week, I’m delving into a topic that no one wants to talk about and everyone worries about: long-term care. If you went into a nursing home tomorrow, a private room in a Philadelphia-metro area will cost over $14,000 (approximately $170,000 annually). Our region runs high above national averages, driven by cost of living and staffing challenges.
The price tag is daunting, but cost is only part of the challenge. Nursing homes are definitely not ideal places to call home, so more seniors are attempting to live independently as long as possible. Many do this without nearby family who can step in with daily support. As the Wall Street Journal recently reported (“More Older Americans Are Aging Alone. Who Will Take Care of Them?”), nearly 16 million Americans age 65+ now live alone—over 28% of that population. Community agencies are stretched thin, and even people with resources and savings struggle to find reliable in-home help.
I recently saw these pressures firsthand. A younger client of mine was trying to care for her older sister, who had been diagnosed with dementia. The sister, single and no kids, insisted on staying at home, even though she could no longer drive, manage her household, or care for herself. This resistance is common—and understandable. Identity, independence, and familiarity matter deeply to all of us. The family did everything “right”: safety assessments, doctor consultations, repeated conversations. Yet the sister refused to relent. Ultimately, the situation required a court-appointed guardianship—always a last resort, and something all of us hope to avoid.
Scenarios like these are becoming the norm. People want to remain at home, but their care needs can escalate suddenly, and our support system simply wasn’t designed for this scale. Agencies juggle waitlists, caregivers are continually in short supply, and the burden shifts to families, friends, and neighbors—often at the worst possible moment.
On a national level, solving the long-term care dilemma feels nearly impossible. Costs and complexities make it one of the toughest policy issues for Congress. In the meantime, families and community organizations are left to cobble together solutions. But for some, round-the-clock care in a nursing home eventually becomes unavoidable.
I’m often asked: “What can I do to protect my estate if I ever need nursing home care?” The answer is that there are strategies, though none are perfect. Long-term care insurance can be a fit for some, and newer policies on the market offer options that didn’t exist a decade ago. Certain assets—like a second home—may also be structured in a specific trust to preserve wealth and legacy.
Even if you don’t have insurance, there are always steps that can be taken to preserve part of your estate. A well-drafted Durable Financial Power of Attorney is critical, and families should contact a qualified elder law attorney promptly if nursing home care becomes necessary. If you don’t know who to call, reach out to me and I’ll connect you with the right attorney.
What struck me most from the Wall Street Journal piece is how many people have nobody they can call or trust in a crisis. Don’t let that be you. Identify at least two people you trust—family, friends, neighbors, or even former co-workers—who can step in if needed. And, as I remind readers often: don’t wait until it’s too late. If you don’t yet have a Power of Attorney in place, make that your first step today.