#long-term care

#long-term care

Every November, the country observes National Family Caregivers Month a tribute to the millions of Americans who help aging parents, disabled spouses, or loved ones with chronic conditions. But once the tributes end, the reality continues. On any given morning commute on the subway or bus, chances are one of the riders alongside you is juggling a full-time job and a second, hidden shift as a family caregiver.

Every day at Encore Community Services in Midtown Manhattan, I meet older New Yorkers who worked their whole lives and now face an impossible choice. They can drain their savings to pay for home care, or try to live without the help they need to stay safe at home. Medicaid, the public insurance program for people with very low incomes, will pay for long-term home care.

Medi-Cal is California's program that helps people with low incomes pay for healthcare, like doctor visits or nursing home care. Starting January 1, 2026, Medi-Cal will check your assets-things like savings or a second home-to see if you qualify. If you have more than $130,000 (or $195,000 for couples), you might not get benefits unless you plan smartly. Trusts and stacked gifting are two ways to keep your assets safe while still getting Medi-Cal help.

The rate of Alzheimer's diagnosis has declined steadily in recent decades, but as baby boomers age, the number of new cases continues to rise. The top risk factor for dementia is age, and by 2030 more than one in five Americans will be 65 or older. That means the prevalence of Alzheimer's in the U.S. could exceed 13.8 million people by 2060.

Ireland has experienced tremendous improvements in life expectancy in recent decades. This means there is, and will be, a much larger population at older ages who require long-term care services to support them at home, or within residential facilities.