LONG-TERM CARE
By OneAmerica Financial
Long-Term Care Reaches Inflection Point
The United States is entering a defining decade for long-term care. As Americans live longer, the need for care is expanding faster than the systems designed to support it. Families, caregivers, health care providers, insurers, employers, researchers, and government programs are all feeling the strain. The 2026 Long-Term Care Market Outlook introduces a new framework—interconnected care—recognizing that no single solution or stakeholder can address these challenges alone. The complexity and scale of aging, caregiver shortages, rising costs, and increasing consumer expectations demand an interconnected response. A sustainable long-term care future requires coordination across sectors. Families remain the backbone of care, but they cannot carry this responsibility alone. Insurers, health care providers, researchers, government agencies, employers, and technology providers must align to support early detection, care access, caregiver resilience, and financial protection. Interconnected care reflects the reality that outcomes depend on collaboration, not isolation.
In this report, we explore three themes impacting the long- term care landscape in 2026:
1.The Rise of Preventive Long-Term Care
The future of long-term care is shifting upstream. With the emergence of brain-health science, blood-based biomarkers, lifestyle medicine, and early screening, long-term care planning is becoming a preventive pathway rather than a late-life emergency response.
2. The Caregiver Workforce Crisis
Even the best care plans collapse without caregivers. America faces a structural shortage of home health care workers, facility staff, nurses, and dementia-trained specialists—making caregiver access one of the most powerful determinants of future long-term care quality.
3. Family Caregiving Under Extreme Pressure
Family caregivers remain the backbone of America’s long-term care system, but they are doing so at great personal cost. There is increasing emotional, financial, and structural pressure on family caregivers, particularly Gen X households balancing multiple responsibilities. Their needs are expanding beyond emotional support to include financial protection, time-saving resources, mental health services, and professional coordination.
Theme 1: The Rise of Preventive Long-Term Care
Early Detection, Early Planning, Early Intervention
Early detection, brain-health science, lifestyle medicine, cognitive screening, and biomarkers are prompting long-term care planning to begin much earlier. The rollout of digital health and home technology solutions is surging, with 350,000 mobile health apps, nearly 3,000 AgeTech companies, and 18.8 billion connected devices now deployed globally.
For the first time, individuals can better understand dementia risk earlier in life and take steps to delay its onset or reduce its severity. Prevention is allowing long-term care planning to start proactively, rather than in the midst of a crisis. Public health policy increasingly emphasizes prevention, and research shows that earlier intervention can reduce downstream health care and long-term care costs.
Why This Matters for 2026:
- Consumers can now know their risk earlier than any previous generation.
- Early planning reduces crisis-driven decisions and caregiver burnout.
“If we think about where we were 60 years ago with heart disease, we didn’t have anything until you suffered a heart attack … and now we can prevent it … we see this long time period (with Alzheimer’s) where we can come in and intervene with medications with the hope that we can prevent the cascade of downstream events.”
— Donna Wilcock, Ph.D., Professor of Neurology and Director of the Center for Neurodegenerative Disorders at Indiana University School of Medicine
Only about 50% of adults aged 55+ use assistive or health-related technology to help them age in place.
Key Takeaway
Early detection and early long-term care planning are becoming the most powerful tools in long-term care.
Theme 2: The Caregiver Workforce Crisis
The shortage of caregivers is defining the future of care access. As the U.S. population ages, demand for long-term care continues to rise; yet, the supply of professional caregivers is declining. The shrinking caregiver workforce has become the most significant constraint on future care access. America faces a structural shortage of home health care workers, facility staff, nurses, and dementia-trained specialists—making caregiver access one of the most powerful determinants of future long-term care quality.
Burnout, low wages, and high turnover threaten the availability and quality of home- and facility-based care, demanding innovation and support. Technology can support caregivers, but it cannot replace the human relationships at the heart of quality care. Without a stable workforce, even well-funded families may struggle to access services.
Why This Matters for 2026:
- Demand for long-term care is doubling; caregiver supply is shrinking.
- Burnout and low pay drive turnover across all care settings.
- Families increasingly provide care themselves—often without training.
“The widening gap between the demand for in-home care and the available supply of professional caregivers is unprecedented and concerning. … Insurance carriers and service providers who are willing to collaborate on joint initiatives offer a unique opportunity to support both clients and staff in navigating the complexities of our national health care challenges.”
— Tafa Jefferson, Founder and Chief Executive Officer of Amada Senior Care
The number of family caregivers has increased by 45% in just 10 years.
Key Takeaway
Insurers could lead by offering holistic caregiver-support benefits for the entire family that help caregivers navigate long-term care, including training solutions and collaborations with home-care networks.
Theme 3: Family Caregiving Under Extreme Pressure
Emotional, financial, and structural burdens are transforming consumer needs. Families continue to carry the weight of long-term care, often at great personal expense. The emotional, financial, and logistical demands have never been more intense. Caregivers require new forms of support, including navigation tools, financial protection, mental health resources, and respite options.
Families provide the majority of long-term care in the United States, delivering hundreds of billions of dollars in unpaid care each year. And they often do so without formal training or adequate support. In 2021, unpaid family caregivers collectively provided an estimated 36 billion hours of care, which was valued at $600 billion.
The emotional, financial, and physical toll on caregivers is substantial and growing. Many caregivers reduce work hours, delay retirement, or leave the workforce entirely.
Demographic forces are intensifying this strain. In 2025, over 20% of Americans were age 65 and older. And the oldest of the Generation Xers began turning 60 last year. Often referred to as members of the “sandwich generation,” many of them are caring for their aging parents while also supporting their children under 18 and simultaneously assessing their own future long-term care needs.
The pressures caregivers face lead them to take action. Having a family member who needed long-term care is a significant catalyst for creating a long-term care plan (88%) and buying long-term care protection (75%).
Why This Matters for 2026:
- Multigenerational caregiving is rising.
- Caregivers sacrifice income, health, and career opportunities.
- Many families discover long-term care needs only AFTER a crisis.
“Caregiving has so many layers, and each family can have a different journey. It is easy for caregivers to become desensitized to all that they do for their loved ones. Helping them acknowledge and accept where they are allows us to then begin providing and strengthening the necessary support.”
— Jody Hirst, Licensed Clinical Social Worker for Pike Medical Consultants
63% of informal caregivers are family members—but only 9% of all informal caregivers are paid.
Key Takeaway
Insurers could provide financial tools that replace income loss, navigation services that reduce decision fatigue, and benefits that support mental health, respite, and family communication.
Conclusion: A Call to Shared Responsibility
The 2026 Long-Term Care Market Outlook calls for interconnected care. Ideally, it should include a network comprised of public policy, private insurance, employers, health care systems, researchers, and families. Together, they would share the responsibility for extending health, protecting wealth, and sustaining care for those who need it—as well as those providing care to loved ones.
Our Commitment
OneAmerica Financial is committed to developing diverse long-term care protection solutions that can help meet the evolving needs of our customers. That’s why our product portfolio includes flexible, affordable hybrid products designed to support care beyond the basics. Our Care Solutions portfolio includes long-term care protection with options such as Care Benefit Concierge services that provide dedicated support—helping care recipients and their families confidently navigate life’s challenges. Additionally, we offer flexible payment options, including recurring premium options that can be customized based on a set number of years, as well as lump sum payments using qualified and non-qualified dollars. By focusing on flexibility, simplicity, and technology, we’re helping create greater certainty for better moments every day.