If you’ve ever tried to talk about long-term care with your aging parent, you know it’s not an easy conversation to have. For many Black families, it can feel even more overwhelming. Maybe you’re one of the 13 percent of Black Americans who are caregivers, or you know someone who is. You might be juggling doctor’s appointments, managing medications, and handling daily tasks—all while caring for your own children or supporting a loved one with a disability. In fact, more than half of Black caregivers are younger adults, and 36 percent are part of the sandwich generation, caring for both kids and elders at the same time, according to the National Alliance for Caregiving and AARP. That’s a lot to carry. That’s why it’s so important to start talking about long-term care early, learn what resources are out there, and make sure you and your family get the support you deserve.
The first step in preparing is understanding what care might look like, says Lily Vittayarukskul, founder of Waterlily, an AI-powered platform that helps families forecast when care may be needed and what it may cost.
“That’s why we built Waterlily. You don’t need to ask your parents all of these sensitive questions. You probably already know quite a few of the answers, and you can fill out the intake form to get a sense of what your parents’ or in-laws’ long-term care needs are going to look like, as well as the costs and how family members may step in,” Vittayarukskul tells BlackDoctor.
From there, consider a few practical questions:
“We guide people through all of those questions in a really simple, linear flow so that, in the worst-case scenario, you understand what a reactive plan looks like, but in the best-case scenario, you find an opportunity to create a more sustainable care plan,” Vittayarukskul notes.
Caregiving can take several forms, and each comes with its own demands on your time, energy, and finances.
Vittayarukskul breaks it down into three main roles and their associated costs:
As a physical caregiver, you help a loved one with daily activities such as bathing, dressing, eating, toileting, continence, and getting in and out of bed. But the cost goes beyond the physical demands. If you need to step away from work, consider how lost income—especially during your highest-earning years—could affect your retirement savings and long-term financial security. Those trade-offs matter when deciding whether to provide care yourself or bring in a professional.
As a financial caregiver, you help pay for a loved one’s care. That may mean covering professional caregiving costs. Home care can cost roughly $30 an hour on average, while assisted living can range from $5,000 to $10,000 per month, depending on your ZIP code. Before taking on this role, estimate what those expenses could mean for your budget.
You may not provide hands-on care or pay for it yourself, but coordinating appointments, professional caregivers, and schedules still takes time. Consider whether those responsibilities would require you to step away from work. Even from a distance, balancing caregiving with your other commitments can be challenging.
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For the sandwich generation, caregiving often means balancing two sets of needs at once. Think of adults between 40 and 60 whose children are in college, have recently graduated, or still live at home, while their parents are in their 70s or 80s and may be a few years—or even a decade—away from needing care.
Vittayarukskul recommends three ways the sandwich generation can plan ahead for caregiving costs:
You no longer have to rely on national averages to try to guess what your parents’ future long-term care needs could look like. Waterlily offers a free tool with a three-minute intake form so you can understand what those costs could look like and get a sense of what a plan might look like financially, physically, and logistically.
Would caregiving require you to step away from your career? What other commitments do you have, and what can you realistically take on? Answering those questions also means looking at your own retirement plan. Your ability to retire comfortably matters just as much as your parents’.
“This especially affects daughters disproportionately. Women are about twice as likely to become caregivers as men, despite the population being split roughly fifty-fifty,” Vittayarukskul says.
If you may need to step away from work to care for Mom or Dad, consider how you can strengthen your retirement plan now. Are you on track to meet your goals? Could financial products, other resources, or professional advice help you build more security before caregiving becomes a reality?
RELATED: How to Manage Aging Parents Who Can’t Live Alone: A Guide For Caregivers
Medicare, Medicaid, and long-term care insurance may all come up when families discuss paying for care. But one common misconception needs clearing up: Medicare does not pay for ongoing long-term care needs.
“Medicare, under certain circumstances, can pay for up to 100 days of care, and then the rest of the cost is generally your responsibility,” Vittayarukskul explains. “That’s important because long-term care, on average, lasts roughly three years. So if a nursing home costs $10,000 a month and Medicare stops paying after a qualified event, how are you going to pay for the remaining years? That can be financially devastating.”
Medicaid may be an option if you spend down your assets enough to qualify.
“Medicaid is our social welfare program and can cover long-term care supports and services,” Vittayarukskul notes.
Still, coverage is not guaranteed, and the application process can be lengthy and difficult. Care may not begin immediately after approval. Waiting lists can leave families uncertain about when the state will begin covering care.
Long-term care insurance is another option to consider.
“There are several types of long-term care insurance that can provide additional leverage, but the most important thing to understand is that not all policies are created equal. It’s important to work with an expert who can explain, in a way you can understand, how much you would put into the policy and how much you could potentially get out of it under various care scenarios,” Vittayarukskul adds.
The insurance options discussed include four main types of products with some form of long-term care coverage:
An expert can help you weigh the different long-term care options.
When choosing an expert, Vittayarukskul recommends watching out for anyone who seems more focused on making a sale than helping you plan.
“Oftentimes, there are folks who classify themselves as experts or specialists, but largely what they focus on is, ‘Here’s a product. Here’s how great this product is. You should buy this product.’ That’s usually a red flag,” she shares.
Instead, look for someone whose approach centers on education and planning.
“They focus on what your needs are likely to look like in the future and try to get as accurate as possible. Or, if you have a unique scenario, like Mom went through something specific and you want to avoid that outcome, they help you solve for the situation you’re most concerned about,” Vittayarukskul explains.
That conversation should also address your preferences:
From there, an expert should help you understand potential care costs and explore whether self-funding could work for you.
“Sometimes the best solution isn’t always an insurance policy. As I mentioned, it could be self-funding. It may simply be a more intentional plan for how you’re going to use your assets,” Vittayarukskul adds. “So if someone is telling you that the only way to have a plan is through insurance coverage, that’s not always true. If someone is recommending coverage, you should understand exactly how it works for the specific scenario you’re trying to solve for.”
Planning also means looking beyond today’s prices, especially if you or your parents may not need care for several decades.
An assisted living community that costs $5,000 per month today, for example, is unlikely to cost the same amount in 20 or 30 years. Accounting for healthcare inflation can help you estimate those future expenses.
The financial side of caregiving is only part of the picture. Mental and emotional well-being deserve a place in the plan, too.
“I’m so passionate about that topic, and it was very intentional for us to include mental health,” Vittayarukskul shares. “When most people think about long-term care needs, they immediately think of a nursing home. But in reality, long-term care needs are closely tied to the fact that we’re living longer as a population.”
Living longer does not necessarily mean living healthier. Several factors can influence whether those extra years bring good health or a greater need for care.
Among people who live beyond age 85, approximately one in three will develop some form of dementia, Vittayarukskul notes. Dementia-related care is often significantly more expensive than care for physical limitations alone because it may require supervision and additional support.
Mental health matters, too. Social connection, loneliness, depression, and overall emotional well-being can influence how healthy we remain as we age.
“One thing we’ve observed is that individuals who report greater mental health challenges during the intake process often have a higher likelihood of experiencing long-term care needs and may experience those needs for a longer duration,” Vittayarukskul says.
As you prepare, Vittayarukskul also encourages checking whether your parent already has long-term care coverage. If so, gather the policy information now.
“If cognitive decline develops later, they may forget that coverage exists. If you can locate an existing policy, you can upload it into the system and evaluate how it’s expected to perform under the most likely care scenarios,” Vittayarukskul notes.
You don’t have to figure everything out in one conversation. Start by asking what your loved one wants, getting a clearer picture of potential costs, and being honest about what you can take on. For Black families balancing care across generations, the goal isn’t to carry more—it’s to build a plan that supports your loved one without losing sight of your own health, finances, and future.
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