San Diegans expect to experience a long-term care event, and nearly 3 in 4 want in-home care

As San Diegans live longer, their likelihood of experiencing a long-term care event is increasing – and more than six in 10 (64%) adults in the city predict that it will happen to them. Should that occur, a resounding 73% of those in San Diego say they want to remain in their house and receive in-home care – while just 10% say they would prefer to live in a nursing home.

These are the latest findings from Northwestern Mutual’s 2025 Planning & Progress Study, which examines the latest attitudes, behaviors and beliefs related to financial planning and financial security.

People Want to Stay at Home

Long-term care is the assistance provided to someone who has a chronic condition that is progressive in nature, gets worse as time goes on and generally has no cure. Someone who needs long-term care requires supervision because they are unable to perform at least two activities of daily living, including eating, bathing or showering, getting dressed, using the bathroom and getting in and out of bed or a chair. Typically, long-term care does not include medical care or treatment of the underlying illness or injury.

According to Northwestern Mutual’s 2025 Planning & Progress Study, San Diegans are right in line with the rest of the country in terms of preferring to age gracefully at home if they experienced a long-term care event – 73% compared to the nationwide average of 74%.

Most in San Diego Expect to Need Care and to Be a Caregiver

More than half (58%) of adults in San Diego believe their retirement will last longer than their parents’ “golden years, and nearly one-third (32%) expect 10 or more extra years in retirement than their parents.

Perhaps considering their extra longevity, most San Diegans (64%) say it’s likely they’ll need long-term care services for themselves at some point. A similar proportion (65%) believe it’s likely they will need to provide these services for a loved one at some point in their life. According to data from the U.S. Department of the Treasury, they may be right: approximately half of Americans turning age 65 today will need some type of long-term care in their lives.

“The belief that long-term care can be managed spontaneously is a financial oversight many individuals and families share,” said Brian Davis, financial advisor with Northwestern Mutual in San Diego. “These situations arise frequently, and having a plan can help ensure better care options. Engaging with a trustworthy financial advisor is crucial for evaluating each person's specific financial scenario and developing a customized plan to guide them through these complex decisions.”

Cost of At-Home Care Could Soar to Half a Million

Despite San Diegans’ wishes to remain at home, the cost of providing long-term care could make it very difficult. According to the 2024 Illumifin Cost of Care Study, the annual cost of a home health aide providing only eight hours of care per day is $96,360. If those costs hypothetically increase by just 5% over the coming years, potential out-of-pocket costs could exceed half a million dollars by the year 2058 – a time when many of today’s working adults may need care.

Potential Out-of-Pocket Costs

Hypothetical projection based on annual increase of 5% in long-term care costs provided by a home health aide 8 hours per day.

Many people also think that the costs of long-term care will be completely covered by health insurance or Medicare—but they're typically not. Medicare pays for doctors, hospitals, medication and short-term rehab after hospitalization—but not for independent or assisted living.

To see what care costs are and how much they’re projected to change over time for your area and across the country, visit https://www.whatcarecosts.com/NorthwesternMutual.

The Impact on Caregivers if Plans are Not Fully Funded

Half of San Diegans have been a caregiver at some point in their life. Two in ten people in San Diego (20%) say they are currently providing care. Meanwhile, around one-third of San Diego residents (30%) say they have provided care for someone in the past.

These opportunities to support a loved one in a significant time of need often come with a cost. Caregivers report having to cut back on spending, raid their personal savings, work more than expected, accumulate more debt, or even pull from their retirement funds.

“The act of caregiving is inherently selfless, but it can lead to strain across physical, emotional, and financial fronts,” said Davis. “Through strategic planning, people can help protect their loved ones from the full financial weight of long-term care situations. With effective and proactive planning, families can reduce financial concerns, allowing them to focus more on their loved ones.”

For more information about the study, visit https://news.northwesternmutual.com/planning-and-progress-study-2025.

About the 2025 Northwestern Mutual Planning & Progress Study

The 2025 Planning & Progress Study was conducted by The Harris Poll on behalf of Northwestern Mutual among 4,626 U.S. adults aged 18 or older. The survey was conducted online between January 2 and January 19, 2025. Data are weighted where necessary by age, gender, race/ethnicity, region, education, marital status, household size, household income, and propensity to be online to bring them in line with their actual proportions in the population. A complete survey methodology is available.

About Northwestern Mutual

Northwestern Mutual has been helping people and businesses achieve financial security for more than 165 years. Through a comprehensive planning approach, Northwestern Mutual combines the expertise of its financial professionals with a personalized digital experience and industry-leading products to help its clients plan for what's most important. With nearly $700 billion of total assets(i) being managed across the company’s institutional portfolio as well as retail investment client portfolios, more than $38 billion in revenues, and $2.4 trillion worth of life insurance protection in force, Northwestern Mutual delivers financial security to more than five million people with life, disability income and long-term care insurance, annuities, and brokerage and advisory services. Northwestern Mutual ranked 109 on the 2025 FORTUNE 500 and was recognized by FORTUNE® as one of the "World's Most Admired" life insurance companies in 2025.

Northwestern Mutual is the marketing name for The Northwestern Mutual Life Insurance Company (NM), Milwaukee, WI (life and disability insurance, annuities, and life insurance with long-term care benefits) and its subsidiaries. Subsidiaries include Northwestern Mutual Investment Services, LLC (NMIS) (investment brokerage services), broker-dealer, registered investment adviser, member FINRA and SIPC; the Northwestern Mutual Wealth Management Company® (NMWMC) (investment advisory and services), federal savings bank; and Northwestern Long Term Care Insurance Company (NLTC) (long-term care insurance). Not all Northwestern Mutual representatives are advisors. Only those representatives with "Advisor" in their title or who otherwise disclose their status as an advisor of NMWMC are credentialed as NMWMC representatives to provide investment advisory services.

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[1] Includes investments and separate account assets of Northwestern Mutual as well as retail investment client assets held or managed by Northwestern Mutual.