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Caught in the middle: Today’s older adults are caring for adult children and aging parents

Nationwide Retirement Institute® survey reveals the challenges and opportunities impacting the sandwich generation when it comes to caregiving

For many older adults, seeing parents, children and even grandchildren is a regular occurrence, often because they are living under the same roof or providing ongoing care. But taking care of extended family can be both a blessing and a challenge for many older adults who balance providing for aging parents and their own children. Commonly known as the sandwich generation, this group not only has to prioritize caregiving but also planning for their own retirement. For some, this has been the plan all along, while for others, it is out of necessity.

A new Nationwide Retirement Institute® survey conducted online by The Harris Poll of 1,462 adults age 50 or older with investable assets of at least $50,000 who are retired or planning to retire within the next 10 years reveals nearly two in five of these “older adults” (38%) have or have had their adult children live with them, while about one in five (16%) have or had their parents live with them. In addition, 21% of older adults are somewhat or very concerned about financially supporting their adult children and/or parents.

Contrastingly, only 15% of older adults expect their adult children to live with them when they get older and even fewer (12%) expect their parents to live with them when they get older. In addition, only 12% expect to be a caregiver (excluding those who are or were caregivers), while in reality one in three older adults either are or have been a caregiver.

“Today’s reality is hard for older adults caring for aging parents or adult children, as they will likely be caregivers and need a caregiver themselves in the not too distant future,” said Kristi Rodriguez, vice president of thought leadership for Nationwide Financial. “This generation can prepare for their own future now while also considering that of their parents and children by establishing a plan that accounts for their own long-term care and addresses the current impact caregiving has on their finances, retirement plan and experience.”

Caregiver challenges

Nationwide Retirement Institute’s annual survey included a separate sample of 516 U.S. adults age 50 or older who are or have been caregivers, meaning they have or are now providing paid or unpaid long-term care to a friend or family member, not through an agency, business or non-governmental organization. The survey reveals the impact and challenges of being a caregiver. On average, caregivers spend 54 hours per week fulfilling their role and some experience financial pain points. 

Few caregivers have received any financial support for their efforts and more than half (62%) spend their own money on caregiving expenses. On average, caregivers who pay out-of-pocket for related expenses spend an average of $4,012 of their own money per year on caregiving expenses. In addition, 21% of caregivers fear that caregiving expenses will prevent them from ever retiring.

Beyond time and financial commitments, half of caregivers (48%) say they face added stress in balancing things and nearly one in four (26%) say that their own health has been negatively impacted. However, many caregivers are grateful to provide care to their loved one with over a third (37%) saying that being a caregiver has brought meaning and purpose into their life. 

“Balancing these challenges can be difficult but caregivers shouldn’t overlook their own retirement,” Rodriguez said. “Setting aside time to develop a plan with an advisor can help them focus on the meaningfulness and sense of purpose they experience as a caregiver versus the impact on their current and future finances.” 

When the caregiver needs caregiving 

The survey reveals 54% of older adults would rather die than live in a nursing home, yet half (50%) are worried about becoming a burden to their family as they get older. In addition, about three in four (74%) prefer to receive long-term care in their own homes, but only 53% expect to be able to achieve that. Only 5% indicated they would prefer to live in a family member’s home while receiving long-term care, yet most of the help provided to older adults (83%) comes from family members, friends, or other unpaid caregivers.1 Forty-two percent of older adults say they are concerned about becoming a burden to their children, which may be why they do not want to receive care in a family member’s home.

In addition, a majority (58%) of older adults would like to have the option of relying on a family member if they needed long-term care; however, they would not expect help from (72%) or rely on (69%) a family member unless they were able to pay them. 

“Older adults fear nursing homes but are concerned with becoming a burden to their families,” Rodriguez continued. “One of the greatest gifts you can give your family is creating a plan to address health care and long-term care costs in your retirement. Today, many older adults don’t discuss their long-term care needs, and as a result of not planning, many have fewer options when they do need care.” 

Concerningly, many older adults are not taking advantage of long-term care insurance and planning; only 25% currently have long-term care insurance for themselves or someone else. 

Older adults keep their biggest retirement fear to themselves

Only 41% of older adults are confident in their plan to pay for long-term care expenses. Despite their concerns, more than a third (36%) have not discussed long-term care costs with anyone including a spouse, partner, children or financial advisor. Less than a third (32%) of older adults plan on discussing long-term care costs with a financial advisor.

One reason people may avoid the conversation is that a third of older adults (34%) doubt they will live long enough to use long-term care insurance. More so, 46% of older adults think a long-term care policy is most often used in a nursing home, while in reality, the majority of long-term care insurance claims (52%) are used for home health care provided by paid professionals.2  

“Developing a plan for long-term care costs based on an individual’s personal situation and future preferences can be impactful,” Rodriguez said. “Financial advisors can help people plan for and live in retirement by providing a fact-based estimate of long-term care costs and a unique plan of action to address those costs, which will also ease the burden on their own caregiver.”

To simplify this complicated issue and encourage discussions around health care and long-term costs in retirement, Nationwide’s Health Care/LTC Cost Assessment tool uses proprietary health risk analysis and updated actuarial cost data such as personal health and lifestyle information, health care costs, and medical coverage. It provides a meaningful, personalized cost estimate that will help advisors and clients plan for future medical and long-term care expenses. 

To learn more about the 2019 Nationwide Long-term Care Consumer Survey, visit



This survey was conducted online by The Harris Poll on behalf of The Nationwide Retirement Institute between March 25 and April 10, 2019 among 1,462 U.S. adults age 50 or older who are either retired or plan to retire within the next 10 years, with investable assets of $50K or more (“older adults”).  and 516 U.S. adults age 50 or older who are or have been caregivers.  Caregivers are defined as those who have ever or are now providing paid or unpaid long-term care to a friend or family member, not through an agency, business, or non-governmental organization. Data for both groups are weighted where necessary by age by gender, race/ethnicity, region, education, income, marital status, and propensity to be online to bring them in line with their actual proportions in the population. Data for the older adults are also weighted as necessary by size of household, retirement status, and assets. Because the sample is based on those who were invited to participate in panels (and not random), we cannot calculate estimates of theoretical sampling error.


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