What Is the Lifetime Risk of Needing and Receiving Long-Term Services and Supports?
Cited in 3 Likelier entries (3 risks, 0 decisions).
Used in 3 entries
For each citing entry, the verbatim excerpt and Likelier's calculation notes (how the source's number was converted to the lifetime-probability framing) are shown below. Click through to read the full claim ledger.
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- Statistic
38% of severe LTSS need episodes last more than 4 years; 9% last more than 10 years; only 5% of older adults receive paid LTSS for more than 5 years
“"About 70 percent of adults who survive to age 65 will develop severe LTSS needs before they die and 48 percent will receive some paid care over their lifetime. Only 24 percent of older adults receive more than two years of paid LTSS care, and only 15 percent spend more than two years in a nursing home."”
Calculation notes
The 2019 ASPE/Urban Institute analysis provides the historical duration distribution: of severe need episodes, 40% last ≤2 years, 38% last >4 years, and 9% last >10 years. Applied to the 70% conditional prevalence: the >4-year group is 0.70 × 0.38 ≈ 27% of those reaching 65. Only 24% receive more than 2 years of *paid* care, and only 5% of all older adults receive paid LTSS for more than 5 years — lower than the 22% with any LTSS need >5 years because many long-need individuals rely on unpaid family care.
Independence note: The 2019 ASPE/Urban Institute report and the 2022 ASPE brief use different methodologies and cohort definitions; both are included to bracket the plausible range. The 22% figure (2022) refers to any LTSS need >5 years while the 5% figure (2019) refers to paid care >5 years, explaining much of the gap between the two estimates.
Source date: 2019-04-03 · Accessed: 2026-05-14
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- Statistic
70% of adults surviving to age 65 develop severe LTSS needs before death; 48% receive paid care; average severe need duration 2.2 years; women 75%, men 64%
“"About 70 percent of adults who survive to age 65 will develop severe LTSS needs before they die and 48 percent will receive some paid care over their lifetime. Only 24 percent of older adults receive more than two years of paid LTSS care, and only 15 percent spend more than two years in a nursing home."”
Calculation notes
ASPE/Urban Institute 2019 report uses DYNASIM microsimulation of Health and Retirement Study (HRS) data. The 70% headline is the conditional probability of severe LTSS need (2+ ADL limitations for ≥90 days OR severe cognitive impairment) among those reaching age 65. Women: 75%, Men: 64%. Average duration of severe need: 2.2 years overall; women's severe needs last longer (44% of women vs 28% of men have needs lasting >2 years). To produce the unconditional lifetime estimate: 0.70 × 0.82 (probability of surviving to 65) ≈ 0.57. The 48% paid-care figure implies roughly 22% develop severe needs but rely exclusively on informal/unpaid care.
Independence note: The ASPE/Urban Institute analysis is based on the Health and Retirement Study (HRS), a nationally representative longitudinal survey of Americans over 50 conducted by the University of Michigan. It is independent of nursing home administrative data and insurance claims databases.
Source date: 2019-04-03 · Accessed: 2026-05-14
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- Statistic
28% of adults age 65+ receive at least 90 days of nursing home care; 15% spend more than 2 years in a nursing home
“"Only 24 percent of older adults receive more than two years of paid LTSS care, and only 15 percent spend more than two years in a nursing home."”
Calculation notes
The ASPE/Urban Institute 2019 report provides the complementary LTSS perspective. The 28% nursing home care figure (≥90 days) is the subset of the 56% RAND figure who have longer stays; the majority of nursing home stays are short (rehabilitation, post-surgical recovery). Used here to contextualize the duration distribution: most nursing home admissions are brief, but 28% involve clinically significant stays and 15% exceed two years.
Independence note: ASPE 2019 uses DYNASIM microsimulation of HRS data, overlapping with the RAND 2017 source but using a different modeling approach. The two are not fully independent but represent separate modeling teams and methodologies applied to the same underlying survey data.
Source date: 2019-04-03 · Accessed: 2026-05-14
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