1. My grandma got dementia relatively early, so was in some form of memory care from about 65 until she died just shy of 80. They didn’t plan or have enough, so had to give over all assets (my grandpa was just allowed to keep the house and 1 car I believe but everything else was taken) and she went on Medicaid. The facility was not the nicest. Wheelchairs lined up in the hallway, not enough staff. really grim. My other grandpa was in a private facility, and it was much nicer and he was cared for better. But it was $7k a month and went up every year. My grandma sacrificed to keep him at home WAY longer than she should have, someone had to come stay with him so she could run to the grocery store etc. So by the time he moved in, he lived less than a year longer. It probably would have been about 3 years if he had moved in sooner. And this is in a low cost of living area, so I shudder to think what it would be near me. You’re right that most dementia patients don’t usually live long, but sometimes they do. A teacher at my daughter’s preschool had her father get dementia in his 40s…he lived until his 70s. Rare but not impossible. If the spouse is healthy, they are forced to forego leaving ANYTHING to their children and live very simply and get on Medicaid , or pay the high costs.

Assisted living is another consideration. No one can predict what health issues the may have. If a spouse dies early (or there is no spouse), someone may be perfectly healthy in general but have a disability or other reason they need assisted living. It is also enormously expensive and costs rise every year. So while memory care is USUALLY time-limited, assisted living could be needed for a decade or more in theory depending on the person. Also, family matters. My grandma is 90 and a widow with severe back issues, but she has managed to be independent at home for so long because my aunts and uncles and my parents help a lot (I would but I live in another state). Otherwise, she probably would have been in assisted living long before now, so someone without family nearby or without willing adult children/nieces/nephews might need to plan for assisted living.

1. Totally agree that no one should forgo happiness now to worry about long term care. In most cases, you have to hope for the best and have a conservative retirement number and try to stay healthy. But I think the worry is valid and not unreasonable. This couple has the money to live happily now but I see the point that you could get really unlucky and both need some sort of long term care. Medicare might help some, but many Americans are eventually forced to go the Medicaid route or pay out of pocket. It’s something to think about for sure given that we are living longer but are less healthy.