Long-Term Care: Are You Prepared?
Most retirement and estate plans are built around a quiet assumption: that the money set aside will either be spent gradually and predictably, or passed on largely intact to children and to the church. Long-term care has a way of breaking that assumption. A fall, a stroke, the slow progression of dementia — any of these can turn a carefully built plan upside down almost overnight, as the cost of in-home care, assisted living, or a nursing facility draws down savings far faster than anyone expected. For a Christian couple who had hoped to leave an inheritance to their children or a legacy gift to their church or favorite ministry, that possibility raises a real and uncomfortable question: what happens to those plans if the money is needed for care instead?
It’s worth naming the two unhealthy ways people tend to respond to that question, because both of them miss the mark. One is denial — assuming it won't happen, making no provision, and leaving a spouse or children to sort out an expensive crisis with no plan in place. The other is fear-driven hoarding — clutching every dollar “just in case,” to the point that generosity quietly disappears from the family’s giving altogether. Scripture doesn’t ask us to choose between denial and anxiety. It asks for something steadier: wise, prayerful preparation that takes real risks seriously without letting fear write the whole story.
Planning Ahead Is Wisdom, Not Worry
Joseph’s seven years of storing grain during Egypt’s years of plenty (Genesis 41) is often remembered as an economic plan, but it’s really a picture of stewardship — using a season of abundance to prepare responsibly for a season of need that hadn’t arrived yet. Proverbs commends the same instinct on a smaller scale: “Go to the ant, O sluggard; consider her ways, and be wise. Without having any chief, officer, or ruler, she prepares her bread in summer and gathers her food in harvest” (Proverbs 6:6–8). Preparing for a possible future need isn’t a failure to trust God. It's one of the ordinary ways trust gets expressed — through foresight rather than presumption.
In practice, that foresight looks like a few concrete steps, ideally taken well before a health crisis forces the issue. Long-term care insurance, or one of the newer hybrid life-insurance-and-LTC policies, can convert an unpredictable risk into a known, budgetable cost. A realistic contingency reserve — money set aside and mentally earmarked for care rather than assumed available for other goals — keeps a future need from forcing the sale of investments at an inopportune time. For those whose plans may eventually involve Medicaid, understanding the program’s look-back period and spend-down rules matters a great deal, and this is genuinely a place to sit down with an elder law attorney or financial planner rather than guess; the rules are detailed, they vary by state, and getting them wrong can be costly. None of this is unspiritual work. It’s the kind of “counting the cost” Jesus commends before any serious undertaking (Luke 14:28), applied to one of the more sobering costs most families will eventually face.
Why a Charitable Gift Annuity Can Help
One tool worth understanding in this context is the charitable gift annuity, or CGA. In simple terms, a donor transfers cash or appreciated securities to a ministry or charitable organization in exchange for a fixed, guaranteed income paid for life. The payments can be structured for one person or for a couple, continuing as long as either spouse is living. Part of each payment is typically a tax-free return of principal; the donor generally receives an immediate partial charitable tax deduction in the year the gift is made; and whatever remains when the agreement ends passes on to the ministry you choose to support—like your local church or the Great Commission Fund.
What makes a CGA particularly relevant to the long-term care question is that it doesn’t force a choice between providing for yourself and giving generously — it does both at once. The income is fixed, so it doesn't fluctuate with the market, which makes it easier to plan against the kind of predictable, recurring costs that in-home care or assisted living tends to create. Because the rate is based on the age of the donor when payments begin, it increases meaningfully for older donors, often providing a stronger income stream at the very stage of life when care costs are more likely to appear. Many organizations, like Orchard Alliance, also offer a deferred charitable gift annuity, which can be funded now, during healthy working or early-retirement years, with payments beginning later — timed, if a donor chooses, to start right around the age when care needs statistically tend to rise. It's Joseph’s grain-storage principle, applied to personal finance: setting resources aside during the years of plenty so they're available during the years that may bring more need.
It’s worth being honest about the limits of this tool as well. A CGA is irrevocable — once the gift is made, the principal can’t be withdrawn again, even in an emergency — so it isn’t something to fund with every available dollar. Wise planning usually means pairing a CGA with other liquid reserves, insurance, or investments, so that flexibility remains alongside the guaranteed income. A conversation with both a personal financial advisor and a gift planning officer at the ministry in question is the right way to work out what portion of a portfolio might sensibly go into this kind of gift, and what should stay elsewhere.
The Both/And of Faithful Planning
What a tool like this really offers is a picture of what stewardship can look like when it isn't forced into an either/or. First Timothy 6:17–19 tells those who are rich in this present age “not to set their hopes on the uncertainty of riches, but on God,” and to be “rich in good works, generous and ready to share” — while also, in the same breath, Paul elsewhere commends the kind of ordinary provision that keeps a family cared for. A charitable gift annuity, and long-term care planning more broadly, let a family hold both commitments together: providing responsibly for a future that may include significant medical and custodial costs, and still giving meaningfully toward Kingdom work in the meantime. Neither commitment has to cancel out the other.
Faith & Finance Perspective
Long-term care is one of the more unpredictable costs a family will face, and left unplanned, it can quietly consume the very resources a couple hoped to leave to their children or give to their church. The healthiest response isn’t denial, and it isn’t anxious hoarding either — it’s the same wisdom Joseph showed in Egypt, and the ant shows in Proverbs: using a season of plenty to prepare deliberately for a season that may bring need. Long-term care insurance, a realistic reserve, and sound legal and financial counsel all have a place in that preparation. So does the charitable gift annuity, which turns a portion of a family’s assets into guaranteed lifetime income — income that can help cover future care costs — while still ensuring that a meaningful gift eventually reaches the ministry the family wanted to support all along. Planned well, and prayed over together, a family’s long-term care strategy and its giving strategy don’t have to compete. They can be part of the very same act of faithful stewardship.
And God is able to make all grace abound to you, so that having all sufficiency in all things at all times, you may abound in every good work.
- 2 Corinthians 9:8
