Long-Term Care Planning for Expats and Internationally Mobile Individuals

Long-term care is the silent risk in most retirement income plans. Internationally mobile individuals think carefully about market returns, currency risk, pension drawdown, and tax residency — but care costs in later life are frequently underestimated or ignored altogether. For internationally mobile individuals, the complexity is greater still: they must decide not only how to fund potential care costs, but where they would receive care, what quality of care is available in their chosen retirement location, and how cognitive decline might affect their ability to manage complex international financial arrangements. This guide addresses these questions.

Why Long-Term Care Planning Matters

Care costs in retirement — particularly residential or nursing care in later life — can be very large. In the UK, a residential care home for a self-funding resident typically costs between £50,000 and £100,000 per year depending on location and level of care required. A memory care or nursing home is at the upper end of that range. If someone spends three to five years in residential care (a plausible average for those who do enter long-term care), the total cost can be £150,000–£500,000 or more.

Not everyone needs residential care — many people manage well in later life with some additional support at home. But the uncertainty of whether and when care may be needed is itself a planning challenge. A retirement income plan calibrated to modest ongoing care costs can be devastated by a sudden requirement for intensive residential care.

For internationally mobile individuals, there is an additional dimension: the cost, quality, and availability of care varies significantly across popular retirement destinations, creating both risks and opportunities.

Long-Term Care Costs Across Popular Retirement Destinations

United Kingdom

The UK state social care system provides care funding support for those below certain asset thresholds. As of 2026, self-funders (those above the capital limit) pay the full cost of their care. Annual costs for residential care vary by region and care type but typically range from £40,000 to £100,000+ in specialist settings. The quality of NHS-funded continuing healthcare is variable, and access is subject to strict eligibility criteria.

Spain

Spain has a network of state and private care facilities. State-funded care is means-tested and subject to a contribution from the resident. Private residential care costs range broadly from around €20,000 to €50,000 per year depending on location, type of care, and quality of facility. Major cities (Madrid, Barcelona) and the Balearic Islands command premiums; smaller towns and rural areas are considerably cheaper. The quality of private facilities has improved significantly over the past two decades.

Cyprus

Cyprus has a relatively young formal care sector. Private care homes are available in the main urban areas; care costs are generally below UK levels, with residential care ranging from approximately €15,000 to €35,000 per year for private-pay residents. The GESY national health system covers some healthcare costs but does not generally fund residential social care. The warm climate and outdoor lifestyle make Cyprus popular as a retirement location; the care infrastructure is developing but is less comprehensive than Northern European equivalents.

Greece

Greece has a growing private care sector, particularly in Athens and Thessaloniki. Costs are generally moderate by Western European standards, ranging from approximately €15,000 to €40,000 per year. The state welfare system for older people has been under fiscal pressure; private provision is preferable for those who can fund it.

Thailand

Thailand is one of the most popular Southeast Asian destinations for expat retirees, partly because of the quality and relative affordability of its healthcare and care provision. Upmarket care facilities in Chiang Mai and Bangkok are available at costs significantly below UK equivalents — in the range of £12,000 to £25,000 per year for high-quality residential care. Some internationally accredited hospitals provide rehabilitation and long-term care. The main risks are the requirement to maintain valid visas and insurance, the distance from family in Europe, and the quality variance outside major cities.

UAE

The UAE does not currently have an extensive residential care infrastructure for elderly residents. The model is primarily home-based care supported by domestic helpers, or return to a home country for more intensive care. High-end hospitals provide excellent acute care; long-term residential care is limited.

International Long-Term Care Insurance

International long-term care insurance is a specialist, relatively narrow market. Key products and considerations:

Standalone care insurance: policies that pay a monthly benefit when the insured meets defined care triggers (typically inability to perform a specified number of Activities of Daily Living (ADLs) such as washing, dressing, toileting, and mobility). International policies covering care in a defined range of countries are available but relatively few in number. Premiums are substantial and increase significantly with the age at which the policy is taken out.

Combined life and care products: some life assurance products include an accelerated death benefit or care rider that pays out some or all of the death benefit early if the insured requires care. These are less flexible than standalone care insurance but may be more accessible.

Critical illness insurance: covers a lump sum on diagnosis of specified serious conditions (cancer, stroke, heart attack, and others). While not specifically a care product, the lump sum provides financial flexibility that may help fund care or home modifications.

Limitations: international care insurance underwriters face the challenge of varying care costs and definitions across countries; many providers have pulled back from international markets. Policies are typically only available up to age 65 or 70; those who did not plan ahead may not be insurable. Pre-existing conditions are excluded.

The bottom line: for most internationally mobile individuals, self-funding of care costs — from retirement savings and property assets — is the primary mechanism, with insurance as a supplement where available and affordable.

Planning for Cognitive Decline Abroad

Cognitive decline — progressive conditions such as Alzheimer's and other forms of dementia — creates specific challenges for internationally mobile individuals beyond the physical care dimension:

Financial management complexity: managing multiple bank accounts, investment portfolios in different jurisdictions, pension claims from several countries, and tax filings in multiple jurisdictions requires significant cognitive capacity. A gradual decline may first manifest as confusion or missed obligations in financial management — a risk that is higher for internationally mobile individuals than for those with simple, single-country financial lives.

Power of attorney: having appropriate, legally recognised power of attorney arrangements in every jurisdiction where significant assets are held is the most critical protective measure. If capacity is lost before appropriate POA is in place, obtaining authority to act requires court applications across multiple jurisdictions — a slow, expensive, and stressful process for family members. (See the separate guide on powers of attorney for internationally mobile individuals.)

Simplification strategy: consider progressively simplifying financial arrangements in the years approaching or after retirement — consolidating accounts, reducing the number of jurisdictions involved, concentrating holdings with fewer providers. Complexity that may be manageable at 60 can be unmanageable at 80.

Trusted oversight: identify a trusted person — a child, partner, trusted adviser — who has visibility of your financial arrangements and can notice if things are going wrong before a formal loss of capacity is declared.

Choosing a Care Jurisdiction: Key Considerations

Where you would receive long-term care in later life is a strategic decision that affects your financial plan, your family's lives, and your quality of life in a vulnerable period. Considerations include:

Proximity to family: being close to adult children or other family members who can provide informal support, visit regularly, and be involved in care decisions is highly valued by most care recipients. A retirement location far from family may need to be reconsidered as care needs increase.

Language: cognitive decline is harder to manage in a second language. English-language care provision is important for UK nationals; availability varies significantly by destination.

Healthcare quality: the quality of specialist healthcare — particularly for neurological conditions — varies significantly across popular expat retirement destinations. For serious conditions, proximity to a major specialist centre matters.

Cost: a retirement income plan that sustains a comfortable lifestyle may be insufficient to fund several years of private residential care. Model care costs explicitly and verify whether your retirement income plan is adequate.

Return to the UK: some internationally mobile individuals plan to return to the UK if significant care needs arise, benefiting from the NHS for acute healthcare and state social care support if assets fall below the relevant threshold. This is a viable option but requires a realistic assessment of the UK care system and the cost of UK residential care for self-funders.

Integrating Long-Term Care into the Retirement Income Plan

Long-term care should not be treated as a separate planning exercise but integrated into the retirement income plan from the outset:

1. Model care costs explicitly: include a care cost phase in the retirement income projection — for example, assume a probability of three years of residential care at the relevant market rate from age 80 or 85.

2. Ring-fence care reserves: consider holding a portion of retirement savings specifically as a "care reserve" — in liquid, lower-risk assets — that is not drawn down unless needed for care. The knowledge that care costs are provided for allows the remainder of the portfolio to be invested appropriately for long-term growth.

3. Property as a care asset: a property owned in your country of retirement may be a significant care funding asset — either through rental income in earlier retirement, or sale proceeds to fund care in later life. The practical and timing constraints of relying on property sale should be factored into the plan.

4. Insurance where available and cost-effective: if you are young enough and healthy enough to access international care insurance at a reasonable cost, review whether it is a cost-effective hedge against very high care costs.

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The information in this guide is for general educational purposes only. It does not constitute financial, tax, or care advice. Care costs, insurance availability, and state support rules vary by jurisdiction and change over time. You should seek independent professional advice tailored to your circumstances.

How Global Investments Can Help

Global Investments incorporates long-term care planning into the comprehensive retirement income plans we develop for internationally mobile clients. We help model care cost scenarios, review the suitability of the retirement location for long-term care, identify appropriate insurance products where available, and structure retirement savings with explicit provision for potential care costs. Contact our advisory team to discuss how care planning fits into your retirement strategy.