Annuity and Long-term Care Insurance Planning: How to Build Income Protection for Later-life Care Costs

Planning for later-life care can feel like trying to make financial decisions with incomplete information. You may not know whether you will need residential care, how long support will last, or how much care fees could rise, while the products designed to manage those risks—annuities, insurance policies, trusts and investment portfolios—can appear difficult to compare.

This is where annuity and long-term care insurance planning can provide a clearer framework. By combining guaranteed income, care-specific protection and careful use of savings, you can build a strategy designed to preserve dignity, reduce financial uncertainty and protect more of your estate. We’ll explore how the different options work, where AI-driven insurance pricing and claims automation may help, and which risks still require human judgement.

Important: This article is for general information, not personalised financial advice. Tax rules, care funding systems, product availability and eligibility criteria vary by country and can change. In the UK, regulated advice from an appropriately authorised financial adviser may be especially important before buying an annuity or care funding product.

Table of Contents

What Is Annuity and Long-term Care Insurance Planning?
Why Later-life Care Costs Are Difficult to Predict
How Annuities Can Create Guaranteed Income for Care Costs
How Long-term Care Insurance Fits Into the Plan
Immediate Needs Annuities and Care Fee Planning
Annuities Versus Long-term Care Insurance
How AI Is Changing Insurance Pricing and Claims Automation
Benefits and Limitations of AI-Driven Insurance Decisions
Building a Step-by-step Later-life Care Income Plan
How to Calculate the Income Protection You May Need
Common Mistakes and Misconceptions
Questions to Ask an Adviser or Insurer
Frequently Asked Questions
Final Advice for Annuity and Long-term Care Insurance Planning

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What Is Annuity and Long-term Care Insurance Planning?

Annuity and long-term care insurance planning is the process of combining guaranteed income and insurance protection to help meet the costs of care in later life. It usually involves assessing your pension income, savings, property, investments, expected care costs, family circumstances and tolerance for financial risk.

The aim is not necessarily to insure every possible expense. Instead, the aim is to decide which risks you can comfortably retain and which could seriously damage your financial security if they occur.

A complete plan may include:

A state pension or other reliable income.
An occupational or personal pension.
An ordinary retirement annuity.
An immediate needs annuity designed to pay care fees.
Long-term care insurance, where available and suitable.
Cash reserves for short-term costs and emergencies.
Investments intended to provide growth or flexibility.
Legal and estate planning documents.
A clear plan for who can make decisions if you lose mental capacity.

The most suitable structure depends on whether you are planning ahead before care is needed or responding to an immediate care requirement. These are different situations, and using the wrong type of policy can lead to unrealistic expectations.

Planning Before Care Is Needed

Before care is required, you are generally assessing a future risk. You may consider insurance that pays a benefit if you become unable to perform certain activities of daily living, develop a specified condition or require long-term support.

At this stage, underwriting may focus heavily on your age, health, occupation, lifestyle, family history and existing medical conditions. Premiums can be lower when cover is arranged earlier, although paying for many years does not guarantee that the policy will ultimately provide value.

Planning After Care Is Required

Once you need care, the question often becomes more immediate: how can you pay the fees for as long as support is needed? An immediate needs annuity may be relevant because it can provide a regular income based on your health and care requirements.

The financial assessment is usually more personalised than with a standard pension annuity. The insurer may consider medical evidence, life expectancy, the type of care required and whether payments go directly to a registered care provider.

Why Later-life Care Costs Are Difficult to Predict

Care costs are challenging because they combine longevity risk, inflation risk, health risk and investment risk. You may live for many years, require increasingly intensive care or face fee increases that exceed the growth of your income.

Care can also take several forms, including:

Support in your own home.
Assistance from family or privately employed carers.
Sheltered or assisted living.
Residential care without nursing.
Nursing care.
Specialist dementia or neurological care.
Temporary rehabilitation or respite care.

The cost of care can vary substantially according to location, accommodation, staffing, specialist needs and whether nursing support is required. A national average may therefore be less useful than a local assessment based on the type of care you would realistically consider.

The Four Main Financial Risks

Risk	What it means	Possible planning response
Longevity risk	You live longer than expected and need income for many years	Lifetime annuity or diversified income strategy
Inflation risk	Care fees and household costs rise over time	Inflation-linked income, growth assets or regular reviews
Investment risk	Markets fall while you are withdrawing money	Cash reserves, lower-risk assets and guaranteed income
Health and care risk	You need expensive support earlier than expected	Long-term care cover or an immediate needs annuity

A plan that protects against only one of these risks may still leave you exposed. For example, a level annuity could provide certainty but lose purchasing power, while an investment portfolio could provide growth but may fall sharply when care fees must be paid.

How Annuities Can Create Guaranteed Income for Care Costs

An annuity converts a lump sum into a regular income. Depending on the product, payments may continue for a fixed term, for the rest of your life or until a specified event occurs.

For later-life planning, the central attraction is certainty. You exchange some or all of your capital for an income that does not depend directly on stock market performance, which can make budgeting easier when care costs are already stressful.

Common Types of Annuity

Lifetime Annuity

A lifetime annuity pays an income for as long as you live. It can be useful for covering essential expenditure, including household bills, regular care at home or a contribution towards residential care.

Its main weakness is that the capital is usually committed and may not be available for other purposes. If you die earlier than expected, the total payments may be lower than the original purchase price unless a guarantee period, capital protection or value protection feature was included.

Level Annuity

A level annuity pays the same amount throughout the contract. This offers straightforward certainty, but inflation can gradually reduce the real value of the income.

A level annuity may be appropriate for a specific cost that is expected to remain stable, but it is less suitable where fees are likely to rise regularly.

Escalating or Inflation-linked Annuity

An escalating annuity increases over time, either by a fixed percentage or according to an inflation measure. The starting income is normally lower than that of a level annuity, because the insurer is committing to larger future payments.

This type of income may be valuable for long-term care planning, although it is important to compare the escalation formula with the actual history and expected trajectory of care fees.

Joint-life Annuity

A joint-life annuity continues paying an income to a surviving spouse or civil partner after the first policyholder dies. It may help ensure that the survivor can continue meeting household or care-related expenses.

The income is usually lower than that of a single-life annuity because payments may continue for two lives rather than one.

Immediate Needs Annuity

An immediate needs annuity is designed for someone who already requires long-term care. It can pay a regular income directly to a care provider or to the individual, depending on the terms and relevant tax rules.

Because underwriting may take account of significant health conditions, the income offered can be higher than a standard annuity for someone of the same age. However, the policy may require substantial capital and normally cannot be cancelled once purchased.

What Can Affect an Annuity Rate?

Annuity rates can be influenced by:

Your age and life expectancy.
Your health and medical history.
Whether you smoke or have other relevant lifestyle factors.
The amount invested.
Interest rate conditions.
The chosen payment frequency.
Whether income is level or increasing.
Whether payments continue to a spouse.
Any guarantee or capital protection.
Whether the annuity pays a care provider directly.

Health information should be disclosed accurately. Omitting a relevant condition can affect the underwriting decision, and a specialist adviser may help gather appropriate medical evidence so that the quotation reflects your circumstances.

How Long-term Care Insurance Fits Into the Plan

Long-term care insurance is designed to provide financial support if you meet the policy’s definition of needing long-term care. Depending on the product, it may pay a regular benefit, reimburse eligible care costs or provide a lump sum.

The words long-term care insurance can describe several different arrangements, so you should read the eligibility criteria carefully. A policy may not respond simply because you feel unable to manage at home; it may require a formal assessment or evidence that you cannot perform a defined number of activities of daily living.

Typical Activities of Daily Living

Policy definitions may refer to activities such as:

Washing or bathing.
Dressing and undressing.
Eating and drinking.
Using the toilet.
Moving between a bed and a chair.
Walking or transferring.
Maintaining continence.
Communicating or managing cognitive tasks.

The exact wording varies. Some policies may focus on physical limitations, while others include cognitive impairment or medical certification.

Types of Long-term Care Protection

Product approach	How it generally works	Main planning use
Pre-funded care insurance	Premiums are paid in advance for potential future benefits	Planning before care is needed
Deferred care cover	Benefits begin after a waiting or deferral period	Reducing the cost of prolonged support
Immediate care plan	Lump sum purchases income after care has started	Paying known care fees
Benefit-based policy	Pays a fixed amount when eligibility criteria are met	Supplementing other resources
Reimbursement policy	Pays eligible expenses supported by evidence	Covering defined care costs

Availability varies considerably by market, and some products may no longer be widely offered. You should not assume that a policy described as “care insurance” will cover every form of home, residential or nursing care.

Immediate Needs Annuities and Care Fee Planning

An immediate needs annuity can be particularly relevant when a person has entered care and wants to reduce the risk of their assets being exhausted. The policy exchanges a capital sum for a regular income, often paid directly to the care provider.

The most important advantage is that the income may continue for life, even if the policyholder lives considerably longer than expected. This transfers some longevity and investment risk to the insurer.

Example: How an Immediate Needs Annuity May Work

Suppose a care home costs £5,000 per month, while state benefits and pension income provide £2,000 per month. The shortfall is £3,000 per month, or £36,000 per year.

A person might use part of their capital to purchase an annuity designed to cover some or all of that shortfall. If the income is paid directly to a registered care provider, tax treatment may be more favourable under applicable rules, but this must be confirmed before relying on it.

The remaining assets could then be retained for:

Personal spending.
A spouse’s financial security.
Home maintenance.
Unexpected medical costs.
Gifts or inheritance.
Funeral expenses.
A reserve in case care arrangements change.

This approach does not eliminate every risk. Care fees may increase, the policy may not cover additional services and the capital used to buy the annuity may not be recoverable.

Questions About Immediate Needs Annuities

Before proceeding, check:

Does the income increase with inflation or remain level?
Is the policy paid directly to the care provider?
What happens if the person moves to another care setting?
Are nursing or specialist care costs covered?
Is there a guarantee period?
Is capital protection available?
What happens if the care provider closes or changes ownership?
Are fees, commissions and advice costs clearly disclosed?
Can the policy be cancelled or altered?
How is medical evidence assessed?

A regulated adviser with experience in care funding can help compare the cost of transferring the risk with the value of keeping the capital invested.

Annuities Versus Long-term Care Insurance

Annuities and long-term care insurance can appear similar because both aim to provide financial protection, but they address different planning problems.

An annuity mainly converts capital into income. Long-term care insurance mainly transfers the financial risk associated with meeting defined care-related conditions.

Feature	Annuity	Long-term care insurance
Primary purpose	Create regular income	Provide benefits when care criteria are met
Trigger for payment	Contract terms, often immediately or at retirement	Qualifying care need or medical condition
Underwriting	Age, health, rates and selected benefits	Health, eligibility, policy definitions and risk
Payment pattern	Usually regular income	Income, reimbursement or lump sum
Capital requirement	Often substantial	Premiums may be paid over time or as a lump sum
Main advantage	Predictability of income	Specific protection against care-related risk
Main limitation	May not match future care inflation	May exclude conditions or fail to cover full costs
Flexibility	Usually limited after purchase	Depends heavily on policy wording
Estate impact	Capital may be exchanged for income	Benefits depend on claims and policy terms

When an Annuity May Be More Suitable

An annuity may be worth considering when:

You value certainty over investment flexibility.
You need income to meet essential expenditure.
You already require care and want to cover a known shortfall.
You have sufficient capital to purchase the policy.
You are comfortable exchanging capital for guaranteed payments.
You want to reduce exposure to market falls.

When Insurance May Be More Suitable

Long-term care insurance may be more relevant when:

You are planning before care is needed.
You want protection against a defined care event.
You prefer to preserve more savings for other purposes.
You understand and meet the policy’s eligibility criteria.
You can maintain premiums without financial strain.
The policy offers meaningful protection relative to its cost.

In some cases, a blended approach may be appropriate: guaranteed income for essential costs, insurance for a defined care risk and investments for flexibility. The correct balance depends on your resources and the risks you are willing to accept.

How AI Is Changing Insurance Pricing and Claims Automation

AI-driven insurance pricing and claims automation are changing how insurers assess risk, calculate premiums and process applications. Machine learning systems can identify patterns in large datasets, while automated tools can extract information from medical records, forms, invoices and supporting documents.

For consumers, this may lead to quicker quotations and faster claims decisions. However, speed should not be confused with accuracy, fairness or suitability.

AI in Insurance Pricing

AI may be used to analyse:

Age and demographic information.
Medical history and underwriting data.
Previous claims.
Policy characteristics.
Mortality and morbidity trends.
Behavioural or lifestyle information, where legally permitted.
Care costs by region or provider type.
Historical lapse and cancellation patterns.

The system may then help estimate the likelihood, timing or cost of a claim. In theory, more accurate risk assessment can support more precise pricing and reduce cross-subsidisation between different groups.

In practice, the quality of the result depends on the data used, how the model was designed and whether its conclusions can be explained. A model trained on historic decisions may reproduce historic inequalities rather than remove them.

AI in Claims Automation

Claims automation can support several stages of the process:

Checking whether forms are complete.
Extracting information from medical or financial documents.
Identifying duplicate submissions.
Matching invoices to policy benefits.
Flagging potential fraud.
Prioritising urgent cases.
Sending routine updates.
Escalating complex cases to human handlers.
Calculating payments within defined limits.

For straightforward claims, automation can reduce administrative delays. For complex care claims involving dementia, fluctuating capacity or multiple medical conditions, human review remains essential.

Benefits and Limitations of AI-Driven Insurance Decisions

AI can make insurance administration more efficient, but it does not replace the need for clear policy wording or consumer protection.

Potential Benefits for Policyholders

Faster processing: Routine applications and claims may be handled more quickly.
Fewer administrative errors: Automated checks can identify missing or inconsistent information.
More consistent decisions: Similar cases may be processed using the same criteria.
Better fraud detection: Suspicious patterns can be referred for further investigation.
Improved customer communication: Automated updates may show the stage of a claim.
More responsive pricing: Insurers may model changing care costs more frequently.

Potential Consumer Risks

Opaque decisions: You may not understand why a premium or claim outcome was produced.
Data quality problems: Incorrect medical or personal information can lead to a poor result.
Historic bias: Previous inequalities may be embedded in training data.
Overreliance on automation: Complex or vulnerable cases may need human judgement.
Privacy concerns: Sensitive health and financial data require careful handling.
Inconsistent explanations: A chatbot or automated message may not explain the contractual position properly.

If an automated system declines or limits a claim, ask whether a human review is available. Keep copies of your application, medical evidence, policy wording and all communications, because a clear record can be important if you need to challenge a decision.

Questions About AI and Insurance Fairness

Ask the insurer:

Is AI used to price, underwrite or assess claims?
What information does the system use?
Can a human review an automated decision?
How can you correct inaccurate data?
What is the complaints process?
Is the decision based on the policy wording?
How is sensitive health information protected?
Can the insurer explain the reason for a refusal or exclusion?

Consumer champion Martin Lewis has repeatedly emphasised the importance of comparing the real cost and conditions of financial products rather than focusing only on headline prices. The same principle applies here: a fast digital quotation is not necessarily a suitable or comprehensive solution.

Building a Step-by-step Later-life Care Income Plan

A structured process can help you avoid making decisions based on fear, urgency or a single attractive quotation.

Step 1: Define Your Care Planning Objectives

Start by deciding what you want the plan to achieve. Your priority may be to remain in your own home, protect a spouse, avoid selling a property under pressure or preserve a predictable inheritance.

Write down your objectives in order of importance. This can reveal whether you need maximum guaranteed income, greater flexibility or a compromise between the two.

Step 2: Calculate Reliable Income

List income that is expected to continue, including:

State pension.
Defined benefit pension.
Existing annuity income.
Rental income, allowing for vacancies and maintenance.
Investment income.
Benefits or support payments.
Income from a spouse or civil partner.

Separate reliable income from uncertain income. Dividends, withdrawals from investments and property income may fluctuate, while a guaranteed pension or annuity may be more dependable.

Step 3: Estimate Care and Household Costs

Create separate estimates for:

Current household spending.
Home care costs.
Residential care costs.
Nursing or specialist care.
Utility and property costs.
Transport and personal spending.
Medical and dental expenses.
One-off adaptations or equipment.
Professional advice and legal fees.

Use a range rather than one number. For example, calculate a lower-cost, expected-cost and higher-cost scenario, then consider how long your assets could support each outcome.

Step 4: Review Assets and Liabilities

Your balance sheet should include:

Cash savings.
ISAs and investment accounts.
Pension funds.
Property.
Business interests.
Trust assets.
Debts and mortgages.
Expected inheritances, without treating them as guaranteed.

Do not assume that property can be sold quickly at its full market value. A forced sale, delayed probate or a falling local market may affect how much capital is actually available.

Step 5: Decide Which Risks to Insure

Insurance is most valuable when the potential loss is large enough to threaten your financial security. It may be less attractive for small, manageable costs that could be funded from cash.

Consider insuring or guaranteeing:

Lifetime care fees.
Essential income for a surviving spouse.
A large care-cost shortfall.
A period when investment markets could be especially damaging.
Costs arising from a severe or qualifying condition.

Step 6: Compare Products on Realistic Assumptions

Compare policies using the same assumptions:

Care fee level.
Inflation rate.
Investment return.
Life expectancy scenarios.
Tax treatment.
Escalation terms.
Fees and commissions.
Guarantee periods.
Death benefits.
Exclusions.

A policy can appear inexpensive because it provides a lower benefit, excludes common conditions or offers no inflation protection.

Step 7: Build in Review Points

Review the plan after major events, including:

Retirement.
A significant health change.
A partner’s death.
Moving home.
Entering care.
Changes to tax or care funding rules.
A major inheritance.
Changes in interest rates or annuity rates.

Avoid repeatedly changing long-term products without a clear reason. Reviews should test whether the original objectives remain valid, not encourage unnecessary transactions.

How to Calculate the Income Protection You May Need

A simple starting calculation is:

Annual care and essential living costs − reliable annual income = annual funding shortfall

For example:

Item	Annual amount
Care and essential living costs	£72,000
State and pension income	£30,000
Other dependable income	£6,000
Estimated annual shortfall	£36,000

The next step is to stress-test the shortfall. If care fees rise by 4% annually, the required income after ten years will be materially higher than the initial amount.

You should also model different lifespans. A strategy that works if care lasts three years may fail if care continues for twelve years, particularly if investments are sold after a market fall.

A Practical Stress-test Checklist

Test your plan against:

A five-year care period.
A ten-year care period.
Higher-than-expected care inflation.
A major investment market decline.
A surviving spouse needing independent income.
A move from home care to residential care.
A period of vacant property or delayed sale.
Higher tax or reduced public support.
Additional costs for dementia or nursing care.

These scenarios are not predictions. They are decision tools that show whether your plan is resilient or depends on one optimistic outcome.

Common Mistakes and Misconceptions

Misconception 1: “An Annuity Always Protects Against Inflation”

Reality: A level annuity provides a fixed payment, unless the contract includes an escalation feature. Even an escalating annuity may not increase at the same rate as care fees.

Check the increase mechanism, starting income and maximum escalation before comparing quotations.

Misconception 2: “Long-term Care Insurance Covers Any Need for Help”

Reality: Policies normally contain specific definitions and eligibility tests. Assistance with one activity may not be enough to trigger benefits, and some conditions or forms of care may be excluded.

Read the policy schedule and definitions rather than relying on the product name.

Misconception 3: “The Cheapest Premium Is the Best Deal”

Reality: A lower premium may reflect a smaller benefit, longer waiting period, more exclusions or no inflation protection. Compare the benefit received, not simply the price paid.

Misconception 4: “AI Makes Insurance Decisions Objective”

Reality: AI can process data consistently, but the outcome still depends on data quality, model assumptions and human oversight. A consistent decision can still be wrong if the underlying information is incomplete.

Misconception 5: “You Should Keep Everything Invested for Growth”

Reality: Investments can provide long-term growth and flexibility, but selling assets to pay urgent care fees during a market downturn can permanently damage the portfolio.

Guaranteed income can reduce the amount you need to withdraw at the worst possible time.

Misconception 6: “Care Planning Is Only for People Already in Residential Care”

Reality: Planning earlier can help you consider home adaptations, family responsibilities, insurance availability and the protection of a partner. Waiting until a crisis may leave fewer choices.

Misconception 7: “A Will Solves Care Funding Problems”

Reality: A will determines what happens to assets after death; it does not normally decide how care is funded during your lifetime. Powers of attorney, trusts and lifetime planning may also be relevant, subject to professional advice.

Tax, Legal and Consumer Protection Considerations

Tax treatment can materially affect the value of an annuity or care insurance policy. Payments may be treated differently depending on whether they are paid directly to a qualifying care provider, paid to the policyholder or connected to a pension arrangement.

Do not rely on a general online explanation for a personal tax decision. Confirm the position with a regulated adviser or qualified tax professional before purchasing a policy or transferring assets.

Legal planning may include:

A valid will.
Lasting powers of attorney or equivalent documents.
Property and financial decision-making arrangements.
Health and welfare instructions.
Reviewing ownership of property and investments.
Checking beneficiary nominations on pensions and policies.
Understanding any trust arrangements.

Avoid transferring assets solely to try to qualify for public support without obtaining specialist advice. Deliberate deprivation rules, tax consequences and family disputes can create serious problems.

Questions to Ask an Adviser or Insurer

Take a written list to any meeting, particularly if you feel pressured by a recent diagnosis or care decision.

Questions About Suitability

What specific risk is this product designed to cover?
What happens if I never need care?
How much capital remains accessible?
How would this affect my spouse or dependants?
Is the income guaranteed for life?
Does the policy meet my stated objectives?

Questions About Exclusions

Which medical conditions are excluded?
Are cognitive conditions covered?
Does home care qualify?
Are nursing and residential care treated differently?
Is there a waiting period?
What evidence must be provided?
Can the insurer change the terms later?

Questions About AI and Claims

Will an automated system assess my application or claim?
Can I speak to a human decision-maker?
How can inaccurate information be corrected?
How are medical records obtained and stored?
What is the appeal and complaints process?
Will the insurer explain the decision in plain language?

Questions About Costs

What are the adviser fees?
Is commission included?
Are there policy charges?
Is the quotation guaranteed?
What happens if rates change before completion?
Are there costs for medical reports or legal work?

Frequently Asked Questions

Is an annuity a form of long-term care insurance?

Not usually. An annuity creates income from capital, while long-term care insurance pays benefits when the policyholder meets defined care-related conditions. An immediate needs annuity is specifically used to help fund care, but it remains an annuity rather than a conventional pre-funded insurance policy.

Can an annuity pay care home fees directly?

Some immediate needs annuities can pay an income directly to a registered care provider. This may have important tax implications, but the exact conditions should be confirmed before the policy is purchased.

Is long-term care insurance worth it?

It may be worthwhile if the benefit meaningfully reduces a risk that would otherwise threaten your finances. The answer depends on premiums, exclusions, benefit levels, inflation protection, your health and whether you can comfortably self-fund a potential care need.

Should I buy an annuity before retirement?

That depends on your need for guaranteed income and the flexibility you are willing to give up. Some people annuitise only enough to cover essential spending and keep the rest invested, while others prefer a larger guaranteed income.

Does an annuity protect my estate?

Not automatically. Some annuities include value protection or guarantee periods, but these features normally reduce the starting income or increase the purchase cost. Read the death benefit terms carefully.

How does inflation affect care planning?

Inflation can increase care fees, household bills and the amount of income required over time. A plan should compare the expected increase in benefits with realistic care-cost scenarios rather than assuming that all prices rise at the same rate.

Can AI reject my insurance claim?

An automated system may flag or initially decline a claim, but applicable consumer protection rules may provide routes for explanation, human review and complaint. Ask the insurer how to challenge an automated decision and request the contractual reason for the outcome.

Should I use all my savings to buy an immediate needs annuity?

Not necessarily. Retaining an emergency reserve may be important for personal spending, changing care arrangements, family needs and unexpected expenses. A regulated adviser can help assess how much capital should remain accessible.

Is care at home cheaper than residential care?

It can be, but not in every situation. Intensive home care, night care, adaptations and specialist equipment may make home support expensive, while residential care fees often include accommodation and daily services. Compare realistic packages rather than headline hourly rates.

Final Advice for Annuity and Long-term Care Insurance Planning

The strongest annuity and long-term care insurance planning strategy is rarely built around one product. It usually combines a reliable income floor, accessible savings, appropriate insurance, sensible investments and legal arrangements that reflect your family’s needs.

AI-driven pricing and claims automation may make insurance faster and more data-led, but you should still insist on transparent explanations, accurate medical information and human review where circumstances are complex. Technology can support a decision; it cannot decide what level of uncertainty you and your family can reasonably accept.

Before committing capital, compare the guaranteed benefits with the risks of self-funding, test the plan against inflation and long-term care scenarios, and obtain regulated advice where the decision is irreversible. The goal is not to predict every detail of later life, but to create enough financial resilience that care costs do not dictate every decision when you or someone you love needs support.