Disclaimer: General educational research only — not legal, tax or financial advice. Rules differ by state and by family. Talk to an estate planning attorney in your state before you act.
Estate Planning Data & Research → Self-Care Difficulty by State
About 6.9% of Americans age 65 and older — 4,155,459 people — have a self-care difficulty: serious trouble dressing or bathing because of a physical, mental or emotional condition. The Census Bureau’s American Community Survey asks this separately from trouble running errands alone (independent living) and from serious difficulty concentrating or remembering (cognitive).
This page ranks every state and D.C. by the share of residents 65+ with a self-care difficulty, using ACS 2024 1-year estimates. National Estate Planning Awareness Week (Oct. 19–25) is a useful reminder: capacity documents are easier to sign while someone can still manage daily care.
Needing help with bathing or dressing is a practical signal to finish wills, powers of attorney and trust funding while capacity is clear. See how a trust and a will differ.
Downloads
Cite this page URL when reusing findings. Not a substitute for official sources or professional advice.
Key findings
- 4,155,459 people 65+ (6.9%) have a self-care difficulty in the civilian noninstitutionalized population (Census ACS 2024, table B18106).
- The rate rises with age: 4.1% at ages 65–74 and 11.0% at 75+ (2,722,013 people 75+).
- Highest shares: California (9.0%), Mississippi (8.7%), New York (8.7%), Arkansas (8.0%) and West Virginia (8.0%).
- Lowest shares: New Hampshire (4.4%), Maine (4.5%), Utah (4.5%), Wyoming (4.8%) and Colorado (4.9%).
- Largest counts: California (579,649), Texas (328,548), Florida (319,995) and New York (318,786).
Self-care difficulty among people 65+ by state
| State | People 65+ | With self-care difficulty | Share 65+ (%) | Share ages 65–74 (%) | Share ages 75+ (%) |
|---|---|---|---|---|---|
| California | 6,419,948 | 579,649 | 9.0 | 5.0 | 14.5 |
| Mississippi | 514,819 | 44,907 | 8.7 | 6.2 | 12.6 |
| New York | 3,661,417 | 318,786 | 8.7 | 4.9 | 13.8 |
| Arkansas | 546,263 | 43,491 | 8.0 | 5.4 | 11.6 |
| West Virginia | 376,892 | 30,010 | 8.0 | 5.7 | 11.3 |
| Alabama | 932,248 | 72,867 | 7.8 | 4.8 | 12.2 |
| District of Columbia | 88,358 | 6,852 | 7.8 | 4.4 | 12.1 |
| Rhode Island | 213,116 | 16,576 | 7.8 | 4.9 | 11.8 |
| Louisiana | 797,245 | 61,443 | 7.7 | 5.0 | 12.0 |
| Texas | 4,266,726 | 328,548 | 7.7 | 4.6 | 12.6 |
| Alaska | 107,828 | 8,052 | 7.5 | 4.6 | 12.7 |
| Hawaii | 306,423 | 22,374 | 7.3 | 3.6 | 11.7 |
| Oklahoma | 670,498 | 48,532 | 7.2 | 4.5 | 11.2 |
| Georgia | 1,729,272 | 122,030 | 7.1 | 4.0 | 11.7 |
| Kentucky | 804,147 | 57,349 | 7.1 | 4.7 | 10.8 |
| New Mexico | 423,909 | 30,040 | 7.1 | 4.5 | 10.6 |
| Washington | 1,357,193 | 94,670 | 7.0 | 4.0 | 11.4 |
| Massachusetts | 1,299,964 | 90,319 | 6.9 | 4.2 | 10.8 |
| Tennessee | 1,245,935 | 86,411 | 6.9 | 4.0 | 11.3 |
| Nevada | 570,621 | 38,676 | 6.8 | 4.5 | 10.1 |
| New Jersey | 1,671,428 | 113,388 | 6.8 | 3.6 | 11.1 |
| Oregon | 834,150 | 56,817 | 6.8 | 4.4 | 10.3 |
| Pennsylvania | 2,581,112 | 172,313 | 6.7 | 4.2 | 10.1 |
| Virginia | 1,518,684 | 99,153 | 6.5 | 3.7 | 10.5 |
| Florida | 4,990,885 | 319,995 | 6.4 | 3.5 | 10.0 |
| Illinois | 2,209,366 | 141,952 | 6.4 | 3.7 | 10.3 |
| Michigan | 1,949,013 | 124,658 | 6.4 | 3.8 | 10.4 |
| Connecticut | 694,771 | 43,931 | 6.3 | 3.0 | 11.0 |
| Maryland | 1,075,158 | 67,978 | 6.3 | 3.4 | 10.5 |
| Missouri | 1,133,028 | 71,761 | 6.3 | 4.4 | 9.2 |
| North Carolina | 1,937,524 | 122,247 | 6.3 | 3.8 | 9.9 |
| Ohio | 2,198,505 | 138,598 | 6.3 | 3.8 | 10.0 |
| Indiana | 1,180,579 | 72,192 | 6.1 | 3.7 | 9.7 |
| South Carolina | 1,060,670 | 64,596 | 6.1 | 3.8 | 9.5 |
| Kansas | 514,923 | 30,965 | 6.0 | 3.6 | 9.6 |
| Nebraska | 337,113 | 19,404 | 5.8 | 3.4 | 9.2 |
| Arizona | 1,470,782 | 82,225 | 5.6 | 3.2 | 8.6 |
| Wisconsin | 1,144,376 | 64,237 | 5.6 | 3.4 | 8.9 |
| Idaho | 347,090 | 19,229 | 5.5 | 3.3 | 9.1 |
| South Dakota | 167,864 | 9,266 | 5.5 | 3.9 | 8.2 |
| Montana | 235,515 | 12,718 | 5.4 | 2.7 | 9.6 |
| Iowa | 586,410 | 30,091 | 5.1 | 3.3 | 7.9 |
| Minnesota | 1,021,253 | 51,945 | 5.1 | 3.0 | 8.2 |
| Delaware | 223,718 | 11,209 | 5.0 | 2.5 | 8.8 |
| Colorado | 959,844 | 47,240 | 4.9 | 2.8 | 8.3 |
| North Dakota | 133,347 | 6,471 | 4.9 | 2.5 | 8.2 |
| Vermont | 144,883 | 7,110 | 4.9 | 3.3 | 7.3 |
| Wyoming | 114,610 | 5,447 | 4.8 | 2.8 | 7.9 |
| Maine | 319,927 | 14,370 | 4.5 | 2.9 | 6.8 |
| Utah | 429,064 | 19,405 | 4.5 | 2.5 | 7.5 |
| New Hampshire | 293,912 | 12,966 | 4.4 | 2.3 | 7.7 |
| United States | 59,812,326 | 4,155,459 | 6.9 | 4.1 | 11.0 |
Source: U.S. Census Bureau, ACS 2024 1-year, table B18106 (Sex by Age by Self-Care Difficulty). Universe is the civilian noninstitutionalized population. Self-care difficulty means serious difficulty dressing or bathing. Sorted by share of people 65+.
Why this matters for estate planning
- A durable power of attorney and health-care proxy are timed documents. They need to be signed while the person still has capacity — ideally before daily self-care becomes hard. See the incapacity gap (cognitive difficulty) and independent living difficulty by state (trouble running errands alone).
- A living trust can keep bills and care decisions moving if the grantor can no longer manage accounts alone.
- Care costs and Medicaid rules still apply. See home care cost vs retirement income and Medicaid estate recovery.
Related: life expectancy at 65 by state · power-of-attorney abuse watch
Methodology
Census ACS 2024 1-year estimates, table B18106, pulled from the Census API on Oct. 17, 2026, for the 50 states, D.C. and the U.S. Ages 65–74 and 75+ combine male and female rows. ACS figures are survey estimates with margins of error. People living in nursing homes and other institutions are outside this universe.
What this doesn’t measure. Whether someone already has a power of attorney, health-care directive or funded trust; clinical diagnoses; or how many hours of paid care they receive.
Frequently asked questions
How many Americans 65+ have a self-care difficulty?
4,155,459, or 6.9% of the civilian noninstitutionalized population 65+ (ACS 2024).
Is this the same as independent living difficulty?
No. Independent living difficulty (ACS B18107) is trouble doing errands alone, such as visiting a doctor’s office or shopping. Self-care is dressing or bathing.
Is this legal advice?
No. Talk to an estate planning attorney in your state.
Sources
Public-domain government sources only. Fetched 2026-10-17.
Data
- U.S. Census Bureau, ACS 2024 1-year, table B18106: https://api.census.gov/data/2024/acs/acs1/groups/B18106.html
Cite this data
Family Estate Guide, “Self-Care Difficulty by State,” October 2026. https://familyestateguide.com/estate-planning-data/self-care-difficulty-by-state/
You’re welcome to reuse the table with a link back to this page. The underlying government data is public.
Published October 17, 2026 by Family Estate Guide. Data vintage: Census ACS 2024 1-year, table B18106. Editorial standards.