This brief provides new evidence on the lifetime risk that older adults will need long-term services and supports (LTSS) and receive paid help. Our results show that 70 percent of adults who survive to age 65 develop severe LTSS needs before they die and 48 percent receive some paid care over their lifetime. Only 24 percent of older adults receive more than two years of paid LTSS care, and only 15 percent spend more than two years in a nursing home. Lengthy spells of severe LTSS needs and paid care are more common among older adults with few financial resources.