Americans 40 or older know they’ll need some personal care as they age and worry about losing their independence or having to rely on others. Yet, they are more likely to plan for their funerals than for their care needs, have no idea what such care costs, and more than 4 in 10 mistakenly believe Medicare will pay for their ongoing nursing home expenses.

These are just some of the depressing results of a new public opinion poll by the Associated Press-NORC Center for Public Affairs Research. The survey, funded by the SCAN Foundation, is just the latest to report on how poorly prepared Americans are for the high probability they’ll need personal assistance and other supports in old age.

Caring for a parent, spouse, or other relative remains part of the nation’s social fabric. Six in 10 of those surveyed say they have provided care, financed such assistance, or received support themselves.  Of those, three-quarters provided hands-on help.  Just 7 percent say they or someone in their family is currently employing someone to provide in-home assistance.

Most family caregivers are women, with an average age of 59. Most are caring for their mothers and nearly 60 percent have household incomes of less than $50,000.Fewer than 15 percent report caring for a spouse or partner.

While caregivers overwhelmingly say the experience has been positive, more than half add that it has increased family stress. About one-third say caregiving has been burden on their finances. Interestingly, for all the talk about the sandwich generation that is caring for both children and parents, those caregivers report no more stress than those without kids.

Those who have been caregivers are more likely to plan for their own futures than those without personal experience helping a loved one. But overall, people seem in a total state of denial about aging.

About 6 in 10 of those 40+ believe it is at least somewhat likely they’ll need assistance with daily living sometime in the future. (On this, at least, they are right: About 70 percent of 65 year-olds will need some long-term supports before they die).

Trouble is, big majorities are doing nothing to plan for it. While two-thirds say they have discussed funeral plans, two-thirds also say they have done little or no planning for their care needs while they are still alive. A bit more than half say they’ve created an advanced directive but only about 40 percent say they’ve discussed care preferences with their families. About a third report having set aside money to pay for care.

Yet, only a third say they are very concerned about how much they have planned for their long-term care, and another 28 percent are “moderately concerned.” Nearly 4 in 10 are not concerned at all.

So how do they think they’ll get care? Three-quarters expect a spouse or partner will care for them. About 45 percent are counting on their kids or grandkids to help out. More than one-third think they’ll get help from Medicare (they won’t) and about one-third think health insurance will pay for this assistance (wrong again).  Only about 15 percent expect Medicaid to help–even though that government program actually funds half of all paid care.

The survey also asked about policy changes to help prepare for the costs of supports and services. About 8 in 10 favored tax breaks for either saving for long-term care or buying long-term care insurance.

About three-quarters liked the idea of buying LTC insurance through their employer, and nearly 60 percent backed a government-administered insurance plan. Not surprisingly, for those who have been watching the on-going debate over the Affordable Care Act, only about one-quarter favored an individual requirement to buy LTC insurance.

The take-away: After all the years of talking about the importance of planning for care needs in old age, after all the marketing from insurance companies and government, all the consumer-oriented blogs and news articles for people like me, and even after all the experience many of those 40+ have had with their own families, people remain largely clueless about the financial risks they face in old age.