The demand for long-term care (LTC) is growing, raising urgent questions about how such care should be financed and delivered as Ghana’s population continues to age1. In Ghana, rapid population ageing is occurring in the absence of a formal LTC system. As a result, care for older adults is predominantly provided by unorganized caregivers, often family members who not only deliver care but also finance it out of pocket2. These caregivers operate with limited state support, as formal LTC services and financing structures are currently absent, and Ghana lacks a dedicated national LTC policy for older adults. As a result, caregivers bear both the emotional and financial burdens of care provision. Understanding their preferences for future LTC financing mechanisms is essential for designing equitable and context-sensitive policies, particularly in low- and middle-income settings where state capacity is constrained. Globally, a variety of LTC financing models exist, including social insurance systems, tax-funded schemes, and means-tested public subsidies3,4. The adoption of these models often reflects institutional history, public preferences, and cultural values. In Ghana, however, formal LTC financing mechanisms are largely absent, leaving caregiving highly privatized and largely dependent on family support. This arrangement creates unequal caregiving experiences, particularly across income groups...