The majority of women 50 and older in America keep their biggest retirement concern to themselves—the fear of becoming a health care or long-term care responsibility to their families, according to a Nationwide Retirement Institute survey.

The survey of 709 women and 582 men ages 50 or older finds two-thirds of women (66%) are worried they will become a burden to their family as they get older (compared to 50% of men). In addition, 78% of women say they are concerned about having money to cover long-term care (LTC) expenses.

Despite these concerns, six in 10 women ages 50 or older (62%) haven’t talked to anyone about long-term care costs. Of women with a spouse or women with at least one child, the most common reason they aren’t talking with these loved ones about health care costs in retirement is they don’t want them to worry (43% and 62%, respectively).

However, Nationwide says not talking about long-term care now can do more harm than good to women’s families later. “Families need to be aware of what they will face if they do not plan ahead for this risk—both emotionally and financially,” says Shawn Britt, director of long-term care initiatives, advance consulting group at Nationwide.

NEXT: LTC concerns

Among women in the study, 67% say they would rather die than live in a nursing home. Seventy-three percent prefer to get LTC in their own home, but only 51% think they will.

Nealry two-thirds (64%) say they are "terrified" of what health care costs may do to their retirement plans, and 47% are willing to give all their money to their children so they could be eligible for Medicaid-funded LTC.

Nationwide notes that the average life expectancy for women is 86, with one in four reaching age 92. Longevity increases the chance of needing LTC services during their golden years. That's why it's especially important for women to include planning for LTC costs in retirement.

Despite few women 50 or older (9%) having discussed LTC costs with a financial adviser, 57% of those who have discussed retirement with a financial adviser plan to discuss LTC costs with them.

"The good news is more than half of these women say they plan to have these discussions," says Roberta Eckert, vice president of the Nationwide Retirement Institute. "Financial advisers can play a major role in helping women plan for and live in retirement by providing a fact-based estimate of their long-term care costs and setting up plan to pay for those costs."

To simplify this complicated issue and encourage discussions around health care costs in retirement, Nationwide offers a Personalized Health Care Assessment, and women can also visit www.nationwide.com/womenandinvesting for additional retirement planning resources.