Friday, August 20, 2004
As the population ages, who will provide care for the elderly?
[Robert B. Friedland, "Caregivers and long-term care needs in the 21st century: Will public policy meet the challenge?," Issue Brief, Georgetown University Long-Term Care Financing Project, July 2004.]
This recent report makes an excellent but troubling observation. Over the past three decades, the 85 and older population has grown at roughly twice the level of those aged 25 to 54. In this decade, however, the growth rate of the 85 and over population will continue at the same level while that of the 25 to 54 year olds will drop to zero. In a market setting, demand and supply would shift to meet needs. In a system dominated by government programs, though, it is worth asking how society will be able to maintain current levels of service, let alone those necessary in the future:
Long-term care is hands-on assistance provided to people who need help with fundamental daily activities such as bathing or eating, over a substantial period of time. This type of assistance is labor intensive and is provided by family, friends, and volunteers, as well as by hired personnel. Most people with long-term care needs (83 percent) live in their own home; among those living at home, the majority (78 percent) does not hire any help. Families are critical in providing most long-term care, even when care is purchased.
Over the next 15 years the number of people who need long-term care is expected to increase by 30 percent. Soon thereafter, the number of people likely to need long-term care is expected to increase even more dramatically. Estimates of the long-term care population suggest that the number of people with long-term care needs will more than double between 2000 and 2050. Government estimates suggest that the number of people using paid long-term care services—in a nursing facility, alternative residential care (such as assisted living) facility, or at home—could nearly double, increasing from 15 million in 2000 to 27 million in 2050.
Given the sizable increase in the number of people who may need long-term care in the future, it is important to ask: will there be enough paid caregivers and family caregivers to meet projected long-term care needs? Currently, many persons who need long-term care have a number of family members available to provide care or have a significant pool of caregivers available for hire. However, as this paper will show, after 2015 the number of people likely to need long-term care will increase substantially faster than the number of people available either as family or as paid caregivers. Families will need more support to supplement their efforts and more paid caregivers will be necessary to provide this support.
If the market does not respond to meet these needs soon, policy makers, working with payers and providers of long-term care services, may need to find ways to encourage workers to remain in the long-term care labor force, encourage a larger share of the labor force to seek employment in the long-term care sector, and enhance how long-term care providers work with families to expand the capacity of family caregivers. Family caregivers need all the help they can get to provide care, including purchasing modifications to the home, purchasing labor-enhancing and labor-saving technologies, and figuring out how best to integrate paid caregivers into their homes. Paid caregivers will also be necessary for those who do not have any family available to provide care. Since 2015 is slightly more than a decade away, it is not too soon to start working towards fundamentally improving the efficiency and effectiveness of how care is delivered.
[Robert B. Friedland, "Caregivers and long-term care needs in the 21st century: Will public policy meet the challenge?," Issue Brief, Georgetown University Long-Term Care Financing Project, July 2004.]
This recent report makes an excellent but troubling observation. Over the past three decades, the 85 and older population has grown at roughly twice the level of those aged 25 to 54. In this decade, however, the growth rate of the 85 and over population will continue at the same level while that of the 25 to 54 year olds will drop to zero. In a market setting, demand and supply would shift to meet needs. In a system dominated by government programs, though, it is worth asking how society will be able to maintain current levels of service, let alone those necessary in the future:
Long-term care is hands-on assistance provided to people who need help with fundamental daily activities such as bathing or eating, over a substantial period of time. This type of assistance is labor intensive and is provided by family, friends, and volunteers, as well as by hired personnel. Most people with long-term care needs (83 percent) live in their own home; among those living at home, the majority (78 percent) does not hire any help. Families are critical in providing most long-term care, even when care is purchased.
Over the next 15 years the number of people who need long-term care is expected to increase by 30 percent. Soon thereafter, the number of people likely to need long-term care is expected to increase even more dramatically. Estimates of the long-term care population suggest that the number of people with long-term care needs will more than double between 2000 and 2050. Government estimates suggest that the number of people using paid long-term care services—in a nursing facility, alternative residential care (such as assisted living) facility, or at home—could nearly double, increasing from 15 million in 2000 to 27 million in 2050.
Given the sizable increase in the number of people who may need long-term care in the future, it is important to ask: will there be enough paid caregivers and family caregivers to meet projected long-term care needs? Currently, many persons who need long-term care have a number of family members available to provide care or have a significant pool of caregivers available for hire. However, as this paper will show, after 2015 the number of people likely to need long-term care will increase substantially faster than the number of people available either as family or as paid caregivers. Families will need more support to supplement their efforts and more paid caregivers will be necessary to provide this support.
If the market does not respond to meet these needs soon, policy makers, working with payers and providers of long-term care services, may need to find ways to encourage workers to remain in the long-term care labor force, encourage a larger share of the labor force to seek employment in the long-term care sector, and enhance how long-term care providers work with families to expand the capacity of family caregivers. Family caregivers need all the help they can get to provide care, including purchasing modifications to the home, purchasing labor-enhancing and labor-saving technologies, and figuring out how best to integrate paid caregivers into their homes. Paid caregivers will also be necessary for those who do not have any family available to provide care. Since 2015 is slightly more than a decade away, it is not too soon to start working towards fundamentally improving the efficiency and effectiveness of how care is delivered.
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