The growing aging population
As per recent statistics by the United Nations, the proportion of world's population over 60 years has risen from 9.2% to 12% from 1990 to 2019 and is expected to keep rising in the coming decades. Countries around the world are experiencing significant growth in the number and proportion of older persons in their societies. Here in the United States as well, 10,000 Americans are turning 65 everyday and by 2030, one in five of all Americans will be aged 65 or older. This demographic shift has huge implications for healthcare and long term care needs of the growing senior citizens.
Changes in family structure
The traditional family support systems are not as robust as they used to be in the past. With increasing geographical mobility and dual career families, the older adults may not have their adult children living close by to provide care as and when needed. Many adult children also have their own families to take care of and career commitments that limit their ability to be the primary caregivers for their aging parents. All these factors point towards a rising demand for formal long term care options outside the family.
Rising need for assistance with daily living
As people age, the incidence of chronic health conditions and functional and cognitive impairments rises steadily. Conditions like arthritis, heart disease, diabetes, Alzheimer's etc become more common among the older population. According to studies, the need for personal assistance with daily activities like bathing, dressing, eating, medication management etc rises dramatically after the age of 75. Almost 70% of Americans aged 65 and older will require some form of long term care services at some point in their lives. Chronic diseases and disabilities make independent living challenging for many older adults and amplify the need for supervised long term care.
Long Term Care Options
The rising demand for long term care has given rise to several options that can be categorized as institutional care and community-based care:
Institutional Care
Nursing Homes
- Nursing homes provide 24-hour skilled nursing care for those requiring constant monitoring and serious medical assistance on an ongoing basis. They employ nurses and nursing aides to help residents with bathing, dressing, toileting, medication management, meal planning etc.
- Nursing homes are suitable for individuals with multiple co-morbidities, cognitive impairments and those no longer able to perform basic daily activities independently. They offer a secure environment along with social activities for residents. However, the cost of nursing home care is quite high, averaging around $90,000 annually nationwide.
Assisted Living Facilities
- Assisted living facilities provide a less intensive level of care compared to nursing homes. They cater to seniors requiring some assistance but not full medical care and supervision round the clock.
- Residents live in their own apartments or rooms at assisted living facilities that offer meals, housekeeping, medication reminders, emergency response systems and other services. Staff helps with personal care tasks on request or scheduled basis.
- These are a more affordable option than nursing homes and allow residents more autonomy and privacy. However, residents must still be independent with activities like bathing, dressing etc to qualify for assisted living facilities.
Community-based Care
Home Health Care
- Home health care involves medical professionals like nurses, therapists, social workers providing short-term care to seniors in their own homes.
- Services include medication administration, wound dressing, physical therapy, personal care help for a few hours a few times a week. This allows individuals to receive needed medical assistance while continuing to live at home.
- Medicare covers up to 100 home health visits following hospitalization. Private long term insurance plans may also cover home health care to some extent depending on the policy.
Adult Day Care Centers
- Adult day care centers provide daytime supervised activities and care for older adults who live at home but require some assistance during the day.
- Spouses or other family members can drop off their senior relatives at these centers for the day that look after physical, social, recreational and other needs in a group setting.
- This gives caregivers respite while ensuring participants social engagement, meals, limited personal care and supervision outside the home. Transportation to/from the center is often provided.
- Adult day care may cost $50-75 per day depending on the services offered but are much less expensive than other long term care options. Many centers also accept Medicaid payments.
Senior Caregiving and Long Term Care Insurance
While families have traditionally been the primary caregivers for aging loved ones, paid caregiving is now a rapidly growing sector that has seen huge job increases over the past decade. Caregivers providing everything from companionship to complex medical care help fill the gap between what family members can offer and what professional long term care facilities provide.
Caregiver burnout, however, remains a serious problem. Caring for an elderly adult with worsening health conditions, disabilities or dementia can be extremely demanding both physically and emotionally. Family caregivers often neglect their own health and well-being while caring tirelessly for an aging parent or grandparent.
Additionally, out-of-pocket spending on long term care services can drain retiree savings very quickly. The median annual cost of a private nursing home room today exceeds $100,000. Even relatively short nursing home stays or ongoing home health services can lead to catastrophic expenses for families.
That's why long term care insurance has become an increasingly important financial planning tool, especially for middle-aged and older Americans. By paying daily or monthly benefits for qualifying long term care, insurance can cover much of the steep costs of care in facilities, one's home or other qualified settings. Policies vary in covered services, benefits period and premium costs based on one's age at purchase. Consumers are advised to consult insurance agents and consider long term care needs when planning for retirement.
Conclusion
In summary, the United States is experiencing a profound demographic transformation towards an aging society that is raising both challenges and opportunities in long term care. From ensuring family caregiver support to expanding community-based solutions to adequately planning ahead financially, there are important steps individuals and policymakers can take to help older Americans receive the quality long term care they need and deserve with dignity as lifespans increase. Working together, we can build a more elder-friendly system of support that eases the burden on caregivers and enhances quality of life at every stage of aging.
