By Carolyn Spence Cagle PhD, RNC-E
Our population’s increasing aging population pushes society to identify and implement creative and responsive long-term care solutions. Currently 17% of the U.S. population comprises the aging population with an expected 22% of elders by 2040. Although our country spends the most on health care of any country, insufficient older care infrastructure, housing, and transportation prevent accessible, cost-effective, and quality health care for many. Many experts note the current older care system is underfunded, fragmented, and lacks a medical care and social/personal support integration deemed critical for responsive elder care. Current programs such as Medicare do not pay for long-term care and Medicaid ends up as a primary payer of LTC for lower income Americans. Often the 8 M middle income Americans have too many financial assets to receive Medicaid support but not enough to afford current “pricey” care.
How can our society re-think our current long-term care programs to better address our aging population’s needs? Here are some creative and responsive ideas to do so:
- Increase federal and state funding for innovative and personalized community based long-term care options; several national programs such as PACE (Program All-inclusive Care for Elderly) and CAPABLE (Community Aging in Place – Advancing Better Living for Elders) have successfully bundled interconnected services for elders to decrease their depression and hospitalization, saving Medicare and Medicaid an average of $10,000/year/participant.
- Increase use of technology to support aging persons’ home stay and address the caregiver labor shortage; technology will drive more efficient and safe care and give elders more control over their living environments.
- Increase societal discussion of extending the retirement age to lengthen working lives of older persons; this would give those persons purpose, allow mentoring of younger employees, help workplace efficiency, and decrease loss of aging persons’ income to fund later caregiving and societal costs.
- Advocate for public policy change to enhance society’s attitude toward aging and elder needs; in April 2023 the President directed the USDHHS and Veterans’ Affairs to better address pay and benefits of family caregivers, elder care, and those recently discharged from the hospital.
- Expand educational and financial support to better train long-term caregivers, especially for community-based care of elders with disability or those living alone and at risk for depression and shorter life expectancy.
- Increase salaries of home health aides and long-term care nurses, many whom are women of color who face societal devaluation for their work.
- Revisit the issue of adequate retirement savings throughout working persons’ lives that now have longer life expectancies impacting sufficient living funds during retirement.
- Encourage states to develop a master plan for Aging to project the need for caregivers, jobs, housing, and supportive services; Texas is one state with a plan.
- Work with municipal communities to design planned communities accessible to elders and perhaps elder-caregiver pairs for healthy aging.
References Cited
Abrams, A. Elder care grows up. Time (2021, June 21/28). 197(21-22), pp. 84-90.
Expanded support for family caregivers (2023, June). AARP Bulletin, 64(5), p. 4.