We need to prepare now for an aging population

We are getting older, sicker and needing more help.

Our older population is steadily increasing. Did you know that the number of people over the age of 65 is expected to outnumber children under the age of 18 by 2034?

But we have health problems. According to the Centers for Disease Control and Prevention, 85% of older adults have at least one chronic health condition and 60% have at least two chronic conditions. These conditions range from arthritis to cancer and from diabetes to asthma.

Many older Americans need help not only with chronic conditions, but also with activities of daily living, such as bathing, dressing, and eating. In fact, there is a 70% chance that a 65-year-old person today will need long-term care and support services in their remaining life. And 20% of us will need it for longer than five years.

The first place we turn for help as we get older is our family. Families provide 80% of all long-term care in this country, and make up the largest segment of the workforce for our caregivers. But the growing need for long-term medical care along with overworked and unpaid caregivers means that paid care, by professionals and paraprofessionals, is also an important part of the equation.

But how do you pay for it?

Don’t rely on the government for help, unless you have an urgent financial need and can qualify for Medicaid, which covers basic long-term care. If you’re part of the majority of us over 65 who are covered by Medicare or Medicare Advantage plans, you’re out of luck. It only covers short stays in a hospital or nursing home due to an injury.

And have you looked at the cost of long-term care recently? If not, buckle up, as this is going to be a bumpy ride.

In 2020, the monthly cost of staying in a private room in a nursing home, or one that provides nursing care, assists with activities of daily living, and provides around-the-clock medical care, is approximately $8,821 per month. Compare that to the average Social Security check of $1,555, and you can see that you need a lot of savings to cover the balance, even for the most diligent savers among us.

You may ask what about long-term care insurance. Well, you may be one of the 7.5 million Americans who have long-term care insurance, according to the American Long-Term Care Insurance Association. This represents only 14% of the US population aged 65 or older.

Bottom line: Unless you’re wealthy, have long-term care insurance or run out, you won’t be able to afford care.

Although I’d like to see long-term hospice care coverage in Medicare and Medicare Advantage plans, the dollars needed can take years to get.

In the meantime, here are some other actions we can take.

The first is to provide more government support for caregivers of family members.

Today, there are a variety of Medicaid-funded programs to pay for home caregivers who are also family members. These vary by state, but include self-directed Medicaid services for those over 60 who need help at home and are able to direct the caregiving process, as well as resident caregivers.

However, there are no programs that provide financial assistance to family members who care for loved ones on Medicare or Medicare Advantage. I recommend that we ask the government to add direct, self-directed support to providers for Medicare and Medicare Advantage services.

I would also like to see more funding for the National Program to Support Family Caregivers, which is part of the Older Americans Act. It does not compensate family members who provide care, but pays outside caregivers to provide temporary care, or episodic care, when family caregivers need a break.

My second suggestion is to provide more education and support about chronic disease prevention to older Americans.

We need to work on getting the message across that we need to be healthier early in life – exercise a little more, eat the right foods and take care of ourselves. This means that we need to have access to better healthcare so that we can manage our chronic conditions, and be healthier as we age. The people most at risk of chronic disease are the poor or illiterate, so it makes sense to focus on those communities.

In the short term, combining education to manage and prevent chronic conditions as well as support family caregivers in the financial crisis will help older Americans who need long-term care. Ultimately, the United States needs a long-term care policy that will help all older Americans in need.

Josefina Carbonell He is the Senior Vice President of Long-Term Care at Independent Living Systems. She was the Assistant Secretary of Aging in the US Department of Health and Human Services under President George W. Bush.

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