Access and affordability of long-term care weigh heavily on the minds of older adults, many of whom have at least one chronic health condition, according to a new report looking at how the aging population is cared for in the United States.
The country is in the midst of an age wage, in which the population of older adults is rapidly expanding, leading to an increased need for long-term services and supports, noted the authors of the report, “Meeting the Growing Demand for Age-Friendly Care: Health Care at the Crossroads.” At the same time, according to the report, workforce shortages are intensifying, geriatrics expertise is lacking, and fragmentation, cost and inequities in healthcare deny access to that care for older adults.
“These forces are building and converging, driving healthcare to the crossroads and an opportunity to set a new direction,” the report reads. “We need to envision, define and implement a more age-friendly system of care to support the health and well-being of the growing ranks of older adults.”
The John A. Hartford Foundation partnered with Age Wave and The Harris Poll to explore those challenges, identify necessary changes and encourage healthcare stakeholders to build a healthier future. Their resulting report includes the results of a survey of more than 5,000 American adults, half of them aged 65 or more years.
The survey results come at a time when the aging population is dramatically increasing the demand for healthcare in a system that is understaffed and facing growing workforce shortages, experts say.
Argentum has stated that the senior living industry will need more than 3 million workers by 2040, with more than 20 million workers needed across all long-term care settings in that time.
Access is a key desire
Among the key messages from older adults who were surveyed for the new report were that everyone should have access to quality healthcare (95%), the healthcare system is not prepared for the growing and changing needs of the nation’s aging population (82%), and a majority agree that the government should prioritize lowering costs and improving long-term care.
With Americans paying more out-of-pocket for healthcare, many poll participants said they were concerned that they won’t have enough to cover their long-term care expenses through their retirement. According to the report, the average couple will spend $472,000 overall on out-of-pocket health and long-term care expenses throughout their retirement, $89,000 of which will be on long-term care expenses alone.
The industry repeatedly has pointed to research showing the value proposition of senior living, through its cost effectiveness, quality of life, improved outcomes and resident satisfaction. A Genworth Cost of Care survey showed “nothing comes close” to assisted living in providing cost effectiveness — assisted living reportedly saves Medicaid $43 billion annually and Medicare $15 billion annually.
An overwhelming majority (95%) of older adults surveyed said they want to age in place. Most have specific concerns about living in a long-term care facility, including receiving poor-quality care (60%), losing their independence (60%) or being mistreated or disrespected (52%). Loss of independence is of even greater concern for those aged more than 80 years.
Some work ahead
Based on the survey, the report authors estimate that 36 million Americans have a family member or friend living in a memory care community or nursing home. Many worry about the care their loved one is receiving. Only half said they believe that the care facility is the safest place for their loved one, and fewer are confident that their loved one is always treated with dignity and respect (38%), or that their loved one is receiving high-quality care (37%).
The authors said that those concerns reflect the border problem of lack of trust in the motivations of the healthcare system: 81% said the healthcare system is more concerned with making money than providing quality care.
Older adult respondents overwhelmingly agreed (95%) that all Americans should have access to quality healthcare. A large majority said the government should prioritize lowering costs and improving the affordability and quality of long-term care. In addition, 68% of participants said that one of their greatest worries is not being able to afford future health and long-term care needs.
To remove social and financial biases and barriers that lead to health and care-related inequities, the report outlined a strategy to lower costs to healthcare consumers, mainly in the areas of long-term care and prescription drugs. They also recommended screening older adults for social determinants of health, including social isolation.
