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Baby Boomers and the growing care gap

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Who will take care of you if you need care as you age?  If you are like most Americans, you expect your family to step up and provide care. (Sixty-eight percent of Americans believe that they will be able to rely on their families to meet their long term care needs.) 

That’s what happens today.  According to the National Alliance for Caregiving, 65.7 million caregivers make up 29 percent of the U.S. adult population providing care to someone who is ill, disabled or aged.  Eight out of ten people receive care at home.  However, a recent AARP study on the long term effects of the sheer size of the Baby Boomer generation is that as those Boomers close in on 80 years and older, the need for them to have access to long term care services and supports will climb steeply (an increase of 79 percent) while  the cohort that generally provides family caregiving  services (those aged 45-60) is projected to remain flat (an increase of 1 percent).  In 2010, according to the study, the support ratio was more than seven potential caregivers per individual in the age group considered high risk for needing a caregiver.  That ratio will decline to four potential caregivers by 2030 and just three by 2050.

For people hoping to remain in their homes as they age, this is a troubling statistic.  Family caregivers (family members, partners and close friends) provide critical support for individuals with problems with one or more activities of daily living.  If family members aren’t available, more people will require institutional care or in-home care, both of which are substantially more expensive.  As the cohort ratio shrinks, the available number of people to provide paid care will also decrease because paid caregivers come from the same pool of individuals.  From 1990 to 2010, the population of individuals 80 plus increased by 62 percent but the population of potential caregivers increased by 77 percent. The result is that for the last couple decades, families and the public have been able to rely upon the increasing support ratio, the decreasing rate of widowhood, socioeconomic improvements and declines in disability (projected to rise due to the level of obesity) to significantly cut our reliance on institutional care, resulting in savings for both private and government wallets.

Longer life spans, smaller families, a larger number of people who never had children and more divorces will create what AARP calls a care gap in as little as 20 years.  Caregiver Action Network (CAN) is looking outside the circle that AARP recognizes as the caregiver support group to include millennials (those born between 1980 and 2000) and to educating employers about the importance of flexible work arrangements that allow employees to manage both a work life and caregiving responsibilities.

An AARP survey of registered voters 50 and older found that 61 percent are worried about staying in their own homes as they age and 90 percent said it was extremely, very or somewhat important that home and community-based services were available.  But, for those families seeking paid care for in the home, a shortage of trained caregivers already exists, largely due to low wages and poor benefits.

A similar crisis exists though in the professional health industry.  By 2000, the Association of American Medical Colleges, the American Hospital Association and other industry groups began looking into the potential impact of the aging of the Baby Boomers and while projections varied, they all agreed that the future held a substantial shortage of caregivers.  The American Geriatrics Society reported that despite a current demand that exceeds the supply by 7,000 geriatricians, as the population ages, the demand will exceed supply by 36,000 by the year 2030.

While the high cost of schooling, significant income gaps between specialists and generalists, aging of medical professionals and job dissatisfaction all contribute to the shortage, the significant increase in care needs for individuals as they age  (twice as many physician visits for individuals with chronic diseases as compared to those patients without a chronic condition) create a projected 82 percent increase in annual physician visits by 2030 according to a study on workforce shortages.

It’s not really clear how future health care needs will be answered. If you are a Baby Boomer, you may need to begin looking at the kinds of care options that already exist in your community and determine if your community will be able to step up to provide care options as you age.  If not, you might consider moving to a community that has the resources in place that will make it possible to remain at home.   One such community is a Continuing Care Retirement Community.  Another option is to hire an expert on geriatric care.  That expert is called a geriatric care manager.  A care management team can help identify resources that will allow you to continue to live at home and prevent you from becoming a burden on your children and provide resources and assistance to help your children avoid placing you in an institutional setting.  For certain, you should look to care for your own health to keep your health needs and health demands manageable in the future .

To contact a care manager, call 1-877-76-AGING.

Related stories:

Why do I need a Care Manager

When do I need a Care Manager

Options for caregivers that live out of town


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