The U.S. Population, in particular the senior citizen population, has grown exponentially, making up approximately 70 percent of individuals ages 65 and older. With this senior citizen population boom, attitudes have changed in terms of
long-term care. The long-term care industry are facing some real challenges by the expansion of offerings and increasing specialized care.
Long-term care industry in the United States has been experiencing growth from 2016 to 2018 and this trend is expected to continue. The senior citizen population is calling for array of demands for all types of long-term care. However, the ongoing cost will continue to put this industry under extreme pressure.
The
Baby Boomer generation makes up approximately 67 million living in the United States in 2018. This is the group that will be the driving force in making decisions whether senior living is the right fit for their aging loved ones and for themselves.
Due to the rise of the senior citizen population, the increasing rates of chronic diseases, advancement in medical technology, longer life expectancy, there will be many people ages 65 and older (and sometimes younger people with disabilities) that will need long-term care in the near future. There is a dilemma: there are a shortage a health care personnel; this is at an alarming rate. There are some challenges for the health care industry: to begin focusing on fixing the broken system that exists in both in providing long-term care services and the payment system for services that are performed. The long-term care industry is facing some challenges:
*Senior Citizen Population: According to the National Clearinghouse for Long-Term Care Information, about 70 percent of people ages 65 and older will need long-term care in his/her lifetime. At least 40 percent of this population will take place in a skilled nursing-home setting. It is apparent that the combination of an aging population and longer life expectancy will increase the demand for every facet of long-term care services in the future. Other concerns are the trends that show smaller family sizes, higher divorce rates, and higher costs for caring for a family member. These factors have the potential of reducing the amount of informal care unavailable to senior citizens (as well as people with disabilities).
Long-Term Care (LTC) system in the United States should be an asset in our attempts of building a stronger community for everyone, whether local or regional, and regardless of the age and disability. The majority of families at some point will face the necessity for LTC for older family members or younger relatives with a disability. This is very difficult for families to plan effectively for LTC needs, which varies and showed often be provided over a period of several years. The economic and emotional challenges in connection with caregiving can be overwhelming, especially if the care is provided either by a family member or through a facility (e.g. nursing home or assisted living facility).
The long-term care needs will increase within the next few decades with the aging of the Baby Boomers of 10 million Americans who are in need of
LTSS (Long-Term Services and Support), 5.2 are people ages 65 and old, and 1.7 million are ages 85 and older. These numbers are expected to double within the next 30 years. The resources will triple by 2040; this is due to the fast-growing population of people ages 85 or older, and the longevity of younger individuals with physical and mental disabilities.
*Short Staffing of Health Care Personnel in the Workforce: The demand for long-term care is expected to outnumber supply of health care professionals that are qualified to provide these services, which will lead to a shortage of health care professional by 30 percent or more. This shortage of health care professionals already exist in many areas of the country, as there are not enough qualified personnel to fill open positions for direct caregivers to senior citizens. It is a known fact that long-term care workers are paid less than personnel workers in acute health care settings; these are one of the factors in the shortage of workers in the long-term care settings.
The large turnover rate is common in many long-term care settings, which is a contribution to inadequate staffing levels and lack of quality of care. Nurses, along with other long-term care personnel, need more competitive wages, more continuing education opportunities, and better working conditions, if the heavy turnover rate is to be reduced. Long-term care personnel work in a challenging setting, as they must provide care for various individuals with different medical conditions and disabilities to manage and to navigate the challenging family dynamics that is associated with working in long-term care. Low wages, less-than-stellar working conditions, because of short-staffing and a high turnover rate, lack of benefits, and high personal injury rates are the main dilemmas the focus should be on and find a resolution to increase job satisfaction and boost employee morale.
In the long haul, long-term care facilities must take action now to attract more health care personnel into their settings, perhaps either by offering more workable wages and more benefits as well as forming a partnership with educational institutions that will train nurses and other health care professionals, or by aiding with scholarships and/or offering signing bonuses.
According to an AARP report in 2013, "caregiver support ratio" is referred to as the number of prospective caregivers, ranging from ages 45 to 65 for every individual ages 80 and older. The ratio is expected to decline to 4:1 by 2030. The ration is expected to keep decreasing to 3:1 in 2050.
*Quality of Care as a Whole: As long-term care setting is constantly evolving, so has the necessity for quality care. Caring for senior citizens must be of the most important quality, client-focused, responsive, efficient, as well as cost-effective. The quality of care provided varies, depending on the facilities. The gaps in the
Medicaid (Medi-Cal in California) long-term care safety net is in need of discussion as the quality of the safety net varies, depending on the state. Eligibility for services and benefits has its limitations in many states, and not all will qualify for monetary waivers to aid with the care costs. This must be investigated so that the quality of care is available to everyone and the gaps in the safety net has closure.
Speaking of services, the
HCBS (Home and Community-based Services) Medicaid waiver-funded programs have grown faster than other part of the public-funded LTC system within the last decade. This is one of the pivotal reasons for the decline in the nursing home participation throughout the country, from 1.7 million in 2005 to 1.6 million in 2012, and for the federal Medicaid nursing home budget's stabilization at approximately $48 billion since 2006. Ten states has a higher percentage of their Medicaid LTSS benefactories in HCBS programs than in nursing home settings and spend more of their Medicaid dollars in the community than in nursing homes. Several other states are on a mission to succeed in reaching the same goal of having a balanced LTC system within the next few years, mainly under the sponsorship of their more established aging network organizations.
These trends are a large percentage of retirees do not have the resources to pay for their own LTC; this indicates that the senior citizens of the future will be more dependent on public-funded programs and community involvement. Communities will be pressured to get the levels of financing and social capital, which is a requirement. This saves senior citizens that cannot afford to pay for their own LTC from being abandoned or on the streets.
The LTSS system of care is a necessity for the purpose of quality and efficiency of care for senior citizens and to prepare the nation for the large demographic increase within the next 20 years. In most states, the aging network organizations are imperative and widely supported parts of local communities. They are in a great position to serve as a gateway for community-based unified health and LTSS systems. Due to the shift of the aging network by HMOs, this would suggest that a lost opportunity in the development of community-based and person-oriented systems of care.
We, as a society, are at great risk of abandonment of a large number of non-affluent senior citizens and disabled individuals, who will be depending on the LTSS service as these populations rise. The OAA (Older Americans Act) programs are crucial and provide the bare essentials as well as very cost-effective. However, the public-funded LTSS system relies solely on the Medicaid funding.
If the aging networks are constantly shut out from the Medicaid-supported LTSS programs, then one of the lifelines of community-based non-profit social and health care could be lost to the disadvantage of taxpayers an those individuals that rely on the public-funded LTSS system.