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Implications of an Aging Population for Long-term Care
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13867 |
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Section : |
MODERN THOUGHT
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12 / 1988 |
3,879 Words |
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Judith D. Kasper
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As more people live into their 70s, 80s, and beyond, the tremendous variations in health and vigor within the elderly population are becoming clear. Many of the elderly continue to lead active, vigorous lives, exemplifying aging at its most positive. But 5 percent of the elderly reside in nursing homes, and the proportion rises to 20 percent among those 85 years of age or older. And for every nursing home resident, it is estimated that four elderly people in the community are receiving long-term care from family and friends or professionals.
Elderly people use the bulk of long-term care, both of nursing home care and care provided to those living in the community. One in five Americans will be 65 or older 40 years from now. The sheer increase in numbers of elderly people could mean a substantial increase in the numbers needing long-term care, even if the percentage of people needing assistance remains stable. In addition, the composition of the elderly population is changing in ways that are likely to affect the need for long-term care. By the year 2000, one out of every two elderly people will be 75 or older, indicating a shift within the elderly population toward the older ages. This is the group most vulnerable to the physical and cognitive problems that often require long-term care.
Though the long-term care population represents less than a quarter of the elderly, the specter of frailty and decline leading to admission to a nursing home or dependence on others for help with routine daily tasks haunts older Americans, their children, and their grandchildren. Polls indicate elderly people worry about becoming a burden to their children. In addition, most adult Americans feel the costs of long-term care are beyond their means. In response to these fears, federal legislation to finance long-term care is being proposed for the first time. (Congressman Claude Pepper introduced a bill to finance home care; bills have been introduced by Senators George J. Mitchell and Edward M. Kennedy to finance nursing home care.)
To assess the implications of an aging population for long-term care needs, several issues must be addressed. What is the relationship between aging and the need for long-term care? Is this relationship likely to remain in the future what it is today? Who among the elderly needs long-term care? What kind of care is needed? Who can be expected to provide it? And finally, who will pay?
What is Long-Term Care?
Long-term care is usually thought of as assistance provided over an extended period of time because of health problems that limit a person's ability to perform routine, everyday tasks. This type of care goes beyond medical assistance from physicians or nurses to include such services as help with personal hygiene (bathing or dressing, for example) and meal preparation. Some definitions also include transportation services, modifications to housing (to improve mobility, for instance), and psychological care. Two of the difficulties in designing programs or legislation to provide long-term care are the broad range of services that can be included and the gaps in knowledge concerning which services are most appropriate for which people. One recent review of community-based long-term care programs reveals the following range of services across programs: post-hospital skilled nursing care; physical therapy; transportation; home aides to do meal planning, shopping, personal care, and to exercise
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