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Senior Spectrum Newspaper
September 2018
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Senior Spectrum Publications

Adding Life to Years
by Dr. Lawrence J. Weiss
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The Future of Caregiving: Planning is essential

Dr. Lawrence J. Weiss
Dr. Lawrence J. Weiss

As the baby boomers age, more of us older adults who did not have children or very few of them, will find that there are and will be fewer caregivers. Think about this. The number of older adults will double in the next 20 years, the incidence of illness and dementia will increase and the number of caregivers will not keep up. The Census Bureau predicts that by 2050 the number of caregivers will increase by 13 percent, the number of potential care recipients will increase by 84 percent and the potential recipients with Alzheimer’s will increase by 160 percent. These figures dramatically display the major issue of dealing with care of elders that our country has not yet dealt with.

Historically we have relied on family members, primarily children, to provide care for their elders and keep them in their homes. Today, many elders are growing old without family or family nearby, therefore offering a glimpse of what is to come in the future.

The lack of caregiving comes at a time now when boomers are retiring and in a financial and personal squeeze that has not been seen for generations. Incomes that include Social Security and retirement plans have been stagnate for years, and we are not sure about the future. In addition, most have high debt, that in part may have resulted from caring for their own parents. Clearly, as we look to the future, the caregiving from family will not be adequate to meet the needs due to many boomers not having children or having them, but they live far away. The National Academy of Sciences in a 2016 study found that families now have fewer children, many have never married or are divorced, often the children live far away from their parents and may be caring for another parent or kids, as a result many older adults do not have the informal or family caregiving that they need.

As I have reported in the past, every day 10,000 people turn 65. On the other hand, caregivers have decreased resulting in a falling ratio of caregivers to care recipients because of the changing family dynamics. Given that, according to a Merrill Lynch study (2017) there are still 34 million caregivers that provide unpaid care. These caregivers (about 95% are family) provide the bulk of the long-term care needed. This ‘free’ care is worth an estimated $500 billion annually. This figure is three times more than the annual Medicaid professional long-term care spending!

Unfortunately, the private sector of personal care assistance, care managers, home health aides, etc. is not an option for many older adults. Demand for this care is expected to exceed supply by more than three million in the next decade. In addition, a full time home health aide on the average costs $49,000 a year according to a study by Genworth (2017).

This help is not supplied by public support such as Medicare since it is not acute, but chronic long-term care. If you require nursing home care for chronic illness it can cost over $100,000 a year and Medicare does not cover it. If you spend down all your resources then Medicaid, a needs-based federal and state government program, could cover your nursing home or maybe your home-based services. However, it does depend on the state and available services since there are waitlists, especially for the home-based waivered services.

It is unclear how the care for older adults will be provided and paid for given the lack of unpaid as well as paid caregivers. We have to explore alternative methods of service through such means as technology, forming support groups, alternative living situations, and volunteer programs, to name a few. These nontraditional care approaches have to make a difference or many will suffer unnecessarily.

Care for older adults can be facilitated by technology such as personal emergency response systems (such as Philips Lifeline), which can alert family caregivers or professional organizations to issues, emergencies, and help with communication. Developing robots and automated automobiles can help with some personal issues like transportation. Social groupings, like the Village or Co-housing programs where peers live close to each other and help each other in a variety of ways, definitely add value. A great example is northern Nevada’s own N4 – Neighborhood Network of Northern Nevada – which has a volunteer bank where participants help each other for no cash exchange.

Another example of a needed program to help with the shortage of caregivers is the Senior Health Advocate Volunteer program which the Center for Healthy Aging has developed over the last couple of years. This volunteer program takes trained senior volunteers that work with their peers individually and in groups to link them to needed services in a timely and cost benefit manner. Early intervention and prevention can make a difference. It is innovated programs like these that will buffer the tremendous impact of the increasing numbers of seniors in need and decreasing family and professional caregivers. We need to be thinking about our own aging and how we want to and will be able to be cared for – We need to plan for our future. Planning is a great way to “add life to years”!

Lawrence J. Weiss, Ph.D. is CEO of the Center for Healthy Aging. Dr. Weiss welcomes your comments on this column. Write to him at or c/o Center for Healthy Aging, 11 Fillmore Way, Reno, NV 89519.