In a previous post, I wrote about the popularity of "aging in place" and discussed why, in some cases, it isn't always a great alternative for aging Boomers. A recent article in The New York Times discusses some of the financial challenges and addresses in general the costs associated with growing older. The article cites a 2019 study from the federal Department of Health and Human Studies "found that over their lifetimes, about 70 percent of older adults will need help from family caregivers or paid aides or some combination, in their own homes or in long-term care facilities." A more recent study by the Center for Retirement Research at Boston College examined "both intensity and duration — how much help older Americans will need and for how long." The results indicated the following:
"...Seventeen percent of 65-year-olds will need no long-term care. Almost one-quarter will develop severe needs, requiring many hours of help for more than three years.
Most older people will fall between those poles, with 22 percent having only minimal needs. The largest group, 38 percent, can expect moderate needs — like support while they recover from a heart attack, after which they can again function independently."
Another recent article in The New York Times cites a 2018 AARP survey that indicated "76 percent of those ages 50 and older said they preferred to remain in their current residence as they age." The article discusses the plight of home care aides :
"The ranks of home care aides are expected to grow by more than those of any other job in the next decade, according to the Bureau of Labor Statistics. It’s also among the lowest paying occupations on the list.
Nearly one in five aides lives below the poverty line. In six states, the average hourly wage for home care aides is less than $11, and nationally, the median pay has increased just $1.75 an hour over the last decade, when adjusted for inflation."
Considering the information above, Boomers are headed for a long-term healthcare reckoning. If we want to age in place, the older we get, the more likely we will have to get help from family members, which is not always possible, or home care aides. These workers are highly stressed out right now. In the current pandemic, home care aides are one of the more vulnerable groups, not just because of potential exposure to the virus but also because of their low economic status. In The Times article, one of those aides made an important point:
“We should be able to take care of our own families while providing care for other families,” said Lilieth Clacken, a 61-year-old home health aide and member of the 1199SEIU United Healthcare Workers East union. “The work is undervalued and underpaid.”
Some innovative programs, such as the "Aging Well Support Program" at Appalachian State University in Boone, NC, could make a difference to Boomers who want to age in place. It offers "Community Health Screenings, Caregiver Workshops, and programs to support mental and physical wellness. In addition, we offer Individualized Aging Support Services to provide ongoing Care Coordination for concerns related to memory, fall risk, nutrition, and behavioral health." We need more helpful programs like this to limit the risks and improve health outcomes for aging Boomers.
The other side of the equation is long-term care facilities, such as an assisted living facility. If we choose this alternative over aging in place, we will inevitably pay a high monthly fee (and in some cases an entry fee) to be cared for around the clock. Even in these facilities, however, care aides are poorly compensated in terms of salary and benefits.
It's a sad testament to overall national priorities that home care aides and aides at long-term care facilities are at the lowest end of the pay scale -- as are teachers and social services professionals. There is also currently no compensation available to family members for taking care of older relatives. It certainly makes it all the more challenging to answer the question, "Who will take care of us?"