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Issues

The Emerging Crisis in Long-Term Care

More than 13 million older adults and people with disabilities receive long-term care from 65 million family caregivers, home health aides, and other care professionals. Although the U.S. spends over $200 billion on long-term care each year, life is often grim for people receiving care and those who provide it. Basic needs often go unmet. As the population ages and demand for care continues to rise, the long-term care system faces an emerging crisis.

  • Millions Lack Basic Care
  • Unsustainable Costs
  • Caregivers at Risk
  • Over Medicalization
  • Shortage of Care Workers
  • Resident Abuse
  • Millions Lack Basic Care
    The percentage of persons needing long-term care is growing 2x faster than those providing it. Even as of today, 46.9% of frail adults in the U.S. are on their own and lack basic care.
    References:
    • Urban Institute Profile of Older Americans
  • Unsustainable Costs
    In 2035 the cost of long-term care is expected to increase to $315 billion – 100 billion over the cost of $215 billion spent in 2015. The average cost of long-term care per person is expected to be $50,000 a year with Medicaid paying for less that half of that amount for those who qualify.
    References:
    • Robin Wood Johnson Foundation
  • Caregivers at Risk
    23% of family members who give long-term care are more likely to suffer a stroke compared to other caregivers of the same age, not in a familial relationship with the patient.
    References:
    • US National Library of Medicine: Referencing the Lee, Colditz, Berkman, & Kawachi Studies) Caregiving strain and estimated risk for stroke and coronary heart disease among spouse caregivers: Differential effects by race and sex (Jan. 14, 2010). [full article]
  • Over Medicalization
    According to a report by the federal government, 21% of nursing home residents are given antipsychotics, but do not have a diagnosis of psychosis. Medicaid spends more on antipsychotics than on any other class of drugs.
    References:
    • Lucette Lagnado, The Wall Street Journal (Aug. 27, 2013).
  • Shortage of Care Workers
    According to a survey of direct care workers, 60% of their patients’ health is at risk due to staffing shortages. In long-term care, as many as 15% of jobs are unfilled. Staff turnover at many organizations exceeds 50% annually.
    References:
    • Zywiak, W. (2010, June). U.S. healthcare workforce shortages: Caregivers. [full article]
  • Resident Abuse
    Reports of serious, physical, sexual and verbal abuse are "numerous" among the nation's nursing homes, according to a congressional report. The study finds that 30 percent of nursing homes in the United States — were cited for almost 9,000 instances of abuse over a recent two-year period, from January 1999 to January 2001.
    References:
    • Ruppe, David. Elderly Abused at 1 in 3 Nursing Homes: ABC News Report [full article]