By 2034, the number of adults over 65 will — for the first time in history — outnumber the number of children under 18.
This shift will lead to an urgent demand for expanding infrastructure to support long-term care services, according to a study published by Health Affairs. Here are five things to know:
1. "Long-term care services" refer to a range of paid and unpaid services that help people with physician and cognitive impairment live independently at home. The current infrastructure is "woefully inadequate" and has left many older adults and their families with high financial burdens for care, according to the study.
2. There are notable inequities to access to services based on financial resources, geography and family structure. This included inadequate affordable services and not enough trained health personnel to meet local demand.
3. The article does note a shift from nursing homes to home-based care, although infrastructure to support aging-in-place remains underfunded. About 75% of older adults with functional or cognitive impairments rely on unpaid family members for support. Over 40 states have implemented programs such as paid family leave to improve access to care, but these programs remain underfunded.
4. Without reform to the services infrastructure, there could be more middle-income families who do not qualify for Medicaid but who cannot afford private long-term care insurance.
5. Programs like Program of All-Inclusive Care for the Elderly (PACE) and hospital-at-home initiatives show promise in addressing these issues, but require policy changes and funding support to meet demand.