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Will Nursing Home Care be a Viable Option for the Baby Boomers?

Published July 21, 2014 11:45 AM by Brian Garavaglia

The baby boom cohort, those who were born between 1946 and 1964, is the largest birth cohort that has ever been produced in the United States.  As soldiers returned home from the war, the birth rate increased and subsequently for a decade and a half, we witnessed a very large number of children being born. Furthermore, we also have witnessed an increasing life expectancy as many acute illnesses that formerly lead to early mortality have now been controlled or conquered. Given the burgeoning birth cohort, coupled with an increased life expectancy, our population will be witnessing a large increase in those who are 65 years of age and older. The impetus for much of this increase will be found in the baby boom cohort as more and more of the group continues to age and move into the later stages of life. Inevitably, as the population ages, there will be a need for many older adults who will need placement in nursing care facilities. However, given the need, will they actually be able to afford such care is a question that is being asked. 

A recent report, released by the National Institute on Aging, states that the problem of affordability for nursing home care may be very serious in the years ahead and may limit those in the baby boom cohort from being able to obtain the needed nursing home care that many will need. One of the changes that occurred among the baby boom generation is that as they aged and married, their birth rates went down. Many of those baby boomers had significantly less children than their parents and grandparents did. As the baby boom cohort ages, many of them will have more chronic illnesses and will be in need of extended care. However, since they have had fewer children, who in past generations often assisted with parental care, nursing home care for many may be the only alternative. Yet, nursing home care is expensive and will continue to be even more expensive in future years. Furthermore, with a greater life expectancy, more chronic illnesses, and less adult children to assist with care, the baby boomers will be facing the potential need for a greater number of years in which care will be provided from an extra-familial source like a nursing care facility. 

Richard Suzman, who is director for the National Institute on Aging's Behavioral and Social Research division states that this demographic change that will be part of the baby boomers entering later adulthood will approach a crisis situation in the years ahead, stating "Baby boomers had far fewer children than their parents. Combined with higher divorce rates and disrupted family structures, this will result in fewer family members to provide long-term care in the future. This will become more serious as people live longer with conditions such as cancer, heart disease and Alzheimer's"1.

The National Institute on Aging examined the average cost of nursing home care. In 2010, the average cost of a private room within a nursing care facility was $229 a day, which equated to $84,000 each year1. Although semi-private rooms, which most older adults are placed in are less expensive, the costs still are typically well over what most can afford, especially on an extended level. Furthermore, the National Institute on Aging also found that given the cost of nursing home care, less than one-fifth of all older adults in the United States can afford to live within a nursing home for more than three years. Even more disconcerting, nearly two-thirds are unable to afford the cost of nursing home care for even a single year1

As one can see, given the current problems of affordability, coupled with the increasing size of the future older adult cohort, a serious problem for servicing the chronic health care needs of the older adult population is quite evident. Since the current older adult population makes up approximately 13 percent of our population and will expand over the next 35 years to approximately 20 percent of the total population, one can start to see the important issue that arises as it relates to older adults and their potential long-term health care needs. How will they as a group be able to get the needed long-term care to assist with their needs if it is a resource that they will not be able to afford?   

Another concern that needs to be mentioned is that Medicare payment covers at most only 100 days of skilled nursing home care after a qualifying hospital stay. However, even this level of small assistance is not a given. As mentioned, not all individuals qualify for 100 days, and even if they do there are also copayments that also are applied as well. Moreover, as the high inflationary costs of the medical industry continue to place a tremendous burden on our social system, one has to ask will there be any cuts in Medicare as it applies to nursing home care in future years. 

Furthermore, Medicare, an insurance for the indigent, pays almost one-half of the long-term care nursing home expenses in the United States1. However, to qualify, most individuals have to severely reduce most of their personal assets to an indigent level. This has to give many a time to pause and consider that after a lifetime of accruing some level of net worth, at the end of their lives when they need care most, they have to become indigent just to be able to obtain the care they need. This is not a dignified level of existence as one moves to their final stage of life. 

Moreover, currently, the Affordable Care Act has mandated greater allocation of assets to increase the state Medicare coffers. However, that is not explicitly for nursing home care. Furthermore, here again, one has to wonder, given the inflationary health care climate, how long additional resources diverted to Medicaid will be able to last to support this endeavor.

As one can hopefully see, we are approaching a crisis mode for individuals of the baby-boom cohort. As this large birth cohort now is moving into the older adult stages of life, the population that is 65 years of age and over will start to increase dramatically and will be approaching approximately 20 percent of the total population over the next 35 years. However, the question remains, how will many of these individuals, with increasing life expectancies and the greater burden of an ever-increasing amount of chronic conditions be cared for? Will they be able to afford the long-term care options to assist them with their health care needs? Furthermore, with less children available to shoulder the burden of care for their older adult parents, the need for long-term placement, which may be a placement even longer for many in future years than it has been in past years, may become an insurmountable financial burden. This situation definitely is legitimately able to be termed a "crisis" situation that will be part of our future health care years and that we cannot ignore.            

References

Preidt, R. (2014, June 30).  Nursing Home Care Out of Reach for Many 'Boomers'?  WebMD.  http://www.m.webmd.com/a-to-z-guides/news/20140630/nursing-home-care-may-be-out-of-reach-for-many-aging-boomers-study

5 comments

Gerotalk : Will Nursing Home Care be a Viable Option for the Baby Boomers?

November 22, 2014 2:02 PM

Gerotalk : Will Nursing Home Care be a Viable Option for the Baby Boomers?

November 10, 2014 11:55 AM

Gerotalk : Will Nursing Home Care be a Viable Option for the Baby Boomers?

November 6, 2014 3:38 PM

Gerotalk : Will Nursing Home Care be a Viable Option for the Baby Boomers?

October 30, 2014 3:14 PM

I think you meant to say Medicaid, an insurance for the indigent, instead of Medicare.

Jeanne, RN August 7, 2014 4:56 PM
CT

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About this Blog


    Brian Garavaglia, PhD
    Occupation: Long-term care administrator
    Setting: Sterling Heights, Mich.
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