Guidelines Applying History Publications Related Issues
Long-term care Solutions/Policy
Long-term Care History
1.0 Present Situation
1.1 Failure of the current system
Retirement is a relatively late 20th century idea.
A worker from the year 1900 could expect to live into his 70s and would likely work most of that time. If age or medical conditions warranted removal from the workforce, the network of family and grown children was expected to provide. The societal standards of the time did not provide for modern ideas of Social Security or 101k plans.
But experts warn of a time in the next 30 years where the crisis of elder care will reach epic proportions. Families of the late 20th century are nowhere near the size they once were. And standards have changed within society to the point that caring for the elderly will fall to institutions because families either do not exist or are not organized to handle the need from within.
The long-term care (LTC) industry was born. In fact, the need for a long-term care industry developed - in great part - as a consequence of government pressures on income.
High taxes, social security obligations and countless other social program costs (in addition to increasing life spans) placed increasing burdens on family financial survival and quality of life. Thus federal, state and local governmental claims on personal income contributed to the rise of the two wage earner family. Consequently, no one remains home to take care of aging parents and relatives. The fact is that government increased the burden of personal income taxes (from 1918 -2001) from a rate of 3% to now well over 50 % in a well intentioned but wayward effort to address social problems.
Aging baby boomers are a crisis waiting to happen. More than 50 percent of the workforce belongs to this age group and will be retired within 20 years. Fewer people in the workforce will produce certain decreases in social security contributions, a challenge without an answer. But the greater concern is what will happen to people once they get out. Many foresee the lines at the old folks homes to be worse than the department of motor vehicles.
A New Circumstance: Strained Family Resources
Employers even today see and deal with this growing problem. According to a recent Hewitt Associates survey, eldercare benefits have increased 100 percent in the last six years. These benefits include resource and referral services, long-term care insurance, counseling, long term care facilities and adult day care.
Nevertheless the demands of being a caregiver and a full time worker strain those managing a career. According to a Market Facts study in May 2000, 70 percent of caregivers who work full time give up personal time, 55 percent sacrifice time with friends, more than half shirk home responsibilities and six in ten take time away from spouses, children and family.
No matter how great or small the demands of individual circumstances, eldercare is affecting job performance too. Over half of those surveyed reported missing time at work due to their situation and nearly a quarter had lost pay or suffered a reduction in working hours to meet the needs of their retired family.
What to do About It
Retirement looks to be remote for workers aged 20 to 30. But a dependence upon existing government programs or even employer-sponsored plans is a recipe for disaster. Retirement is more than just money, and it includes the care of more than just one. Given the certainty of this growing crisis, pressures for a revised Long-term care industry have never been greater.
1.2 Stigma
Care-giving
Currently, there is a stigma attached to caring for the elderly. In our youthful society, people are not encouraged to develop the skills necessary for interaction with and care of senior citizens. The society that has created this skill vacuum extends as well to the long-term elder care institutional culture that pays people to work as care givers. Current system failures are characterized as follows:
- Lack of adequate knowledge about aging
- Insufficient development of skills sets necessary to assist people with special elder needs.
- Absence of clearly developed, uniform and easily accessible knowledge base.
Long-term elder care facilities nationally are experiencing widespread and catastrophic difficulties including financial failures, high staff turnovers and reports of abuse and neglect that are all indicators of an industry that is out of control and will fail to meet the needs of an ever-growing demand. The situation, problems, and needs of the long-term elder care resident produce a customer requiring a customized structure of resources not to be found elsewhere. But even understanding this does not in itself serve up a solution. Achieving the type of transformation needed requires a novel approach merging the capabilities of a variety of professional disciplines into a new delivery system that creates sustainable change.
1.1 A Bad Staffing Model
Besides the total lack of an industry-standard training program for elder caregivers, there are no career path opportunities for staffing on any level. The absence of career incentives presents additional challenges that further aggravate the system by sidetracking the focus away from their primary obligations - the care needs of the elder resident.
1.5 Confusion and Misrepresentation
In its rapid growth, the long-term elder care industry has failed to benchmark business-operating models, resulting in inability to clearly define the relationship between services provided and the needs of the consumer. Without clear guidelines as to the nature of care solutions provided, consumers find themselves in a quagmire of misinformation. This confusion often leads to unintentional misrepresentation of products and services as knowledge deficient facilities vie to fill their own beds without an accurate understanding of long-term elder care, the nature of the consumer or a staff adequate to meet the challenges.
Family caregivers suffer from a lack of industry leadership that should provide solutions, not more questions about the problems of aging.
1.6 Family Caregiver Crisis
A by product of developing targeted training built on rehabilitation, gerontology and biomedical engineering is a family caregiver information resource. There are 22,000,000 at-home caregivers today in the US. While there are helpful hints and other advice for caregivers (including information on the www), the value of the information is very limited. Recent surveys have verified the lack of accurate and useable information for medical/care needs on the www.
1.7 Increasing Needs
Enormous improvements in the general health of the American population will result in an inevitable and predictable rise in the need for elder care solutions. Both an increased life expectancy and the large stratified population of post war generation people soon to retire will quickly strain the already failing industry resources. Upcoming retirees overall, because of more effective financial preparation, will have more flexibility in making long term living choices and become more capable of supporting the financial demands of future elder care industries. The question of developing quality elder care resources, then, becomes more critical and urgent. In the next thirty years alone, both the demand for elder care opportunities and the aging population will double in size.
1.8 Government Involvement- Congress has been acutely aware of the imminent crisis in elder health care.
- Government power to tax the people will fall short of financial demands of the elder population
- In the year 2000, two efforts were made to finance projects to develop training curricula for elder caregivers.
- Funding was distributed into many small grants that compromised the success of any positive outcome.
- No comprehensive effort is planned or underway that gives reasonable hope of providing meaningful and effective solutions
