What Can We Do About the Failure of Nursing Homes Around the US?
The US is undergoing a major demographic shift in the rising proportion of aging people. In 2014, people older than 65 years of age constituted 14.5 percent of the overall population. In 2040, they will constitute 21.7 percent of the total population — a jump of nearly 50 percent. More than one in five people will be over 65. And by 2060, there will be more than twice as many older people in the US as there were in 2014.
As people age, they are more likely to need medical care. Chronic conditions such as heart disease (stroke, heart attacks), diabetes and arthritis are more common among people over 65 years old. As a result, it is more likely that older people will need care, especially if these or other conditions become progressively debilitating.
Who Cares for the Elderly?
Care for the aging is increasingly being done by family members, particularly in an environment when more and more elderly people would prefer to age in place. The typical caregiver in the US is a woman around 50 years old.
However, another demographic shift is going on in the care of the elderly. Rather than Baby Boomers or Gen X, the Millennial generation is increasingly shouldering the task of looking after parents or grandparents. Currently, 25 percent of caregivers in the US are between the ages of 18 and 34. That percentage is expected to rise in the future.
At the same time, those Millennials are often economically disadvantaged. The Millennial caregiver’s average income is below the US median income. Millennials were hit hard by the Great Recession of 2008. In addition, people in the 18 to 34 age bracket traditionally spend disposable income on establishing themselves: buying homes, starting a family and moving up in a career.
Care-giving responsibilities may impact their ability both to earn more and to begin the traditional growth of homes, families and careers.
Nursing Homes as Part of the System of Care
Millennials and other caregivers may be hurt by the increasing dismantling of one of the traditional methods of elderly care: nursing homes. At one point, nursing homes were frequently located in communities. As a result, elderly people whose care needs were high could be cared for, but family members could also be nearby to visit and care as well. Increasingly, though, budget concerns have caused the closing of nursing homes. Congress has cut Medicare payments severely. The Independence at Home Act was aimed at lessening Medicare costs.
However, as a result of the cuts, many nursing homes can no longer afford to stay open. Several months ago, for example, a plan was announced to reduce Medicaid reimbursements in Oklahoma by 25 percent. As a result, nursing home officials estimate that 93 percent of nursing home facilities will face a shortfall in costs, and thus be effectively forced to close.
Nursing homes face additional challenges, including budget shortfalls caused by the rising cost of care and restrictive zoning that increasingly limits the existence of nursing homes in neighborhoods.
A Role for the Federal Government
While aging in place and family care are viable methods, not every senior citizen has the ability or available family to opt for those methods. In addition, some health complications, such as paralysis from strokes, may be best cared for in a long-term setting. While nursing homes may provide complementary care, they are still highly important in the healthcare system for older Americans.
Some observers suggest that the Federal government should step in to ensure nursing homes can thrive in communities where they are now absent. Historically, the government has provided an important service in geographic areas where the service was lacking. For example: federal funds can pay to build links between unserved areas with railroads and telecommunications networks.
Areas unserved by nursing homes provide a vital link in healthcare networks, and Federal funding could be the fix to an increasing failure to provide nursing homes.