Question

1) Describe the population of older Americans that are in the middle, or sometimes referred to as the "Forgotten Middle".

2) Describe the toll that being a caregiver can take on a person.

3) Why is there a long term care crisis?

Answer 1

1.forgotten middle

As people age and require more assistance with daily living and health needs, a range of housing and care options is available. Over the past four decades the market for seniors housing and care—including assisted living and independent living communities—has greatly expanded to accommodate people with more complex needs. These settings provide housing in a community environment that often includes personal care assistance services.The size of the US population ages seventy-five and older in 2029 (“tomorrow’s seniors”) and estimated their demographic characteristics, health, cognitive and functional status, and financial resources. The analytic model was developed in three stages: the construction of an individual financial resource measure that included income, annuitized assets, and annuitized housing equity; forecasting of the size and demographic characteristics of the senior population in 2029; and estimation of per capita financial resources and selected health and functional characteristics of the forecasted senior population.

The “forgotten middle” refers to middle-income seniors who make too much money to qualify for subsidized housing and too little to afford a high-end retirement community. There is an astounding number of individuals who fall into this category and many more to follow soon. This is not a surprise. However, this underserved population has not been the focus of aging services providers and housing developers.

We are entering a critical time for the forgotten middle. The explosion in this demographics is before us. Finding solutions for this crisis is one of our nation’s most pressing needs. In the housing world, the challenges of developing housing for these renters are similar to developing workforce housing. Most projects won’t pencil out due to the lower rents needed to serve these populations and the high cost of land and construction.

The “silent generation” is passing away and is being replaced by the boomer generation. The “silents” are mostly grateful and appreciative of what is provided for them in the housing choices they have and the services/amenities that are provided. The boomers are much more demanding. It’s not that they aren’t grateful, but they do not hesitate to ask for what they want. For the majority, it’s champagne tastes on a beer budget. This new consumer requires us to redefine senior living and offer a wide variety of housing choices. Now is the time for innovation.

Congregate living is not for everyone, but it is recognized as one of the better ways to serve the most people. Lobbying for government support is critical. There are avenues of support through the U.S. Department of Housing and Urban Development and low-income housing tax credits that help build affordable housing, but no funds for supporting construction of housing that is affordable for middle-income seniors (or workforce). You may think middle-income people have more money and/or they aren’t that desperate. For many, that is just not the case.

2.The toll of being a caregiver can take on a person.

Under the nation’s current elder care system, the responsibility for providing care most often falls on family members and friends. There are an estimated 40 million Americans providing some type of unpaid care to another adult, according to a 2018 Pew Research Center analysis of U.S. Bureau of Labor Statistics data.

On average, these adult caregivers spend about 80 minutes a day doing things like bathing, paying bills, dressing, and providing medical care and transportation, the analysis found.

The consequences of being pushed into a caregiver role are profound.

“The toll is financial, the toll is physical, and it is emotional, and women predominantly shoulder the burden of caring for people in our families,” Kim said.

The median household income in households led by someone 65 or older in the United States in 2018 was $43,696, according to the Census Bureau, while the median net worth for American families ages 65 to 74 is $224,100. For families 75 or older, that number rises to $264,800.

That may sound like a lot, but it’s “not nearly enough” to pay for long-term care, Gleckman said. Full-time home care costs more than $50,000 per year and the median annual cost of a private room in a nursing home is more than $100,000, according to the AARP.

Wealthy individuals can afford the help they need and Medicaid covers the very poor and disabled, but experts say the vast majority of middle- and working-class Americans are left without any options.

On average, these adult caregivers spend about 80 minutes a day doing things like bathing, paying bills, dressing, and providing medical care and transportation, the analysis found.

By 2029, according to the study, there will be 14.4 million middle-income seniors, and more than half will have mobility limitations. The authors also estimate that 20 percent will have high healthcare and functional needs.

“While many of these seniors will likely need the level of care provided in seniors housing, we project that 54 percent of seniors will not have sufficient financial resources to pay for it,” the study states.

The study’s findings echo Gleckman’s analysis of the current elder care system.

“The financial resources are not there, the public programs don’t exist, to be eligible for Medicaid, you need to be very sick and impoverished, and to self-insure for a risk like this, a couple probably needs a million dollars,” Gleckman said. “So what do you do? You rely on your children, you rely on your friends, and then you rely on nobody.”

Between 60 and 75 percent of caregivers are women, according to the AARP and the Caregiving Alliance. An estimated 11 million caregivers are also parents, falling into the so-called “sandwich generation” of caregivers who provide care for both children and elderly family members.

3.The need for long-term care

The U.S. is one of only two developed countries in the world without a social insurance program for long-term care. Private long-term care plans can cost several thousand dollars per year, putting them out of reach for many Americans. Only about 7.2 million Americans have long-term care insurance, according to the AARP, and the cost of premiums continue to rise, reducing demand.

The lack of a public program and an affordable private program presents an enormous problem for a rapidly aging nation that, thanks to improvements in medical technology and public health, is living much longer than it did a hundred years ago.

In 2018, there were 52 million people aged 65 and older, according to the U.S. Census Bureau. By the mid 2030s, that number will surge to 78 million, and Americans over 65 will outnumber children under 18 for the first time in the country’s history, according to Census projections.

Aging baby boomers aren’t the only reason for America’s growing care crisis. In recent decades, women who have historically been far more likely to serve as caretakers have entered the labor force in increasing numbers. This shift in demographics and household structures is creating a “care gap,” whereby there aren’t enough caretakers or care workers to take care of America’s aging population—a group that will need more help than ever before.

Studies indicate that more than half of older Americans will eventually require long-term care, with the average lifetime long-term care costs for Americans over age 65 reaching $138,000, according to a 2016 study by the Urban Institute. For 15 percent of those seniors, those costs will reach at least a quarter of a million dollars.Roughly three in five family caregivers also hold a paying job, according to a 2016 AARP analysis, and more than half are forced to take time off from work, reduce their hours, or quit altogether.The number of people who take on caregiving roles for their parents is likely to surge, just as the home care workforce grows. Home health aide is one of the fastest-growing jobs in the country, though these positions are among the lowest paid and easily exploited.