Who will care for us?

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Caregiver helps senior woman
Caregiver helps senior woman. (Ridofranz/iStock / Getty Images Plus)

By Bob Roth

Every day in the United States, 10,000 or more people are turning 65. This is representative of the Baby Boomers (nearly 71 million Americans) born between the years 1948 and 1964. It wasn’t until 2011 that this phenomenon began, and now the oldest of the Baby Boomers started turning 75 last year, and in nine years, the Baby Boomers will begin turning 85. Couple this fact with the knowledge that nine out of 10 Americans want to age in place – in the comfort of their own home. How are we going to accomplish this? And who will care for us?


During the beginning of the COVID-19 pandemic, we discovered quickly that the elderly with multiple comorbidities were most vulnerable to this virus, especially those who lived in a communal living setting. Former Centers for Medicare & Medicaid Services Administrator Seema Verma said it best: “Residential care will always be an essential part of the care continuum, but our goal must always be to give residents options that help keep our loved ones in their own homes and communities for as long as possible.”

According to the U.S. Department of Health and Human Services, someone turning 65 today has nearly a 70% chance of needing long-term care and support and one out of five (21.3%) will need care for more than five years. Among care recipients aged 65+, more than two-thirds (70%) have long-term physical conditions, 39% have memory challenges and 21% have emotional or mental health issues.

So here is my question to our readers: Are you prepared? Have you appointed someone to be your guardian, conservator or caregiver? If you have, then I want to thank you. If not, then what are you waiting for? Sit down with your family members and loved ones and let your wishes be known. Have a professional assist you in putting together those wishes.

It all starts with having a plan. Hopefully, you have your affairs in order or, at the very least, you are planning to put them in place. Of those 65 or older, 70% will need long-term care and support. If family and friends are not an option for you, and you want to stay home and age in place, who will care for you? I would encourage you to hire a professional, employer-based in-home care aide/caregiver agency, but do you have the necessary funds to pay for this type of caregiving service?

As Americans, we are aging rapidly and the stress that we are putting on the long-term care support system is like nothing we have ever seen before.

There are approximately 50 million Americans who are family caregivers who are making the physical, emotional and economic sacrifices every day to care for their loved ones, of course unpaid. Then there are nearly 6 million paid professional caregivers, typically referred to as in-home care aides/caregivers, underpaid and in scarce supply. These selfless individuals are the backbone of our direct care workforce providing care for the elderly and infirm. Caregiving is hard work; caregivers assist the elderly and disabled in getting out of bed, bathing, dressing, using the bathroom, eating their meals and taking their medications. Caregivers serve as the first line of defense by recognizing symptoms and behavioral changes and preventing costly and potentially dangerous hospitalizations. They make it possible for millions of Americans to stay in their homes and out of expensive and institutional settings like hospitals and nursing homes. Along the way, they often become trusted members of the family.

Performing this necessary and in-demand work takes a physical and emotional toll, yet these caring souls do it with compassion day in and day out. The caregiving relationship with its complexities, difficulties and value is not well understood until you are the one giving or receiving care.

Caregiving is skilled work; it requires resilience and agility. Caregiving produces something so valuable that we can hardly quantify it, which is dignity.

Our long-term care support system is severely challenged – demand is overwhelming the supply of direct care workers. Coupled with the severity of this workforce challenge and increasing costs of care it creates “the perfect storm.” The workforce shortages were here long before the pandemic, and now the pandemic has shined a huge spotlight on this very issue.

Last week, Genworth Financial released its 2021 cost of care report. This was their 18th year, and it is something that we in the care delivery space look forward to every year. This year’s report is quite startling but not surprising after what we have endured through the past couple of years with the COVID-19 pandemic. In all our years monitoring this report, we have never seen double-digit increases across all the care delivery verticals.

Professional caregiving is not paid for by Medicare or managed care organizations. Presently it is paid for in one of four ways: private pay, long-term care insurance, Medicaid or VA Benefits. Most have to pay for these types of services privately, in many cases impoverishing the spouses/partners and their families.

So now that we have demonstrated this problem, how do we solve this?

I believe it begins with awareness and that starts with advocacy; advocating for one of the most vulnerable populations in our country and making sure that they are not forgotten. In many cultures this is a given, but not so much here in the United States.

How do we make this change?

1. Prioritize that care should be delivered in the home setting. It is well known that caregiving in an individual’s home costs much less than a nursing home. In addition, it is the most desired place to receive care.

2. Attract more workers into the direct care workforce field. By 2050, there will be over 83 million Americans 65 and older, that is double the population today. In addition to attracting the workers, give them the tools and pay they deserve.

3. Modernize Medicare or develop a new program to deliver post-acute care in the setting they need and desire in the comfort of their own home, which would include paying for assistance with activities of daily living.

To make change a reality, it is up to us to convince our state and federal legislators. We need to let them know that real, meaningful changes to our health care laws and policies need to be made. We are the ones who elect our legislators, and it’s our duty to share our opinions about what affects us — as constituents and voters.

It is time to shine a light on this reality; let’s not let our lawmakers “kick the can” further down the road where we reach the point of no return.

Here is a question to ponder: Do you think about caregiving as a workforce or responsibility? The answer is it is both.

If we can all come together on this, great things can happen. Let’s start today.

Bob Roth is the managing partner of Cypress HomeCare Solutions. This originally ran in the Jewish News of Greater Phoenix.

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