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Life Health > Long-Term Care Planning

The Coming Crisis in Aging

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With so many Americans approaching retirement age, considerable attention is being focused on how they can invest their assets to last through their lifetimes.

Responsible advisors are also increasingly encouraging their clients to acquire long-term care insurance to protect their assets in retirement against the possibility they should ever need extended care.

But the aging of America presents a looming crisis far beyond the problem of whether baby boomers can afford their retirement. Little attention is being paid to other troublesome issues that will ultimately emerge from the sheer numbers of aging Americans.

Never in our nation’s history have so many people lived so long. Federal data shows the number of people over the age of 65 will increase to about 71.5 million by the year 2030. By that year, the percentage of people over 65 will be about 20% of the entire U.S. population, according to projections.

The statistics also suggest that by 2040, the population age 75 years and up will be greater than the population 65 to 74 years of age.

Encouraging people to buy annuities or to invest in long-term care insurance won’t help them much if there are not enough medical professionals or health workers to tend to them should they ultimately need extended care.

Some of those retiring now and in the immediate future are physicians specializing in geriatric medicine. Ironically, these practitioners are retiring faster than they are being replaced by physicians trained to care for the elderly.

Already, the shortage is troublesome. A 2008 estimate by the Kaiser Foundation found there were only 7,000 geriatricians to treat 38 million seniors.

Beyond the need for more geriatric doctors, the health care work force in general is falling short of the numbers needed to care for the growing elderly population. That work force is neither large enough nor prepared enough to meet that need.

Turnover among nurse aides averages 71% percent, and as many as 90% of home health aides leave their jobs within the first two years, according to the Institute of Medicine, an arm of the National Academy of Sciences, Washington.

The IOM advocates raising the federally required minimum number of hours of training for direct-care workers from 75 hours to at least 120. As it stands now, more training is required for dog groomers and manicurists than for home health care workers.

Medicare, Medicaid and other health plans need to pay more for the services of geriatric specialists and direct-care workers to attract more health professionals to geriatric careers and to reduce turnover among care aides.

Medicare, which subsidizes teaching hospitals for graduate medical education, could mandate that those schools provide adequate geriatric care training of resident physicians.

States could also mandate continuing geriatric education for physicians to become licensed in their states or to receive funds from Medicaid.

Family members and other informal caregivers can only do so much to care for aging loved ones.

And there’s only so much the government can do, as well. The Urban Institute projects that entitlement programs such as Social Security, Medicare and Medicaid will consume an estimated 80% of all federal tax dollars by 2040.

For many, growing older involves an expected loss of vigor and fitness. But it doesn’t have to be so. Some measures that can help moderate the effects of aging include more research on Alzheimer’s disease and other forms of dementia. These illnesses can last 20 years. Reducing their progress can assure a significant reduction in health care needs by the elderly.

Wellness programs for all adults will help, too. Health care has to begin with improved diet and exercise and on the availability of regular medical care throughout the working years of adults, to help assure their healthy aging.


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