Never in the history of the United States has there been more need for living care services for seniors, and yet our public policies toward care, both on a state and federal level, are woefully deficient. Sure, there’s Medicaid for those persons at the lower rungs of the economic ladder and of course highly affluent people can pay for whatever care they need. But what about the rest of us, the middle-class facing financial obliteration in our elder years by paying out of pocket for expensive nursing facilities?
Over the past 30 years, people needing long-term care services has grown significantly. Nearly one-half of older adults in America, some 18 million people, have difficulty with or receive help with their daily activities, according to the National Association of Elder Law Attorneys in its Spring 2015 journal article Where Do We Go From Here: Long-term Care in the Age of the Baby Boomers, by Shana Siegel and Neil T. Rimsky. Nearly three million individuals who need assistance with three or more activities of daily living don’t live in nursing homes. Most of them rely on family caregivers.
But that’s going to change as baby boomers shift from being caregivers to needing care themselves. There’ll be a shrinking pool of informal caregivers. To date, most of our public policy related to long-term care has focused on the financing of it. What’s needed now are policies related to how services will be delivered to the steadily increasing number of older adults.
Authors Siegel and Rimsky note that most older adults “strongly prefer home and community-based care to nursing home care.” That makes a lot of sense, especially given that nobody’s aspiration in life is to live in a nursing home. But lots of people would enjoy making their home at a community where long-term care services are provided. Continuing Care Retirement Communities offer that possibility, but they too come with a price tag. What distinguishes a CCRC from a nursing home is the fact that CCRCs offer financial plans that allow residents to curtail the run-away costs of expensive long-term health care in a nursing home. CCRCs not only provide a home, but they have a plan for care to be provided by people residents know and who know them.
“Provision of coordinated services” is critical to allowing people to successfully age in their homes. What that means is that seniors need to know what services are out there and how they can avail themselves of them. Information about services available to older adults living by themselves in their houses is insufficient. But that’s not the case when it comes to living at CCRCs where there is a constant flow of information related to health, medical services, successful aging, intellectual and physical development and much more. In other words, CCRCs are already accomplishing what the general public needs.
So why don’t all older Americans live at a CCRC if it’s such a logical choice? First, there’s a stigma of living at an “old folks home.” Many people don’t like the negative connotation. Second, the daunting task of physically moving from one’s house is a great deterrent, even though there are many services that make the move very easy. Third, cost is a major consideration. Many seniors who could easily afford to live at a CCRC don’t because their perception is it’s a lifestyle only for rich people. But what many older people don’t appreciate is that paying to live at a community comes with many financial benefits that aren’t available to those living isolated in their houses. There are tax benefits, elimination of household upkeep and major repairs, no more utility bills, gas savings with regularly scheduled transportation and so much more outlined in many ways throughout the pages of this website.
“”We believe that communal living is necessary for cost-efficient service delivery,” write Siegel and Rimsky. And while they are not advocating or promoting CCRCs, their conclusions are correct. Seniors who live in a community enjoy cost-efficiencies that otherwise are not available to those living in isolation. It only makes sense and will continue to be more obvious as more seniors clamor for services.