Johns Hopkins: Long-term care must be expanded to support aging in place
A recent study authored by researchers at Johns Hopkins University’s Bloomberg School of Public Health suggests that the integration of health, social services and community-based support systems must be improved to better accommodate the desires of older Americans to age in place in their homes.
By 2034, Americans ages 65 and older will outnumber those under the age of 18 for the first time in U.S. history. This will lead to “unprecedented” demand for long-term care services, according to the study.
“Aging in place is a primary goal for most aging adults, however, without a national long-term care insurance system in the U.S., most services, which are often expensive, must either be paid out of pocket or be provided by unpaid family members,” the researchers said in a statement.
“Additionally, the study emphasizes that current [long-term care] offerings are often woefully inadequate to meet the needs of aging populations, with pronounced inequities in access to these services based on financial resources, geography, and family structure.”
A review of salient literature led the authors to identify two specific barriers to the wider proliferation of aging in place among older Americans. One is the inadequate availability of affordable services, while the second is a lack of labor necessary to support the expected demand for such services.
“The review concluded that although there has been a shift from institutional care such as nursing homes to home-based care, the infrastructure to support aging-in-place remains fragmented and underfunded,” the study explained.
The health care workforce faces a serious recruitment and retention challenge that needs to be addressed to adequately serve the population of older Americans who prefer to remain in their homes as they age. While emerging technology helps to fill part of the gap, even that element faces shortfalls.
“Technology plays an increasingly important role in enabling aging-in-place with innovations like telemedicine, remote patient monitoring, and home-based care frameworks, such as those under hospital-at-home initiatives, promising to improve communication among patients, caregivers, and healthcare professionals,” the study explained. “However, availability of such technological advances is unbalanced especially in rural areas, and privacy concerns exist.”
But affordability also remains a chief concern, since home-based care is often prohibitively expensive for many retirees, who are already facing challenges in financing their post-employment years.
“Without significant changes, the current [long-term care] infrastructure will continue to be overburdened, and workforce shortages will persist, resulting in many older adults not receiving the support they need to enable them to continue to live in their homes,” the authors found.
“Addressing these challenges is essential for policymakers, healthcare providers, and communities that desire to ensure that older Americans can age with dignity, independence, and a high quality of life.”