A recently published study by the Urban Institute shows that even under the most favorable foreseeable conditions, long term care burdens on families and institutions will increase substantially over the next 30-plus years.
The report examines the impact of the expected collision between a growing demand for LTC services and a declining population of caregivers.
Population aging, especially when boomers reach age 85 and older, points to a likely surge in the use of LTC services, notes the report, "Meeting the Long Term Care Needs of the Baby Boomers."
Urban Institute researchers foresee additional challenges from changing demographics caused by a continued rise in divorce rates, increasing childlessness and declining family sizes. The rising labor force participation of women could also reduce their ability to provide informal care, and it is uncertain whether men would fill the gap, note the researchers, Richard W. Johnson, Desmond Toohey and Joshua M. Wiener.
The future demand for LTC depends a great deal on how old-age disability rates evolve over time, they note. Although recent evidence has shown health improvements among older people, there is no guarantee these trends will continue, the study points out. Disabilities stemming from the increased incidence of diabetes and obesity seen in younger people might offset the future decline in disability rates at older ages.
The analysis combines results from new models of current LTC use with projections of the size and characteristics of the future population until 2040. Population projections were based on Dynasim3, the Institute's simulation model of the older population.
The researchers estimated current LTC demands based on data from the 2002 Health and Retirement Study, a national survey of older Americans. The projections show how changes in disability levels, financial resources, children's availability and other characteristics could affect the future demand for LTC services, both paid and unpaid.
The report projects 3 scenarios, based on different disability projections.
The high disability scenario assumes that old-age disability rates will increase by 0.6% per year from 2000 to 2014 and remain constant thereafter, reflecting recent disability increases at younger ages.
The low disability scenario assumes that overall old-age disability rates will decline by 1% per year for the foreseeable future.
The intermediate scenario, which represents the institute's best guess of the future size of the frail older population, does not assume any particular trend in disability rates. Instead, projected rates depend on changing mortality rates, educational attainment, income levels and age and race distributions.
