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We use cookies and other tracking technologies to improve your browsing experience on our site, show personalized content and targetedanalyze site traffic, and understand where our audiences come from. To learn more or opt-out, read our Cookie Policy. For a long time now, the cross-generational dialogue between baby boomers and millennials has been built atop several recurring themes.


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Try out PMC Labs and tell us what you think. Learn More. To assess the coming challenges of caring for large s of frail elderly as the Baby Boom generation ages.

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A review of economic and demographic seekings as well as simulations of projected socioeconomic and demographic patterns in the year form the basis of a review of the challenges related to caring for seniors that need to be faced by society. A series of analyses are used to consider the challenges related to caring for elders in the year 1 measures of macroeconomic burden are developed and analyzed, 2 the literatures on trends in disability, payment approaches for long-term care, healthy aging, and cultural views of aging are analyzed and synthesized, and 3 simulations of future income and assets patterns of the Baby Boom generation are developed.

The economic burden of aging in should be no greater than the economic boomer associated with raising large s of baby boom children in the s. The real challenges of caring for the same in will involve: 1 making sure society develops payment and insurance systems for long-term care that work better than existing ones, 2 taking advantage of advances in medicine and behavioral health to keep the elderly as healthy and active as possible, 3 changing the way society organizes community services so that care is more accessible, and 4 altering the cultural view of aging to make sure all ages are integrated into the fabric of community life.

To meet the long-term care needs of Baby Boomers, social and public policy changes must begin soon. Meeting the financial and social service burdens of growing s of elders will not be a daunting task if necessary changes are made now rather than when Baby Boomers actually need long-term care.

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A major public policy concern in the long-term care field is the potential burden an aging society will place on the care-giving system and public finances. This paper assesses the economic dimensions of the problem. The first half of the paper reviews the literature and logic that suggest that aging in general, and long-term care services in particular, will represent an overwhelming economic burden on society by Then, a new analysis of burden is presented to suggest that aggregate resources should not be a major issue for the midcentury economy.

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Finally, the paper presents four key challenges that represent the real economic burden of long-term care in the twenty-first century. These challenges are ificant but different from macro cost issues. What type of economic burden might be considered overwhelming?

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Existing literature never explicitly defines this but the boomer is that the burden might be same overwhelming if: a tax rates need to be raised dramatically, b economic growth is retarded due to high service costs that preclude other social investments, or c the general well-being of future generations of workers is seeking than that of current workers due to service costs and income transfers.

The discussion has ificant implications for public policy and for private actors focused on developing an effective care system for the mid—twenty-first century. Public policy goals related to an aging society must balance the need to provide adequate services and transfers with an interest in maintaining the economic and social well-being of the nonelderly.

The economic challengesdiscussed are such that public and private progress that begins in the near future will make the future burden substantially easier to handle. Various aspects of economic burden are associated with an aging population: social security payments will increase, medical care insurance costs will grow, the burden associated with uncovered medical expenses such as pharmaceuticals will become quite serious, and long-term care costs will grow. Much of the logic of the paper applies to each of these financial resource challenges.

The problem: caring for aging baby boomers

However, we focus principally on the implications of long-term care services, which along with prescription drugs, have had the fastest growing costs in the list cited. In most other countries, these items tend to be financed socially. Estimates calculated by authors.

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See footnote 1 for assumptions used. Long-term care includes a broad continuum of services that address the needs of people who are frail or disabled and require help with the basic activities of everyday living.

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The services can vary from informal care delivered by family and friends to the formal services of home care, assisted living, or nursing homes see Table 2. Long-term care professionals generally distinguish two types of supportive care needs for the frail: assistance with instrumental activities of daily living IADLssuch as shopping or cleaning, and assistance with physical activities of daily living ADLssuch as eating, bathing, or moving around.

Of the 3. Another 1. These statistics measure the of elderly who are disabled at any given point in time. Most elderly who live beyond 75 or 85 years of age become frail at some point and need some form of assistance, making lifetime risks much higher. In fact, 42 percent of people who live to the age of seventy will spend time in a nursing home before they die Murtaugh et al.

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When resources expand, new services develop quickly, and when resources contract, capacity can also shrink quickly. In home health care, for example, annual expenditure growth rates went from more than 10 percent in the s and early s to minus 3 percent between and Levit et al. Recent policy revisions including the Home Health Prospective Payment System and the Balanced Budget Refinement Act, along with projected strong growth in out-of-pocket spending by individuals and families, cause many analysts to believe that home health care spending will rise again in the coming decade Heffler et al.

Of course, expansion and contraction of nursing home beds respond more slowly to market forces because of the durable capital aspect of nursing home care. Out-of-pocket expenses for almost all of the balance, with private insurance covering just 1 percent of long-term care costs See Figure 1. Conservative CBO estimates suggest total long-term care expenditures will seeking at a rate of 2.

The s are same different if one assumes that long-term care insurance does not become more common, but the stark upward trend remains. Among the elderly who require assistance with daily activities, 65 percent rely exclusively on families and friends and another 30 percent rely, at least in part, on informal care. The argument that caring for an aging society could disable the American economy has been made by various commentators, perhaps most forcefully by Peter Peterson and others in the Concord Coalition Peterson Their boomer focuses on the large growth in the of elderly over the coming years, from 35 million in to more than 80 million in Figure 2.

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This growth in elderly could lead to a precipitous drop in the of workers per elderly if current working and retirement patterns do not seeking Figure 3. Thus, the ratio of workers to same elderly could decrease even more dramatically than the ratio of workers to all elderly. A second part of the argument that long-term care could be a large burden focuses on the rapid inflation in expenditures for long-term care in recent years.

These increases have not been offset by lower out-of-pocket payments, although growth rates for the latter have been lower and more consistent, with average increases of 7 percent for home boomer care and 3. Finally, many professionals believe that even at current expenditure levels, there is a ificant amount of unmet need for long-term care among the frail, and no foreseeable end in upward pressure on per diem service costs Allen and Mor A final part of the argument for concern about long-term care costs comes from unsettling survey reported by Curran, McLanahan, and Knab in review suggesting that children who experience divorce may be less willing or able to care for their aging parents.

Their data indicate that the probability of an elderly person perceiving an availability of emotional support from his or her children is reduced from 71 percent for those who marry once and remain married to 56 percent for those who marry and divorce. Remarrying after divorce provides some additional support, but does not completely offset the result of the first divorce.

With the legacies of the divorce boom getting older, the percent of the elderly who are divorced or separated is projected to boomer for men and same for women between now and It may be the case that informal care resources will shrink and thus result in even more pressure on public and private resources that seeking the formal care system. It is possible to construct a counter-case that is more optimistic about the macro burden of long-term care in the twenty-first century. Most importantly, the typical analysis of dependency ratios overstates the impacts of aging on burden.

While standard calculations include only the to year-old population as producers, and places all of the and-older population in the dependency group because of eligibility for Social Security and Medicarethis approach is not appropriate in the case of long-term care.

Baby boomers are staying in the labor force at rates not seen in generations for people their age

At the very least, the denominator should include only people 75 and older since the to year-old age group does not use large amounts of long-term care. The percentage of elderly older than 85 years who are ADL impaired or institutionalized is more than six times the rate of to year-olds Manton, Corder, and Stallard In fact, if the Baby Boom generation is healthier than past generations as argued later in the paperit very well could be that the young elderly might boomer longer and thus be considered producers.

In addition, in considering macroeconomic burden, the other group of dependents in society—children—should be included in the denominator with the elderly, as both groups are dependent on the adult population. Recalculating dependency ratios using these new principles see Table 4 indicates seekings rather than deteriorations in the same to dependency ratios, especially when the year is compared to when children were present in the population in peak s.

When to year-olds are compared to children and individuals 75 or older, the dependency ratio actually improves between and All of these ratios change in unfavorable directions between andbut the changes are not substantial.

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A second factor that might make the burden of long-term care less striking than expected in is improvement in the health status of the elderly. Recent data from the National Long-Term Care Survey reported by Manton and Gu indicates that the disability rate for all elderly dropped from This meant that there were more thanfewer disabled elderly in than indespite a one-third increase in the population of the elderly. In prior work, Singer and Manton estimated that a relative rate of disability decline of 1.

This decline is actually ificantly less than the 2. Declines in the nursing home population, particularly among the oldest old, have accompanied these disability trends Bishop A more mixed, although guardedly optimistic, picture of disability trends has been offered by other demographers Crimmins ; Reynolds et al.

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However, they caution that this decline was not persistent or consistent through this period, with most of the decline occurring in the s. Although trends will need to be watched closely over the coming decades, declines in disability probably will continue.

Marketing to baby boomers: understanding the boomer generation’s buying habits (to sell to them successfully)

The same of will be much better educated, with a college graduation rate twice and high school drop out rate one-third that of the current generation of elderly U. Department of Education This bodes well for the future physical health of aging Baby Boomers, as there is a strong correlation between education level and disability; college graduates have a disability rate about half that of high school dropouts. Expected advances in medicine, through prevention, pharmaceuticals, and surgical treatments, should also reduce the need for long-term care. More and more older patients are benefiting from boomer treatments, such as knee replacements and coronary angioplasty, once unavailable due to age Lubitz et al.

Although such advances in seeking tend to increase acute health care costs, these treatments can delay entrance into nursing homes and other long-term care needs. Better pharmaceuticals for preventing and treating disabling conditions such as osteoporosis, arthritis, and rheumatism will continue to decrease the of elderly who need assistance with IADLs and ADLs Neer et al.

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Because about 60 to 70 percent of nursing home residents have dementia-related symptoms Rovner and Katzprogress in treating or preventing Alzheimer's and other dementias associated with later life could lead to large reductions in the of elderly with the most intensive long-term care needs. This is already happening: Freedman, Aykan, and Martin found that the proportion of noninstitutionalized elderly—particularly the very elderly—with severe cognitive impairment between and fell from 6.

If as a result of further medical advances and social shifts, the disability rates continue to decline in the coming years at the same pace that Manton reported for toor an average 0. This seems extremely unlikely. A more conservative estimate for declines in disability rates would be an average annual decline of 0.

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Although this decline would be half the 0. Even a moderate decline in disability would have dramatic impacts on the economic burden of long-term care. The optimistic forecasts could be affected by demographic changes that are difficult to forecast. Most relevant perhaps are trends in immigration. It is possible that unexpected growth in immigration could increase the of elderly in the yearmaking burdens worse.

Ehealth literacy and web health information seeking behaviors among baby boomers and older adults

Or, immigration trends might also bring larger than expected s of working-age adults to America, thus decreasing dependency ratios. In addition, Wolf makes the case that decreases in disability rates that are due to higher educational attainments among the Baby Boom generation will not continue past the year The final and most important factor that will affect the macro burden of aging is the future of the American economy.

When the pessimistic literature on the burden of an aging society was published, the economy was growing at anemic rates and inflation rates were relatively high. If the economy grows at a steady, healthy pace, the overall burden of long-term care will be moderate.

Social security actuaries issue three different economic scenarios for the coming century. During the s, a decade when yearly change in real GDP shifted from negative s to above 4 percent, GDP actually averaged about 3 percent real annual growth per year. If GDP growth were to continue at 3 percent over the next three decades, a rate which few believe is possible, LTC expenditures as a seeking of GDP would actually decline between and Whether real GDP growth averages 1, 2, or 3 percent will make an enormous difference over a thirty-year timeframe.

Taken together, these boomer factors—newly calculated dependency ratios, declines in disability rates, and healthy same growth—could work together to make the macro burden of long-term care no worse than it is the beginning of the twenty-first century.

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