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STUDY: Elder Americans Face Unmet Daily Care Needs

September 17, 2014

Nearly half of adults over age 65 — 18 million people — require some assistance with activities of daily living, say researchers at the University of Michigan in a recent report based on data from the National Health and Aging Trends Study.

In non-nursing home settings, one in five older adults reported receiving help with the most basic self-care activities — a figure much larger than previous estimates from the mid-2000s. The study suggests that this trend could grow at a time when the pool of available caregivers is shrinking.

Of further concern, 30 percent of older adults reported an adverse consequence due to unmet need for assistance in the past month. Individuals who received paid care — a group also more likely to have greater care needs — and low income older adults reported even higher levels of unmet need.

Currently, the vast majority of elders who require daily assistance benefit from informal, unpaid help from family, neighbors, and friends. According to the study, 95 percent of these elders had some assistance from informal caregivers; 65 percent relied solely on this personal network. By contrast, 34 percent received paid help and only 5 percent relied solely on paid help.

However, these trends will likely change as many of the baby boomers age out of caregiving and become care recipients. According to the U.S. Census Bureau, over the next 20 years the number of elders over age 85 — those most likely to require care — will grow 40 percent faster than the number of people aged 25 to 64 — potential caregivers.

The predicted care gap is exacerbated by other factors as well, the report explains. First, the pool of informal caregivers is shrinking as more women enter the labor force and have children later in life. Furthermore, public health issues like increased rates of obesity will likely increase demand for long-term care among elders.

The U.S. Bureau of Labor Statistics corroborates this narrative — it projects there will be one million new home care jobs added over the next ten years. The number of homecare workers — personal care aides and home health aides — will grow by nearly 50 percent and will add more jobs than any other occupation.

The authors note, “Policies to improve long-term services and supports and reduce unmet need could benefit both older adults and those who care for them.”

Other notable findings from the study include the following:

  • One in four older adults lived in a supportive care or nursing home setting.
  • Nearly 3 million elders living outside of nursing homes — mostly from lower income brackets — received assistance with three or more daily activities in the previous month.
  • Nearly all of those who received care outside of nursing homes had at least one potential unpaid, informal caregiver — such as a family member or friend.
  • Three in ten older Americans received paid care.

— by Stephen Campbell, PHI Policy Research Assistant

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