Who will take care of our frail elders?


By Judith Boyko

Every day, 10,000 baby boomers turn 65. That’s one day closer to retirement and one day further along in the aging process. As the baby boomers age, who will take care of them?

In its AARP Public Policy Institute report, “The Aging of the Baby Boom and the Growing Care Gap: A Look at Future Declines in the Availability of Family Caregivers,” AARP says that in 2010, “the caregiver support ratio was more than seven potential caregivers for every person in the high-risk years of 80-plus.” By 2030, it says, that ratio is expected to decline to four to one. That’s 70 million boomers to 17.5 million caregivers. Furthermore, in 2050, when boomers will be in their high-risk years, the caregiver support ratio will fall to three to one.

headshot_jboykoThe Family Caregiver Alliance indicates that the “typical” U.S. caregiver is a 46-year-old woman who spends more than 20 hours a week caring – unpaid – for her mother and working outside her home. It also reports, “the cost to businesses to replace women caregivers who quit their jobs because of caregiving responsibilities has been estimated at $3.3 billion,” and “absenteeism among women caregivers due to caregiving responsibilities costs businesses almost $270 million.”

So, what are the options for caregiving that meet our expectations and lifestyle needs as well as those of our caregivers?

1: A nursing home. While a nursing home provides many benefits to its residents, including mental stimulation, ongoing medical and other care and a safer living environment, the cost may be prohibitive. “The average cost of nursing home care nationwide is about $75,000 per year for a semi-private room. Massachusetts nursing home costs are above the national average,” according to Community Resources Information, Inc.’s MassResources.org.

2: An assisted living facility. Assisted living facilities are geared toward individuals who require minimal daily living support and who do not need ongoing medical care or supervision. However, the Assisted Living Federation of America says, “the average cost for a private one-bedroom apartment in an assisted living residence is $3,022 per month.” Some assisted living facilities are touted as “concierge living” environments and can run more than $10,000 monthly for larger living spaces; three meals daily; recreational activities; access to medical care and specialized programs for conditions like Alzheimer’s; and laundry, cleaning and spa services.

3: Home sweet home. For those wishing to remain in the comfort and familiarity of their own homes, in-home care might be the best option. Certified home care aides and licensed nurses support activities of daily living (i.e. bathing, dressing, toileting and hygiene maintenance.) Companions provide socialization, caregiver respite and accompaniment to medical appointments. Homemaking and nursing services may also be available. In-home care costs vary depending on the number of hours the individual needs supportive services.

The Bureau of Labor Statistics projects that between 2010 and 2020, home health and personal care aide occupations will increase by 70 percent — from 1.87 million of these workers in 2010 to nearly 3.2 million in 2020.

Thinking about how to care for your loved ones — and yourselves as you age — is of paramount importance. If you and your family wish to remain at home, in-home care may be your best bet — economically and in terms of availability.

Judith Boyko, MBA, MS, RN, is CEO of Century Health Systems, Distinguished Care Options and Natick Visiting Nurse Association. She can be reached at infonvna@natickvna.org. For additional information, visit www.centuryhealth.org, www.dco-ma.com or www.natickvna.org. Archives of articles from previous issues can be read at www.fiftyplusadvocate.com