Build a strong long-term care system


By Mike Festa, State Director, AARP Massachusetts

Mike Festa

America’s long-term care system is not just broken — it doesn’t exist.

Americans 50-plus and others in need of long-term care face a patchwork of public and private services, costly institutional care, and unpaid family caregivers. Today, many are often pushed into costly nursing homes — the only form of long-term care automatically covered by Medicaid — even though the vast majority of seniors would prefer to live independently in their homes and communities.

The COVID-19 pandemic has raised alarms about the safety and quality of institutional care. More than 70,000 residents and staff of nursing homes and other long-term care facilities have died, accounting for more than 40 percent of all U.S. COVID-19 deaths. Even before the pandemic, the Government Accountability Office found more than 80 percent of nursing homes were cited for infection control deficiencies.

In Massachusetts, nursing home residents and staff account for 65.7 percent of all probable or confirmed deaths. As of August 31, there were 8,827 deaths among confirmed cases.  Probable or confirmed COVID-19 deaths reported in long-term care facilities currently stands at 5,802.

Unfortunately, options like home and community services are often unaffordable and not available through many state Medicaid programs. While unpaid family caregivers allow millions of seniors to live safely at home, instead of in costly nursing homes, these family members need more support.


Challenges ahead


The age 85+ population—those most likely to need assistance with daily activities—is projected to more than triple between 2015 and 2050, making the need for an effective long-term care system even more important.

Our elected leaders must rethink institutional care to improve the safety and quality of nursing homes and other long-term care facilities and protect residents against sickness, neglect and isolation. COVID-19 has shown that few facilities are prepared with adequate staffing, resources and proper infection control.

At the same time, state and federal officials must increase access to the home and community care seniors prefer. They also must do more to support the 48 million unpaid family caregivers who make it possible for their older parents, spouses and other loved ones to live at home.

AARP guiding principles

As you consider a candidate, keep in mind AARP’s priorities for long-term care. AARP is asking Congress and state lawmakers to:

Improve care in nursing homes and other long-term care facilities, especially amidst the COVID-19 pandemic by:

  • Ensuring regular, ongoing testing and adequate personal protective equipment (PPE).
  • Creating transparency through public reporting of cases and deaths in facilities, discharges and transfers, and the spending of federal funds.
  • Requiring access to virtual visitation.
  • Improving residential care through adequate staffing, oversight, and access to ombudsmen.
  • Stopping attempts to provide blanket immunity for long-term care facilities related to COVID-19.
  • Expand access to home and community services that allow seniors to live at home, reducing the need for costly taxpayer-funded nursing home care.
  • Provide greater support to unpaid family caregivers to make it easier for seniors to remain in their homes and communities.

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