The number of people 65 and older will more than double between the years 2000 and 2030, increasing from 35 million to over 70 million. This demographic change represents an incredible success, as people are living longer and healthier than ever before, with more years spent in post-retirement than at any time in history.
This demographic also poses new challenges to our communities. Many elders experience a period of living with dementia, frailty or another disability prior to death, and most will require help from another person at some point. Some will only need care for a short time, but others will need help for years.
Consider these facts:
▪ 7 out of 10 adults will need assistance from another person as they age;
▪ 43.5 million Americans provide unpaid care to someone who is ill, disabled or aged, and many of those caregivers (most of them women), will lose wages or lose their job due to caregiving;
▪ Caregiver services are valued at almost half a trillion dollars annually;
▪ Individuals 85 years and older, the oldest old, are one of the fastest growing segments of the population, and the number of people with memory impairment in this age group could more than triple by 2050;
▪ The Alzheimer’s Association estimates that one in nine Americans age 65 and older are affected with dementia.
There are wonderful resources in Whatcom County to help elders and their caregivers.
Our society has not yet developed programs and policies that support caregivers or that are elder- or family-friendly. Most elders are not equipped — particularly financially — to remain in their homes if they require assistance with activities of daily living. The cost of in-home caregivers can be $24 or more per hour. The annual cost of assisted living facilities averages $55,000 in Washington State, and considerably more than that for specialized dementia-care units. Nursing home care can cost almost $100,000 annually. A minority of people own long-term care insurance, and even those that do often find what the policies cover is far from comprehensive.
There are wonderful resources in Whatcom County to help elders and their caregivers, such as the Alzheimer Society of Washington, The Whatcom County Council on Aging, The NorthWest Regional Council and the Volunteer Center of Whatcom County, to name a few. Despite these resources, none of them are adequately funded or scaled to meet the need, and that is only going to get worse. We don’t have enough facilities for patients with dementia, and some patients wait in the hospital for weeks or even months for an appropriate placement to open up.
What are the solutions? One approach has to be to improve policies at the state and national level for elders and family caregivers of elders. When I was in Scotland in 2011, I learned that every single person over the age of 65 can get a caregiver from twice to four times daily under the National Health Service if it is ordered by a social worker. That policy allowed many elders to stay home who would likely be institutionalized in the U.S. But our country has a lopsided system in which our insurance programs will pay thousands of dollars a month for a medication and almost nothing for direct caregiving. We also need more dementia care units.
The Whatcom County Medical Society is working to promote family- and elder-friendly policies is the Family Caregiver Platform Project. We are working with other advocacy organizations at the state level to promote policy changes such as increasing insurance coverage for caregiver and respite services, providing tax breaks for caregivers and providing more opportunities for paying caregivers outside of the Medicaid program.
Another approach is to come together as a community to find innovative solutions locally. A new initiative through the Whatcom County Council on Aging, Bellingham At Home, is based on the Village-to-Village movement that promotes elders aging in place. Their vision is that by working together through volunteers and partnerships with community businesses, elders at home will have enhanced access to services such as transportation, home chores, gardening and social activities. You can learn more at firstname.lastname@example.org.
I hope you consider joining one of these initiatives as a supporter, a volunteer or a community member with ideas to share.
ABOUT THE AUTHOR
Dr. Bree Johnston is director of palliative care for PeaceHealth and president of the Whatcom County Medical Society.