Addressing the 73 Million Elephants in the Room: How to Care for the Baby Boomers as They Age

By 2030, 20% of Americans will be over the age of 65. This population, known as the baby-boomer generation (BBG), will challenge our healthcare system in ways never seen before. The current care infrastructure cannot withstand the volume, nor does it meet this generation’s unique expectations and desires.
This shift stems from the post-World-War II advent of a dual income household, rendering traditional caregiver roles untenable. This phenomenon led to the creation of Medicare/Medicaid legislation, resulting in growth of the skilled nursing facility (SNF) industry, which turned out to be a temporary solution to an ever-evolving, complex problem. Over time, licensed staff requirements amid a shrinking workforce demanded an alternative approach to meet healthcare needs.
The 1980s met these demands with the beginning of the assisted-living (AL) industry, which then rapidly expanded in the 1990s. Less regulation and licensing requirements meant scaling was easier. However, lower Medicaid reimbursement margins and lack of Medicaid acceptance in this setting posed challenges. Due to the uncertainty surrounding payment, many AL operators opt for private-pay only or require two years private-pay before Medicaid applies (AL average length-of-stay is 22 months), which is problematic financially for many. Despite payment disparities and efforts to minimize institutional atmospheres, many baby boomers view AL as an institution and prefer in-home care or a community care approach such as a group home.
Given financial and staffing constraints and BBG preferences, ALs and SNFs will not meet demands and desires of the future. Pivoting to care that is home based, family driven, and affordable is the future of BBG. The process has already begun through the federal government’s GUIDE model for community-based dementia care and the RAISE Family Caregivers Act to provide resources to family-based caregivers who will form the backbone of the caregiving workforce for the BBG. As more caregiving occurs in the community, health care will need to adapt to meet them where they are.
Learning objectives: 1) Understand the current state of elder care. 2) Identify barriers to the current industries. 3) Understand upcoming trends to meet demands for the BBG.