The federal government should invest more in home care

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Diane Walker
Diane Walker

When you talk about future job opportunities in America, people tend to think of high technology, computers, biochemical research and space exploration—all of which are important. But according to the Bureau of Labor and Statistics, the fastest growing occupations involve caring for seniors.

And this group is going to keep growing because the fastest growing segment of the American population is adults over 65 years of age. There are more than 36 million seniors today; that figure will soon double to more than 70 million.

So President Obama's plans to expand federal support to families in the so-called “sandwich generation” is both timely and appropriate. The additional $52.5 million for support programs and $50 million dedicated to transportation, adult day care and other services are welcome. But this is not enough.

The sandwich generation gets its name from the growing tendency of Americans to marry and have children later in life, which forces them to simultaneously cope with both child-related expenses like college and the costs, in addition to caring for senior parents. All while engaged in full-time jobs. And those burdens will become all the greater because life expectancies are growing too.

These are long-term trends. Baby boomers populate today's sandwich generation, but tomorrow it will embrace everyone. Caring for seniors will play an increasingly important role in everyone's lives. That will make providing the resources to deliver the best form of care for seniors—whether that involves remaining in the family home or moving to a long-term care facility—an increasingly important priority for governments at all levels.

For many seniors, staying in the family home could be the best option. Those whose main problem is managing such daily tasks as cooking, bathing, taking their medications on schedule or getting dressed need assistance—but perhaps not round-the=clock. Policies that enable them to remain at home will take some of the pressure off long-term care facilities, which will be undergoing considerable expansions to meet the growth in the senior population.

Federal policies to assist in home care for seniors should complement support for long-term health care. For one thing, home care is less expensive than even the lowest level of long-term care, saving taxpayers considerably. The national average for 40 hours a week of one-to-one care in the home is $29,000. A year in a low-cost assisted living facility averages about $50,000 per year; a private room in a nursing home averages over $70,000.

Putting seniors into long-term care facilities when it's not necessary, not only consumes scarce resources, but allocates long-term care space poorly—space that will be needed for those who really will need such care. 

By dedicating more than $100 million to senior healthcare, federal policy is starting to balance the need for home care and long-term care, in ways that will strengthen both areas in the long run. Already, the best estimate is that in 2010, about $100 billion will be spent on home health services. So while the federal government's $100 million policy guarantee is a step in right direction, it's less then a tenth of one percent of what the real cost of senior health care will be in the coming years. Some of these costs will involve expenditures for medical equipment, but most will be for care services.

Even though they are only a start, the new proposals and funding are an important milestone, because they constitute recognition of the problem at the highest levels of our government. Home health care must become a higher priority at all levels of government.

A more comprehensive solution that places non-medical home care on a comparable footing to long-term health care, with provisions to pay for it through public insurance programs should be debated next. Expanding care of all kinds will help generate additional employment, save money and perhaps most importantly provide the best possible care for our seniors. Additionally, these jobs will remain in the United States.

Finally, by putting home care and long-term care on a more even stage, we will take much of the fiscal and emotional pressure away from choosing whichever option is best for the individual and his or her caregivers. Seniors will feel that their needs—and not those of relatives or institutions—are the priority.

This will ultimately benefit all involved, because decisions about care are more likely to be seen as the best answer to the facts of the case, as opposed to being the best way to leverage existing programs to finance options available. Thus, whatever decisions are made are less likely to be resisted or resented.

Both home care and long-term care are going to become more important as the sandwich generation weighs its options. Both sectors are going to grow, even in the absence of sound public policies, because demand for them is rising with the population. But policies that set the proper balance between home care and long-term care will ultimately enable each sector to do what it does best in serving our senior population.

Diane Walker is vice president of Learning & Performance Systems at Griswold Special Care. She has been with the company since 2000 and is responsible for developing and implementing educational opportunities for franchise directors, including the Steps-To-Success and Catalyst Programs that promote growth and superior quality services. Walker is also responsible for developing regional, educational programs for office staff and voluntary Caregiver educational opportunities. She is a member of the Quality Review Team and provides management consultation to Offices nationally. She is the editor for Caring Times, a publication and Web site for family caregivers and healthcare professionals. E-mail her at Diane@GriswoldSpecialCare.com.


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