COVER STORY - Aging is Changing

Is the experience of getting old the same as it was a generation ago? Things have definitely changed. 

Shifting Demographics

Thanks to the Baby Boom, not only are there more people over age 65, the over-90 segment is growing. From 720,000 in the year 1980 to more than 1.9 million in 2010, the number of Americans who are 90 years of age or older has nearly tripled, the Census Bureau reported after the 2010 census. Over the next four decades, this number is projected to more than quadruple. People 90 and older now comprise 4.7 percent of the older population (age 65 and older), as compared with only 2.8 percent in 1980. By 2050, this share is likely to reach 10 percent.

The distribution of Takacs McGinnis clients along the age continuum mirrors national trends. Just under half of the firm’s clients are in the 61 to 79 age bracket with roughly the same proportion in the 80 to 100 age range. Five clients are over 100. People are coming to the firm at younger ages and with more debilitating chronic illnesses such as Parkinson’s disease, Alzheimer’s disease, and strokes.

Healthier Than Ever

Despite growing concerns about chronic conditions, older people in general are healthier than ever.

A 2013 Danish research study suggests that longevity can follow two different paths: people might survive longer because they are healthier, and therefore they may not experience much disability as they age, or, more individuals may live longer with serious illnesses or disability but receive support from extensive medical interventions. Recent data suggests that the oldest old — centenarians in particular — may enjoy better health than people in their 70s or 80s, hinting that those who do survive into old age may be stronger to begin with, and less likely to experience disability. Some recent studies have also found that cognitive scores among the elderly have risen, which may reflect growing levels of physical and mental activity, both of which have been linked to better mental function — among today’s elderly populations.

New Living Options

In 1994, 1.74 million older adults were living in nursing homes. By 2004, the number had fallen to 1.32 million—a 25 percent reduction—and the number continues to decline. Why the decrease when the number of Baby Boomer seniors is growing?

Ten years ago, elderly adults had basically two living options: a private residence, either their own home or the home of children or other relatives, or the nursing home. Today, the situation is very different.  Many who would have ended up in nursing homes in the past are being diverted to assisted living facilities, multi-level adult congregate living facilities, green house communities, and a myriad of other care settings. These facilities offer varying levels of care depending on the senior’s needs. Though the nursing home population is decreasing, the total number of seniors in long-term care facilities is not.

For elders looking to delay or avoid the transition to a long-term care setting outside the home, additional resources like non-medical home care companies make it possible to live independently without burdening family caregivers.

Whether the elder ages at home or in a long-term care facility, family caregivers are often shocked to discover how much long-term care can cost, especially when they learn that Medicare covers very few of these services. Unless older adults have long-term care insurance, they will likely pay for this care out-of-pocket—from savings, home equity and, often, other family members’ assets.

In Tennessee, the state Medicaid program, known as CHOICES, can help pay for some types of care for seniors who meet income and resource limits. CHOICES 1 pays for nursing home care in institutions contracted with the state of Tennessee. CHOICES 2 covers home and community-based care including care in assisted living facilities that are contracted with the State of Tennessee. Unfortunately, few assisted living facilities are part of the CHOICES program, which limits access to this type of care for people with limited resources.

More Guidance for Families

Historically, there has been virtually no guidance for people during the long-term care journey. Caring for elders has long been considered a private matter. It was the family’s responsibility to meet all the older person’s needs until end of his or her life. The only instruction available was observation—watching how previous generations handled care responsibilities. As a result, family caregivers cobbled together solutions, lurching from one crisis to the next and often sacrificing their own well-being in the process.

Things started to change in the 1990s when new businesses catering to the needs of older adults and their caregivers began to emerge. Today, families can choose from a wide variety of services. Elder law attorneys, senior advisors, geriatric care coordinators, non-medical home care companies, home health companies, senior relocation specialists, home modification companies, senior transportation services, and many other firms now offer support to caregivers that wasn’t available a generation ago. Life Care Planning, a concept familiar to Takacs McGinnis Elder Care Law clients and professionals in the long-term care community, was part of this new wave of services. In addition to solving the legal and financial problems created by the prohibitive cost of care, Life Care Planning is unique in its ability to help family caregivers overcome the analysis paralysis created by the presence of so many options for support. 

Will your aging experience be better than that of your ancestors? Probably.  Good genetics, a healthy lifestyle, the ability to live as independently as possible, and access to trusted guidance can make the long-term care journey easier. It’s a good time to be growing old in America.

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