The appalling and dysfunctional national elder care system

It’s a sad fact of reality but the elderly in the United States who are unable to care for themselves are being let down by a high-priced, dysfunctional system of long term care.  When private industry is benefiting at the expense of the elderly, while at the same time, providing subpar living conditions, care and access for necessary services, something is very wrong.

The face of aging in the United States is changing dramatically.  Consider the fact that the fastest growing age segment of the United States population is people 85 or older with approximately four million in this group.  It is estimated that by 2050, this number will swell to 19 million.  The longer we live, the ability to remain independent and not rely on caregivers or living in a long term care facility, dwindles.  The needs and expense of caring for this vulnerable age segment needs an overhaul in order for it to function in the best interest of our elderly.

Book addresses problem with long-term elder care

Laura Katz Olson, professor of political science at Lehigh University in Bethlehem, Pennsylvania, authored a book called, Elder Care Journey, A View from the Front Lines illustrating her own personal journey as a caregiver for her aged mother, Dorothy Katz, and the indignities she experienced by the social welfare system.  Her book highlights the unwarranted hurdles set up by the bureaucratic welfare system and the appalling care she witnessed in some nursing home facilities. 

Much of the problem lies with a senior’s ability to pay for long term care.  Consider that in 2012, the median income of someone age 65 or older was $28,056.  The median net worth of such households, excluding home equity, was $27,300, according to the U.S. Social Security Administration publication.  Contrast this with the 2012 median annual cost of a nursing home stay (for a semi-private room) was $73,000 and $39,600 at an assisted living facility.  Even if an elderly person stays within their own home with a personal caregiver or caregiving service, this totals on average around $43,472 annually.

The reality is the cost of long-term services and supports (LTSS) far surpasses what most elderly people have the ability to pay for.  The exorbitant cost of care quickly evaporates any and all assets and savings forcing the majority of low- to middle-class seniors onto Medicaid.

Olson expounds in her book the burden of filling out a multitude of forms, having to supply documentation and being treated disrespectfully by agents within the welfare system.  All of this resulted in feelings of helplessness at the hoops she had to go through just to acquire services for her elderly and disabled mother.

The worst though was the treatment her mother received at a couple of facilities for post-acute care in Florida.  Her mother’s physical and cognitive needs went unmet along with other patient care overall being below average.  Olson does point out that her and her mother have experienced far better nursing home facilities where she has encountered nurses and aides who are very dedicated, hard-working individuals providing quality care for the residents.

Olson’s investigation into the multi-billions of money spent by the government compared to what senior citizens actually receive was an eye-opening experience.  She discovered that many nursing homes – the majority of nursing homes and assisted living facilities are for-profit – drain a large percentage of federal and state taxpayer money allocated for long-term care.  In fact, one-third of all Medicaid funds ($492.3 billion in 2014) were spent on LTTS and nursing homes, many privately owned, being the main beneficiary of these taxpayer dollars. 

The treatment facilities in Florida where her mother stayed receiving poor care, was a facility that is repeatedly bought and sold with the main goal of profit maximization for the company stockholders and investors.  Investing in the long term care health care sector has a lot of potential for economic growth due to the rising number of elderly people, many of whom will need care.  The private equity firms intention is to sell the entity within five years to make a profit with little regard for the long-term viability of the facility or its residents living there.

A possible solution

Olson points out in her book many areas of long-term care that need to be addressed and to have a national conversation on.  Olson has her own opinion on how this problematic issue should be handled by suggesting the US government should implement a mandatory government-run LTSS social insurance program and to implement a single-payer system to de-stigmatize the receipt of benefits, all with the purpose of saving money.  Equalizing access and benefits, irrespective of household income or where one resides is another factor Olson recommends to solve this problem. 

Families also have a responsibility in having a conversation with their loved ones on what their wishes are in regards to long-term care, who will be the durable power of attorney, do they want a do not resuscitate (DNR) order or not, being open about their finances and so on.  Once these difficult but necessary conversations and details are worked out and there is a plan in place, then if and when the time comes for needing long-term care, the process can go much smoother and everyone will feel more comfortable with decisions that have already been made.