Independence for Older adults and People with Disabilities
Americans with disabilities and those who are aging are concerned about preserving their independence and freedom:
According to the Commission on Long-Term Care’s September 2013 Report to the Congress, more than 12 million Americans rely on personal assistance and other Long-Term Services and Supports (LTSS) as a way to maintain their quality of life and independence.[1] This diverse group – inclusive of adults who are age 65 and older (56 percent), as well as children and adults under 65 (44 percent) – is expected to grow as, in a little over a decade, “the leading edge of the Baby Boom Generation will enter its 80s.”[2,3] Many receive LTSS through family or friend caregivers “who provide unpaid assistance out of love and commitment and by paid caregivers who have chosen to earn their living in an intensely personal caring profession.”[4]
Nearly two-thirds of the cost of paid LTSS today (more than $131 billion in 2011) is financed through Medicaid.[5] And while the role of paid LTSS is significant, the role of unpaid LTSS provided primarily by family members and friends represents more than 75 percent of demand; most adults in the community who use LTSS receive unpaid help.[6]
Increasingly, Americans with disabilities and those who are aging are concerned about preserving their independence and freedom:
- Most Americans prefer to live in their own homes or in comfortable
community settings, not institutions.[7] - Nearly 90 percent of adults who are age 65 and older want to stay in
their home for as long as possible.[8] - Seventy-eight percent of adults who are age 65 and older intend to
remain in their current residence as they age.[9] - Eighty-seven percent of individuals with disabilities who are age 50
and older prefer to live in their own homes.[10]
Many Americans are unaware that few options exist for those who require assistance with daily activities and personal care. It is not until the need for LTSS becomes personal that most Americans even begin to experience and recognize the complexities of our nation’s health care infrastructure. It is often only when individuals have to manage these issues in their own lives that they find a common theme prevails—the health care infrastructure is broken.
It is the opinion of this National Advisory Board that the modernized health care infrastructure required to meet the needs of older adults and individuals with disabilities will only come about as others join with us in promoting and furthering the following six foundational principles:
[1] U.S. Senate Commission on Long-Term Care, “Report to the Congress” (September 30, 2013): 3, http://ltccommission.lmp01.lucidus.net/wp-content/uploads/2013/12/Commission-on-Long-Term-Care-Final-Report-9-26-13.pdf.
[2] U.S. Senate Commission on Long-Term Care (2013), 8.
[3] Susan C. Reinhard et al., AARP with the Commonwealth Fund and the Scan Foundation, “Raising Expectations: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers” (2014, second edition): 8, http://www.aarp.org/content/dam/aarp/research/public_policy_institute/ltc/2014/raising-expectations-2014-AARP-ppi-ltc.pdf.
[4] U.S. Senate Commission on Long-Term Care (2013), 4.
[5] U.S. Senate Commission on Long-Term Care (2013), 4; see also National Health Policy Forum, based on data from the 2011 National Health Expenditure Accounts.
[6] Judith Feder, Harriet L. Komisar and Robert B. Friedland, Georgetown University Health Policy Institute, “Long-Term Care Financing: Policy Options for the Future” (June 2007), http://ltc.georgetown.edu/forum/ltcfinalpaper061107.pdf.
[7] Enid Kassner, AARP Public Policy Institute, AARP Blog, “Home- and Community-Based Services: The Right Place and the Right Time” (August 19, 2013), http://blog.aarp.org/2013/08/19/home-and-community-based-services-the-right-place-and-the-right-time/.
[8] AARP Public Policy Institute and National Conference of State Legislatures, “Aging in Place: A State Survey of Livability Policies and Practices” (2011), http://assets.aarp.org/rgcenter/ppi/liv-com/ib190.pdf.
[9] Joint Center for Housing Studies of Harvard University, “The State of the Nation’s Housing” (2014): 16, http://www.jchs.harvard.edu/sites/jchs.harvard.edu/files/sonhr14-color-full.pdf.
[10] Enid Kassner et al., AARP Public Policy Institute, “A balancing act: State long-term care reform” (July 2008): 1.
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