To Stay in their Communities, Seniors First Need A Place To Live

Sometimes, you just have to say what is crashingly obvious. And when it comes to older adults aging at home, here it is: If seniors are going to avoid a nursing home, they need a safe, affordable alternative. Without one, they may die prematurely. And even if they live, they will almost surely need institutional care, which may be a bad alternative for them and, if they are poor, will cost the government a small fortune.  In short, you can’t age in place without a “place.”

Can Big Data Help Us Understand the Lives of Family Caregivers

What do family caregivers really do? What is their day like? Remarkably, though there are tens of millions of children, parents, and spouses in the US helping millions of frail older adults and younger people with disabilities, we know very little about their daily experiences. In an effort to better understand what it is like to care for a relative or friend, the California-based Family Caregiver Alliance has just concluded a fascinating experiment: Is it possible to use a mix of interviews, personal logs, and new technology to map a caregiver’s day?

What If Government Pays for All Long-Term Care?

How much would it cost if government pays for all long-term care?  About $4 trillion over the next decade.

We know because Democratic presidential hopeful Bernie Sanders has proposed to do just that, as part of his ambitious Medicare-for-all health insurance program. And, in an effort to calculate the overall cost of Sanders’s domestic policy agenda, a group of my Urban Institute colleagues have run the numbers.  The overall net increase in federal government spending for all health and long-term care: $32 trillion over 10 years. As part of that project, Urban long-term care expert Melissa Favreault estimated the net increase in federal spending for long-term supports and services only: about $3 trillion (after accounting for the roughly $1 trillion Medicaid already pays).

Age Discrimination in the Workplace? Not in Major League Baseball

A new study finds that healthy people who continue to work after age 65 are likely to live longer than those who retire.  But many older adults don’t get the chance, too often tossed aside by employers who can’t see past their gray hair. And that got me thinking about major league baseball, now in full swing. Why? Because often the boys of summer are managed by old guys. Sometimes by really old guys.

Age discrimination may infect much of the American workplace, but not the major league baseball diamond, where demands for immediate success are intense.

Medicare Takes A Big Step Toward Changing the Way It Pays Docs

Last year, Congress changed the way Medicare pays physicians, It scrapped a system that paid docs based largely on the number of procedures and tests they do, and instructed federal Medicare officials to come up with a design that rewards quality and value. Medicare has already moved in this direction for hospitals and health systems, and the new law was potentially an historic shift in the way physicians deliver care. But what exactly does it mean for them and their patients?

One Cheer for Congress Renewing the Older Americans Act

Congress has finally renewed the Older Americans Act—a key piece of the social safety net for seniors. It is good that, after a decade in limbo, the law finally has been reauthorized. But before you break out the balloons and champagne, remember that keeping programs alive on paper is not the same as paying for them. And the government safety net for seniors has been fraying for years, victimized by woeful underfunding.

A Medicare Long-Term Care Benefit?

Public opinion surveys show that most Americans incorrectly think Medicare pays for long-term supports and services (LTSS). It does not. But should it? Should Congress add a long-term care benefit to the program’s current package of insurance for hospital care, doctor visits, and drugs?

Three highly respected health researchers, Karen Davis, Amber Willink, and Cathy Schoen, think it should. In a blog post for the journal Health Affairs, they’ve proposed Medicare Help at Home. It has three elements:  A limited benefit for support at home, a new health delivery model called an Integrated Care Organization that would provide both medical care and LTSS; and team-based home care.

A New Look At The Big Differences In Financial Well-Bring Among Older Adults

For years, experts have been arguing over whether Americans are financially prepared for old age, especially after including the costs of health care and long-term care. But those debates often focus on averages (or medians), a perspective that misses a key point: While some seniors are sitting pretty, many others face a huge challenge. In other words, it isn’t just about the total housing and financial assets that older adults hold, or how much they make each year. It is about how much of that wealth and income is in the hands of a relatively few seniors.

Men Are Living Longer, More Active Lives Than Ever Before. The News Is Not So Good For Women.

Older men are living longer and enjoying more active lives than ever before. In fact, in a dramatic change from three decades ago, these men can now expect their last decades of life to look very much like that of women.

Even as men live longer, they are less likely to suffer physical limitations than in past years, and when they do, those disabilities will come later in life, according to a new study by Vicki Freedman of the University of Michigan, Doug Wolf of Syracuse University, and my colleague Brenda Spillman of the Urban Institute.  The three published their results in the American Journal of Public Health. It is available online here (paywall).

What Assisted Living and Other Residential Care Looks Like

You’ve probably heard somebody say, “assisted living is the new nursing home.” A new study suggests that, in important ways, it is true.

People living in residential care communities, including assisted living, care homes, or adult group homes, look a lot like those who once lived in nursing homes. They suffer from serious chronic conditions, need assistance with daily activities such as bathing or dressing, and many visit emergency departments or are hospitalized over the course of a year.