When we give lunch and learn talks at companies or do workshops for community groups it is surprising how little people know about the lack of infrastructure for providing elder care in this country. The math is pretty easy. There are over 74 million boomers—a cohort bigger than the population of France—who are turning 65 at a rate of roughly 10,000 a day, their wave peaking in about 10 years in 2030. Genworth Financial, the long-term care specialists, estimates that on average a person turning 65 will require some two years of assistance with activities of daily life before passing away. Today there are only about 900,000 assisted living beds in commercial facilities across the country, and only about 1.7 million skilled nursing beds. The number of skilled nursing beds is declining even as aging in the population accelerates because nursing facilities are closing every year. That’s a total of fewer than 3 million long-term care beds for 74 million boomers.
We can’t build our way out of this; that ship sailed decades ago. Fortunately 90 percent of boomers hope to “age in place” — a good thing because there probably won’t be a commercial bed available. And as they age in place, more family members will be drawn into the responsibilities of caregiving. For that reason we have to do a better job of preparing people for family caregiving roles that will be critical to our health care system. The way things appear home-based care will be the wave of the future.