Caring for the Disabled Elderly: Who Will Pay?

By Alice M. Rivlin; Joshua M. Wiener et al. | Go to book overview

Chapter One
Introduction and Summary

It is time for Americans to face a serious problem--how to organize and pay for long-term care for the disabled elderly. More and more Americans are living past 75, 85, and even 95. As they age, the elderly suffer not only acute illnesses requiring care in hospitals and by physicians, but chronic disabling conditions that require long-term care either at home or in nursing homes.*

Alzheimer's disease, osteoporosis, heart disease, and stroke predominate among the many diseases that cause chronic disability in the elderly. The toll is not only physical but emotional as people experience and relatives watch a decline in the ability to do things that most of us take for granted. Long-term care is the help needed to cope, and sometimes to survive, when physical or mental disabilities impair the capacity to perform the basic activities of everyday life, such as eating, toileting, bathing, dressing, and moving about. 1

Most long-term care services are provided by family members and friends of the disabled person, often at considerable personal sacrifice. Paid services are offered by nursing homes, home health care workers, homemaker and personal care workers, adult day care centers, and respite programs for family caregivers. Costs can be high. Paying for a long stay in a nursing home, at an average cost of $22,000 a year, is beyond the financial capacity of most families. 2

At present the United States does not have, either in the private or the public sector, satisfactory mechanisms for helping people anticipate

____________________
*
Although people can require long-term care at any age, this study is concerned with physically and cognitively impaired persons aged 65 and over. It does not include the mentally ill, developmentally disabled, or nonelderly physically disabled--all important populations with pressing needs, but beyond the scope of this study.

-3-

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