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Long-Term Care Crisis Is Now, Report Says

By 2030, the number of Californians 85 and older will rise by 40% and the overall senior population will comprise about 18% of all Californians. That’s the sobering news from a fact sheet released this week by the SCAN Foundation, a not-for-profit organization that tracks long-term care issues.

“There are many changes evolving here in the state, so being able to articulate that we’re in a time of increasing need is important,” said Gretchen Alkema, vice president for policy and communications at SCAN. “We feel there will be increasing needs in the state, especially when we’re seeing a scaling-back for providing those services.”

The higher demand for senior services, particularly from the 85-plus population, coupled with budget cuts to health care programs adds up to a potentially huge problem, Alkema said. “We need to transform our systems of care, and not just for seniors because we know those long-term care needs aren’t created in a vacuum, they’re usually brought on by a number of chronic conditions.”

Those chronic conditions can develop before people hit their senior years, Alkema said, so if Californians can get quality health care ahead of those years, then that could minimize some of the potential costs to the state.

The fact sheet projects a population of 9 million seniors in California by the year 2030. Alkema said state policies to encourage and facilitate the purchase of long-term care insurance will be important in the next few years. Alkema said an effective conversion of dual-eligibles to Medi-Cal managed care will be crucial for effective state programmatic changes to handle  increased demand and  diminishing revenue.

“In terms of where to put the energy, the most effective place to put the energy would be in thoughtful and timely and considerate handling of the duals demonstration program,” Alkema said. “If we can figure out how to do really good care, if we can help change the health system for duals, that would have an incredible impact on everyone. It’s a great opportunity to affect the whole system of care,” she said.

Individuals can do a lot to alleviate the coming crisis, Alkema said, not just by getting long-term care insurance, but by having conversations now about family members’ expectations and plans for the future.

The SCAN Foundation has developed a document that lays out what those conversations should include, Alkema said.

“People need to start the conversation with their families, so they’re not caught in a crossfire [after it’s too late to plan],” Alkema said.

The state has its own long-term care conversation to conduct, as well, she said.

“The biggest key is putting the person in the center of care, and putting family in the center of care,” Alkema said. “The systems and programs now, the family isn’t necessarily a part of care. That needs to change.”

That’s true, both individually and at the state policy level, Alkema said: “Because the reality is,” she said, “if not now, when?”