We should have resolved this issue over 20 years ago when we knew what kind of LTC system was most cost effective and that people most wanted . Many people spent a lot of time back then trying to make the case that Washington and Oregon has proven beyond a doubt that Long-term Care (LTC) systems featuring home and community based care and run through the non-profit aging network were the way to go and that we needed a national LTC policy that moved every state in that direction. Illinois may be an extreme case, but many states are likely to be where Illinois is now in a few years as the older population grows and money remains tight. Florida, for example,is very much on course to end up like Illinois in the next decade.
Today about 15 percent of Americans are 65 or older, a percentage that will grow steadily in the coming decades as more and more baby boomers reach retirement age. Even some boomers’ oldest children aren’t that far away from hitting that milestone. Those demographic realities will put intensifying pressure on our systems of long-term health care. How they will evolve to handle the growing demand can’t be predicted, but one aspect is already becoming clear: The boomers aren’t going quietly into nursing homes.
They want care on their terms, and a big part of that means being able to stay in their homes and communities as they age. “The trend is shifting at every level to care at home and in community-based settings,” says Kevin Prindiville, executive director of the advocacy group Justice in Aging. “People are increasingly asking for and expecting this.”