Links of Interest

Why Do Late Boomers Have So Little Retirement Wealth?

Over the last 40 years, the retirement system has shifted from defined benefit plans to defined contribution plans, primarily 401(k)s and Individual Retirement Accounts (IRAs). This shift has been accompanied by a decline in Social Security benefits relative to pre-retirement earnings as the program’s Full Retirement Age has moved from 65 to 67. Thus, the […]

Battling The Mental Health Crisis Among The Underserved Through State Medicaid Reforms

Total deaths from suicide, alcohol, or drugs, what some call “deaths of despair,” increased by 51 percent from 2005 to 2016 in the United States, and drug overdose deaths increased by 16 percent per year between 2014 and 2017. These statistics reflect the well-documented opioid crisis and what some experts have called a national “mental […]

Spousal Caregivers Are Caregiving Alone In The Last Years Of Life

Caregiving in the last years of life is associated with increased depression and negative health outcomes for surviving spouses, many of whom are themselves in poor health. Yet it is unclear how often spouses are caregiving alone, how they differ from supported spouses, and whether lack of support affects postbereavement outcomes. We hypothesized that spouses […]

U.S. Nursing Home Violations of International and Domestic Human Rights Standards

We present a review of the international covenants and conventions and U.S. domestic laws and regulations that are designed to protect nursing home residents in the United States. Based on a review of research studies, government reports, and news reports, we found extensive evidence of widespread and systematic abuse and neglect of nursing home residents […]

The Forgotten Middle: Many Middle-Income Seniors Will Have Insufficient Resources For Housing And Health Care

As people age and require more assistance with daily living and health needs, a range of housing and care options is available. Over the past four decades the market for seniors housing and care—including assisted living and independent living communities—has greatly expanded to accommodate people with more complex needs. These settings provide housing in a […]

Half of Single Older Adults in U.S. Lack Income to Pay for Basic Needs

Researchers tracking the economic security of America’s older adults have found that half who live alone and nearly a quarter of those living in two-person households where both are age 65 or older are unable to afford basic necessities without extra assistance. The 2019 Elder Index and a companion report, Insecurity in the States 2019, […]

Pharmacy Benefits and the Use of Drugs by the Chronically Ill

The use of medications such as antihistamines and NSAIDs, which are taken intermittently to treat symptoms, was sensitive to co-payment changes. Other medications—antihypertensive, antiasthmatic, antidepressant, antihyperlipidemic, antiulcerant, and antidiabetic agents—also demonstrated significant price responsiveness. The reduction in use of medications for individuals in ongoing care was more modest. Still, significant increases in co-payments raise concern […]

How Do Older Workers Use Nontraditional Jobs?

Working consistently through one’s fifties and early sixties is key to attaining retirement security. However, workers also need access to retirement plans – so they can continue to accumulate resources – and health insurance – so they can avoid withdrawing assets in the event of a health shock. Workers without access to these benefits will […]

Will More Workers Have Nontraditional Jobs as Globalization and Automation Spread?

Recent research has called attention to alternative employment arrangements that often leave workers without retirement and health benefits and with income instability.  At the same time, workers are facing increasing competition from automation and globalization.  This competition is of special concern for older workers, who increasingly need longer careers to secure an adequate retirement and […]

Institute Talk: A Conversation With Vince Mor on Alzheimer’s Care and the State of Nursing Homes

Vincent Mor is a leading academic expert on eldercare issues and a national authority on research related to nursing homes. The Brown University professor has been principal investigator in more than 40 grants funded by the National Institutes of Health that focus on the use of health services and the outcomes experienced by frail and […]

Improving Care Through Public Policy

Without the development of a disease-modifying biomedical therapy, the number of people aged 65 years and older with Alzheimer’s dementia may nearly triple, from 5.5 million to a projected 13.8 million, by 2050 (Alzheimer’s Association, 2017). It is imperative that society be able to care for them. The practices featured throughout this supplement are just […]

Alzheimer’s Association Dementia Care Practice Recommendations

Alzheimer’s disease is a degenerative brain disease and the most common cause of dementia. Dementia is a syndrome—a group of symptoms—that has a number of causes. The characteristic symptoms include difficulties with memory, language, problem solving, and other cognitive skills that affect a person’s ability to perform everyday activities. According to the Alzheimer’s Association 2017 Alzheimer’s […]

It’s Time For The Health Care System To Reckon With The Human Costs Of Climate Change

This year, an estimated five million people worldwide will die from climate change. On its own, this statistic would seem unbelievable, even absurd, to most. However, if one considers even a fraction of the direct and indirect consequences of a hotter planet—air pollution, reduced food production, the spread of diarrheal diseases—it becomes apparent that climate […]

Time for a New Strategy in the War on Alzheimer’s Disease

Policy makers, public officials, and researchers alike are fond of “declaring war” on diseases. The wisdom of this “one disease at a time” approach, however, is questionable. Consider, for instance, the war on cancer. At the time it was declared by Richard Nixon in 1971, cancer was the second leading cause of death in the […]

The Faux Scholarship Foundation of the Regulatory Rollback Movement

With the full participation and consent of Congress, President Trump has embarked upon a radical project to freeze and roll back federal regulations that protect public health, safety, the environment, and the economy. The principal justification for this project, publicly announced by both Congress and President Trump, is the claim that regulations are costing the […]

Long-term Care Providers and Services Users in the United States, 2015–2016

This report presents the most current national results from the National Study of Long-Term Care Providers (NSLTCP) conducted by the National Center for Health Statistics (NCHS) to describe providers and services users in five major sectors of paid, regulated long-term care services in the United States. This report provides information on the supply, organizational characteristics, […]

Effects of long‐term care setting on spousal health outcomes

Over the past three decades, there has been a large expansion in noninstitutional long‐term care (LTC) use, and public financing of long‐term care services has been shifting away from nursing homes toward home and community‐based services (HCBS). Medicaid, the primary payer for LTC for elderly people, spent 46% of its total LTC dollars on HCBS […]

A National Examination Of Long-Term Care Setting, Outcomes, And Disparities Among Elderly Dual Eligibles

The benefits of expanding funding for Medicaid long-term care home and community-based services (HCBS) relative to institutional care are often taken as self-evident. However, little is known about the outcomes of these services, especially for racial and ethnic minority groups, whose members tend to use the services more than whites do, and for people with […]

The Financial Burden Of Paid Home Care On Older Adults: Oldest And Sickest Are Least Likely To Have Enough Income

Paid home care can significantly improve the lives of older adults with disabilities and their families, but recipients often incur substantial out-of-pocket spending. We simulated the financial burden of paid home care for a nationally representative sample of non-Medicaid community-dwelling adults ages sixty-five and older. We found that 74 percent could fund at least two years […]

Financing Long-Term Services And Supports: Options Reflect Trade-Offs For Older Americans And Federal Spending

About half of older Americans will need a high level of assistance with routine activities for a prolonged period of time. This help is commonly referred to as long-term services and supports (LTSS). Under current policies, these individuals will fund roughly half of their paid care out of pocket. Partly as a result of high […]