Who is Looking Out for the Elderly?

Bob Meister

Jul 8, 2010

Who is Looking Out for the Elderly?

Recently I attended a workplace benefits convention in Nashville. I was impressed with the variety of benefits being offered to the workplace, and the growing interest in combining benefits into a value-added package. There was everything from legal services, to ID theft and pet care discounts, but not much focus on a growing problem for American families and employers… health care for the elderly.

Since the passing of Health Care Reform, our industry has been focused on how it affects insurance. While I have not studied those potential affects, I do have an opinion about the CLASS Act. I think it is truly what it implies – an act. At $100 to $150 per day on average for home care services, not to mention the skyrocketing costs of facility care, grandma and gramps won’t be going too far with CLASS benefits that are anticipated to pay only $50 or $100 a day, depending on ADL criteria.  It also appears some folks on Medicare may not be approved for at least part of the care and procedures they need and have grown accustomed to getting. A November 2009 article in the Wall Street Journal raised one of the red flags that has seniors on edge; “Like most of Europe, the various health bills stipulate that Congress will arbitrarily decide how much to spend on seniors every year – and then invest an unelected board with  extraordinary powers to dictate what is covered and what is paid for. White House budget director Peter Orzag calls this Medicare commission “critical to our future” and “one of the most potent reforms.” Many elderly have told me they are frightened by the possibility of not getting care they need because they won’t qualify.  Physicians are hearing the same fear expressed to them. Last December, an orthopedic surgeon I know said he was getting a run on knee and hip replacements from Medicare patients who had been putting off their surgery, but now wanted to get it done as soon as possible.

Medicaid has its own problems according to Governor Mike Beebe of Arkansas. In the March issue of Aging Arkansas he wrote, “Ask any governor how to fix the healthcare dilemma and you’ll get the same answer; “We have to control costs”.  If left unchecked Medicaid is anticipated to grow eight to ten percent a year for the next two years. We have to slow this growth and we can’t wait for Washington to do it. Most governors are prohibited from deficit spending, as none of us can print more money when we run short.” Another article in the same publication points to the shortfalls in state tax collections that could place in-home care in jeopardy. The state cannot find $100 million to match additional federal funding that would total $400,000.  Arkansas needs to spend the $100,000 to get an additional $300,000 from the feds, but lawmakers adjourned their February meeting without making a decision on the matching funds.  Even if you set aside the Medicaid and Medicare dilemmas, there are several other factors looming on the horizon that promise what appears to be unmanageable health care problems in America:  Aging, Baby Boomers and Caregiving.

Longevity

Living longer- I call it life extension- is bringing us old folks to the edge of the cliff, but we are not going over. We are hanging on, thanks mainly to advancements in medical technology and pharmaceutical products.  According to life expectancy tables, we are living longer and will continue to increase in age, albeit not so gracefully. On average, anyone born in 2006 could be expected to live to the current life expectancy estimate of 77.5 years. That is contrasted with 68 years in 1942. That average is somewhat misleading for our purposes, because it takes into consideration death at young ages. If a person dies at 18, that is 59.5 years lost in the calculation.

Life Expectancy at 65 – as people age, their life expectancy increases. The average 65-year old today can expect to live another 18.4 years to the age 83.4 years.  And, if you make it to 75, your life expectancy jumps to 86.8 years. That means the average 75-year old will live 9.3 years longer than the average child born in 2006.  Looking at the growth rates of various age groups presents a picture of what is ahead in terms of longevity. The fastest annual growth rates, all between 45% and 50%, are found in the older age groups: 55 to 65, 90 to 95 and over 80 years old. The bottom line is that as a nation we will soon have more parents than children, increasing the burden of family caregiving, and in the opinion of some, is near a crisis situation even today.

The Baby Boomers

Now about 75 million strong, the Baby Boomers are the largest demographic cohort that has ever moved through American society, and an American Hospital Association study, When I’m 64 – How Boomers Will Change Health Care reveals that the Boomers are carrying a lot of baggage into old-age.

Chronic Disease – Of Americans 65 and older, 80% have at least one chronic disease that requires care and management. As Boomers age, the number with multiple chronic conditions is expected to grow from almost 8.6 million today to almost 37 million in 2030, when more than six of every 10 Boomers will be managing a chronic condition. The AHA study estimates that the number of Americans with diabetes is expected to rise from 30 million today to 46 million in 2030, which will require continuous medical management. The number of Americans with arthritis is expected to be 67 million at that time with almost 50% of Boomers living with the condition. The main health culprit for the Boomers is said to be obesity.  Obesity patients cost Medicare about 34% more than those of normal weight. By 2030 it is expected that over 93 million of the population will be obese, and 21 million will be Boomers. Another disturbing statistic considering the health and age of the Boomer cohort is that the incident of chronic disease becomes most prevalent at age 50, and by 2012 there will be 100 million people age 50 or older.

Caregiving and the Workplace

Americans have diverse opinions about the benefits of health care reform and how it will affect many aspects of life in America. Regardless of where you stand, the fact is that under the current  circumstances, attempting to provide health care for more people is going to require a change in the existing paradigm. Age Wave’s Ken Dychwald doesn’t see the CLASS Act solving a problem; he calls it the caregiver crunch. Dychwald says, “Before the baby boomers families had an average of four children, meaning that a lot of sons and daughters and their spouses could share the burden. But the Boomers now turning 65 have averaged only two children – kids who most likely don’t live close to their parents anymore.’

The professionals at Mature Market Institute (MMI)and the American Hospital Association offer similar conclusions drawn from studies conducted during the last four years. The most recent MMI study results were released in February 2010. These studies examined the effects of caregiving on lost productivity and the health of employed caregivers. The 2006 study by MMI estimates the average annual cost per employee for those employees with intense caregiving responsibilities is $2,441. Included in that number are eight criteria, including replacing employees due to absenteeism, workday interruptions and supervisor time. The study included a recommendation that employers should take measures now to address these issues by making eldercare resources available. The follow-up study “Working Caregivers and Employer Health Care Costs” found that employees providing eldercare are more likely to report fair or poor health, and are more likely to report depression, diabetes, hypertension, or pulmonary disease.

It concluded, “This brings to the forefront an urgent need for employers to actively address how to best facilitate the realities of employees dealing with eldercare responsibilities.”

While the American Hospital Association study does not specifically examine working caregivers, it does recognize the importance of family caregiving. It suggests that we need to more actively engage patients and their families in the care delivery process.

When I look at this research, and couple it with my personal experience and the knowledge that many of my friends and family members are in some way dealing with the health care needs of older adults, I wonder why more workplace emphasis is not placed on the importance of eldercare. I don’t want to minimize the need to stress wellness and prevention. I have worked at staying as well as possible for over six decades because I believe it is important. I wish I could remember the name of a presenter at the Society of Actuaries a couple years ago who said that an eighty year old cannot expect to be healthy unless he or she was an active and healthy fifty and sixty year old. It is also true that taking on a better life style at any age is beneficial, but the key is to begin early in life.

Having said that, I feel it is equally important as a society to pay attention to our parent’s health and to educate ourselves about aging and how to handle the eventuality of helping to care for them. The workplace is a perfect place to begin, because knowing how to plan for and react to family health care issues and having helpful resources will also benefit employers by mitigating lost productivity as we help employees look out for the elderly.

About The Author

Bob Meister is National Marketing Director for NavGate® Technologies, a division of CareQuest, Inc. headquartered in Madison, Wisconsin. Bob headed Chameleon Corporation advertising agency in Milwaukee, Wisconsin before joining CareQuest in 1997 and turning his interest to the study of America’s aging demographic and healthcare. He assisted in establishing CareQuest University, a self study curriculum for professionals serving the healthcare industry, and now helps market two powerful products developed and marketed by NavGate® Technologies: CareOptions OnLine™, known by the acronym COOL™, and CareOptions Analytics™ Program, or CAP™. NavGate® Technologies (www.navgate.com) designs and develops analytic software, web-based and cloud applications for wellness and care-planning initiatives, for employers, professionals and consumers. NavGate®, CareQuest (www.carequestu.org) and its principals have provided care-planning data, services and educational programs since 1985. COOL™ is an award winning care planning system that provides health care and wellness information, tools and resources to employees and their families and helps reduce absenteeism and presenteeism for employers. CAP™ is a tactical software application that quantifies employer lost productivity and demonstrates the value of long-term care insurance and disability insurance using client information.