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Baby boom essay ideas

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We got out of that penthouse apartment and walked the park as winter bore down. The aim of this essay is to provide a clear understanding of the concept of the rule of law and the different definitions of the concept and indicate which of the definitions is the best.

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It is imperative that you honor this important part of the testing guidelines. Yann Martel uses symbolism to emphasize these points in his book. Open opportunities thanks again for posting this and analysing the purpose writing. We then observe that these goals can often be pursued more directly and immediately by, say, giving them an overdose baby boom essay ideas of pain-killing medications. Sales Representative Resume Fmcg Literary analysis helps readers better understand literary works.

The Kashmir earthquake War alone has a direct and indirect exposure to stress and trauma. Pakistan has been in new political chaos with Prime Minister Nawaz Sharif ousted over corruption allegations. Excellent essay writers cheap exam papers ireland. When I looked down, I glimpsed my exposed triceps and more blood than I had ever seen in my life. This "honor" is fraudulent and for many Native Americans marks the point of no return in U.

You need to keep delivering value time and time again. Yet the same manner different altars which had seized with superstitious veneration. Businesses pride themselves on producing raving fans of the company. Conducting Research In an expository or an argumentative drama essay, you should support your position with solid evidence. You are the researcher, and the resulting paper will be the story of your discoveries.

Notify me of follow-up comments by email. Notify me of new posts by email. Home Health Care. All Rights Reserved. Warrenton Va. Baby Boom Essay Ideas. Amen Autobiography Of A Nun Book Review how to write a happy retirement card In the modern days they are baby boom essay ideas living by making separate home for each family but they don't live way from each other, they are extending their villages by making more homes.

In principle, Medicare does not cover custodial long-term care, but in practice it is an ongoing challenge for Medicare and providers to distinguish custodial care and rehabilitative care. Medicaid acts as a backstop, paying for long-term care services for the frailest elders when they are poor. In most states, the Medicaid program pays for care for the poor and for elders who become poor when long-term care expenses impoverish them.

In , 64 percent of elderly nursing home residents used Medicaid to finance at least some of their care Dey In many states, a large share of all Medicaid long-term care dollars supports frail elders who had been middle class before becoming frail. In New York State, for example, the Medicaid program pays for 80 percent of all nursing home costs; clearly, 80 percent of New York elders are not poor before they become frail.

Most states direct the lion's share of Medicaid dollars to nursing homes as opposed to home care. In , almost 85 percent of elderly Medicaid long-term care expenditures were for institutional care and only 10 percent were for home care services Wiener and Stevenson This is a result of Medicaid's attempts to focus on the most frail, who tend to be in nursing homes.

Many experts feel that this emphasis on nursing homes means that not enough resources are devoted to preventing elders who have some disabilities from becoming more and more frail Kane, Kane, and Ladd Since elders tend to avoid nursing homes as long as possible, the Medicaid emphasis on nursing homes means that many elders go without community-based services that really could help them live better lives. Private insurance accounts for just 4 percent of long-term care costs.

Despite aggressive attempts by the insurance industry to develop a private market for long-term care, the growth of this market has proceeded slowly. Part of the reason is the nature of the contract between an insurer and an elder.

The insurer needs to guarantee a service that often will occur twenty or more years after the contract is set. The uncertainty leads insurers to keep prices high and makes elders nervous about purchasing a private insurance policy. And, the reluctance of people to think about purchasing such insurance at younger ages makes the payments on an insurance policy beyond the reach of many elders.

Finally, the availability of Medicaid as a substitute for private insurance leads many elders to forego insurance premiums and take their chances on remaining healthy McCall etal. Out-of-pocket costs finance about 36 percent of long-term care, but the burden of these payments is very unevenly distributed.

The 42 percent of elders who spend some time in a nursing home—one-half of them for two years or more—pay most out-of-pocket costs for long-term care. Why is it so hard to devise a financing system to replace the current patchwork payment approach? It is very difficult to judge who really needs formal long-term care services, and there may be large amounts of pent up demand currently taken care of by families and friends.

The woodwork effect predicts that total expenditures could grow substantially if public and or private insurance expanded Weissert, Cready, and Pawelak ; Kane, Kane, and Ladd Imbedded within the woodwork issue is the real social challenge of determining how best to allocate limited resources.

Any expanded public insurance system would require new taxes. And private insurance would be paid for from private savings, which are in short supply for most middle-income elders. One interpretation of the indifference of working-age Americans to either save privately or approve taxes to cover future long-term care services is that Americans are not adequately aware of the implications of these nonactions.

Perhaps Americans, more so than other societies, are less mindful of the needs of aging due to a relatively age-stratified society. The other interpretation, however, is that Americans do not value long-term care services. This interpretation is bolstered by the fact that many moderate-income elderly who could benefit from long-term care and could afford to pay for some services choose to make do on their own.

In addition, financing reform has had to compete with various other social priorities. In recent years, lawmakers have directed more attention toward uncovered pharmaceutical costs. Medical care costs in general are high for elders—even with Medicare, elders and their families pay more than a third of their health care costs out of their own pockets. The large number of uninsured among the nonelderly population continues to be a problem that demands attention.

The needs of elders also compete for resources with other problems facing other age groups. Many have concluded that elders have done rather well with social policy compared with other needy subgroups of our population. Child poverty, for example, is higher today than it was three decades ago, while poverty among the elderly has decreased significantly. Finally, tax cuts and a sluggish economy could completely eliminate the funds needed for any new social programs.

Any specific person who becomes frail may face higher burdens because the expected value averages high costs for those who become frail and zero costs for those elders who avoid the need for long-term care services. And, home care costs can be just as high for a frail elder wanting to live at home. The Medicaid Bound: These are individuals who have few financial resources available for long-term care and who have no choice but to rely on Medicaid.

The Tweeners: This is a group whose lifetime income and wealth are adequate but who cannot handle a long-term care shock. Estimates calculated using the Lewin Long-Term Care Financing Model indicate some good news about the future financial viability of elders. In the year , an estimated 45 percent of elders are classified as Medicaid Bound but this estimated percentage drops to 29 percent in the year By contrast, the share of the elderly who are financially independent increases from 27 percent in to 38 percent in As with all simulations and forecasts, the estimates into the future depend on key economic assumptions.

The assumptions used follow the principles of the middle estimates of the social security forecasting model: economic growth averaging 1. To meet this forecast, long-term care cost inflation would need to be brought under control.

If long-term care costs increase at 2. Thus, a relatively modest increase in long-term care inflation rates could eliminate the rosy simulation estimates of changes in the Medicaid Bound as reported above. The other interesting forecast that emerges from the simulation exercise is that the percentage of people in the Tweeners category will not shrink, but will actually increase from 28 percent to 33 percent.

This implies that there will continue to be a large number of middle class elderly who will spend down to Medicaid coverage unless new financing arrangements help make the Tweeners more self-reliant. How do assumptions about future disability rates affect the simulation results? In fact, disability rates only affect the estimates indirectly in that higher disability rates lead to lower income and asset estimates—particularly for the nonelderly—and this increases the number of Medicaid Bound.

Disability rates do not directly affect the simulation estimates because the calculations assess who is able to afford long-term care at a point in time whether a person is disabled or not. Despite the size of the economic shock associated with long-term care needs, very little policy attention is being given to designing new approaches to pay for long-term care.

The Kaiser Family Foundation issued a side-by-side comparison of key health policy positions advanced by the Gore campaign and the Bush campaign in early October The quiet long-term care issue for the elderly was completely eclipsed by attention to prescription drug coverage and the future of social security during the presidential campaign.

When attention does focus on financing options for long-term care, three serious types of options need to be considered: tax deductions for private insurance, public provision of long-term care insurance, and mandatory savings starting at younger ages for private insurance. Tax deductibility for private insurance premiums clearly would expand the number of people who purchase long-term care insurance.

Deductibility would lower the after tax cost of insurance by 15 percent to 40 percent the range of the current marginal tax rates. Unfortunately, the largest after-tax price breaks would go to the most wealthy people who do not need insurance because they can afford to pay for long-term care from existing resources. Thevast majority of working age, middle-class people—who comprise the Tweeners—would experience between a 15 and 25 percent reduction in the costs of insurance premiums after tax deductibility.

While this would be a welcome incentive, past experience with lowering the marginal cost of insurance for middle class families suggests that most will not begin to purchase long-term care insurance unless a major portion of the premium is paid for. Bilheimer and Colby The most likely option for a public program for insuring long-term care would involve a voluntary-type program based on out-of-pocket payments for premiums similar to Part B of Medicare.

This type of program could offer graduated subsidies to make long-term care insurance more affordable for moderate-income people. In order to make the insurance affordable for most people, however, the subsidies would probably need to be large. While this type of program should lead to substantial reductions in Medicaid payments for Tweeners, the net public sector costs would likely be substantial.

Public offerings of insurance would avoid many of the marketing problems associated with private long-term care insurance and would create some healthy competition between existing private insurance policies and the new public offering. A public long-term insurance program with targeted subsidies would likely cause a much bigger expansion of insurance for middle-class families than would occur in a comparably scaled, tax deductibility program. The third type of financing improvement would follow the logic of advocates for privatizing social security: Mandatory savings in private investment accounts could be required for all individuals starting at an age that would make annual savings affordable.

Deborah Lucas presents a detailed plan for a mandatory savings approach to private financing. However, the estimated savings rate for prefunding starting at age 55 is almost four times that of prefunding starting at age 35 and would also be quite sensitive to interest rates Lucas More analysis of these options—and others that might emerge—is needed to encourage some consensus about how to improve the financing of long-term care for the Medicaid Bound and Tweeners.

A few important principles that should guide reform debates emerge from the analysis presented here:. Long-term care is an expensive item that most middle-class families are not prepared to pay. If some type of insurance plan—whether voluntary or mandatory, whether public or private—does not begin to catch hold, the public sector is going to see its expenditures grow faster and faster.

The sooner alternatives to the current Medicaid-based financing system emerge, the less painful the costs of the new system will be. Perhaps consensus about which option is the best reform approach for long-term care financing can emerge only if there is consensus about the criteria for judging options. Unfortunately, the criteria tend to conflict with one another, forcing stark trade-offs.

For example, one desirable criterion for assessing options is the extent to which individuals have free choice to select a method of preparing for their possible long-term care needs. Options strong on this criterion tend to be weak on another desirable criterion: the assurance that a financing approach does not result in people becoming a public burden if they fail to prepare for long-term care needs.

A third criterion also may conflict with the other two desirable features: the ability to maintain incentives to allocate scarce long-term care resources efficiently. At the very least, debates about options need to make clear what criteria related to effectiveness are under consideration. While the Baby Boomers were growing up, the needs of young families were a high priority in community development, with particular concern for family-friendly housing, parks, and schools.

In , these children will start turning 65 in large numbers. Many predict that if communities want to be successful in caring for their aging population, they will have to make significant, yet certainly feasible, changes in housing, health care, and human services. In preparing for the needs of large numbers of elderly, it is crucial to think of the challenge as a community issue. If the care of the elderly begins and ends with entry into a formalized system that takes over when a person is almost unable to function day to day, society will face large service costs and will miss opportunities to help the elderly function as productive, independent citizens for larger portions of their elderly years.

A community's social and economic systems need to become attuned to arranging services to meet the needs of an aging society in natural, informal ways. Most Baby Boomers would like to stay in their own homes, or at least in their own communities, as they age. Nearly three-quarters of all respondents in a recent AARP survey felt strongly that they want to stay in their current residence as long as possible Bayer and Harper The image that most elders will move to a retirement village away from their communities is the exception rather than the rule.

In thinking about community capacity, three stages of community aging can guide planning: the healthy-active phase, the slowing-down phase where the risk of becoming frail or socially isolated increases, and the service-needy phase when an elder can no longer continue to live in the community without some active service in and around the home. Perhaps the most important challenge of the healthy active phase of aging is for a community to learn how to tap the human resources that elders represent in the community.

This is a phase where elders can be key volunteers to improve the life of many segments of a community. Healthy elders can be considered a potential component of the paid workforce if jobs can be structured to meet their changing preferences and capabilities. The second phase of aging, when elders begin to slow down and may face some challenges in doing the every day activities required of community living, represents a subtle challenge for communities.

Elders in this phase often need assistance with transportation to remain independent, and communities need to take the lead to develop affordable transportation systems U. Department of Transportation Safe and affordable housing options also are a priority for community capacity efforts. At this phase of aging, many elders want to move into smaller housing units that are more aging-friendly but still are affordable and integrated in the community.

It is important to begin developing such options on a large scale in the coming 10 to 20 years. In a community with five thousand projected elders, for example, a project with 30 units will not meaningfully attack the problem.

Voluntarism is an important community need for elders who are mostly independent but slowing down Butler Volunteers can provide services in a manner that makes elders continue to feel connected to a community and not dependent on a formal care system.

And, volunteers often can act as preventive medicine, keeping away the effects of social isolation and keeping elders as active and engaged as possible. Volunteer capacity does not emerge without effort, however. Communities need to recruit, train, and support volunteers. These caregivers also need support through training programs and respite programs.

Many believe that additional financial assistance for family caregivers is needed as well Stone and Keigher Such efforts to support family care-giving also represent an important aspect of community capacity to support elders.

It is unclear whether such local care systems can emerge naturally through market forces or whether market failures will emerge to block the evolution of care systems that reflect the wants and needs of elders. Clearly, the large financing roles of Medicare and Medicaid give the public sector an interest in ensuring that adequate systems of care emerge. How many people will require formal services in ? As discussed earlier in the paper, this is an unanswerable question in the year If efforts at healthy aging are successful and if informal caregivers and volunteers can help to meet the needs of elders, the total number of frail who need formal services in a community in could be quite similar to the number in , even though the number of elders will more than double.

Keeping the number of frail constant at levels must be the goal of every community to keep costs affordable. However, even if the aggregate number of frail elders stays the same or grows slowly, formal care capacity must be better structured at the community level. Importantly, most communities rely too much on nursing homes as the source of formal care, at least for Tweeners and the Medicaid Bound populations. Sixty-seven cents of every public dollar supporting long-term care for the elderly is spent on institutional care Congressional Budget Office , despite the clear preferences of frail elders for services in the community.

Why does this mismatch of dollars versus preferences happen? We have not developed social consensus about when and for whom community-based services should be supported with public dollars; therefore few public dollars are allocated to community-based services.

Recent court rulings support the idea that the disabled have a right to receive services in community settings Pear Such rulings are putting pressure on public programs to rethink the balance between nursing home services and community-based services. The challenge over the next 10 to 30 years is to develop new approaches to delivering community-based care. Home care, using a range of unskilled to highly skilled workers, represents the dominant type of community-based care.

But, this service type, relying on a one-on-one model, is expensive and creates challenges for providers to assure quality. New models, such as adult day services and housing-based services that can use one caregiver to assist more than one elder at a time, need to become more prevalent Feldman In addition, emerging technologies might increase the ability of one caregiver to meet the needs of two or three elders through enhanced ability to communicate and monitor a person's needs Gottleib and Caro One other key challenge in assuring community capacity is to recruit the required numbers of caregivers working in formal settings.

With changing demographics and a strong overall labor market, it is becoming increasingly difficult for home care agencies and other providers to find and retain qualified caregivers. New incentives and organizational structures will be required to maintain a stable workforce in long-term care settings. Finally, every community needs to think about what types of institutional long-term care should be available.

Even if community-based services expand, the most frail among the elderly will sometimes require the high level of care that traditionally has been provided by nursing homes. It is possible, however, to think about restructuring nursing homes to make their living environments and caring style more attractive to elders and their families Allen and Mor Assisted living is emerging as a significant option for many elderly—both disabled and nondisabled.

The idea of institutional care should not be considered as a static model that cannot evolve, improve, and become more responsive to the preferences of elders. Expansions in community capacity to care for elders need to be paid for in some way.

In the case of formal services, the financing options discussed previously are the source of expanded resources. In the case of community-based changes beyond formal services, the give and take of the political process will shape how high a priority health-promoting community programs become among the range of local priorities. Perhaps the most important challenge related to aging populations is the challenge of healthy aging. Healthy aging or successful or productive aging is the concept of keeping seniors disability-free and thus avoiding some of the need for long-term care Rowe and Kahn Keeping seniors healthy and functioning could have significant economic impacts Posner In addition to reducing long-term care costs, healthier elderly are more likely to be productive members of society.

In contrast to the scarce attention being paid to improving financing for long-term care, the healthy aging challenge has generated significant interest. Both national and cross-national studies indicate that the rate of disability in a population can be extremely variable.

Studies of elderly Americans with high, average, and low levels of physical activity have shown ranges in the onset of disability of up to ten years, with much lower lifetime disability among exercisers compared to sedentary people.

Right now Americans spend 72 percent of their post years free of disability. Our goal should be to match the Japanese, who spend 91 percent of their time past the age of 65 disability-free. For example, Japanese females at age 65 have an average life expectancy only 4 months longer than American females at age 65, but Japanese elderly women spend just 1.

Although disability and disease were once thought to be commensurate with old age, the examples above, along with many others, have made it increasingly clear that for all but the most genetically programmed diseases, lifestyle choices, social factors, and the environment play just as large or larger roles than genetics in influencing health in later life.

Less than a third of the biological process of aging is attributed to genetics, and the potency of genes that affect aging declines even further after age 65 Finch and Tanzy Thus, society has the ability to promote successful aging and reduce and prevent disability among the elderly. Advances in genomics and medicine may represent the most straightforward strategy at least compared to changing behaviors and lifestyles to reduce disease and disability.

These investments should lead to advances in earlier detection of disease or genetic predisposition to disease, more rational drug design, and possibly even gene therapy. Future medical interventions might transform the initial stages of chronic disease—such as the onset of Alzheimer's or arthritis—into acute disease events that can be remedied or even prevented through vaccination after one or two visits to the primary care physician Singer and Manton Consider Alzheimer's disease alone; an estimated 14 million people in the United States could suffer from Alzheimer's in if today's prevalence rates remain constant.

In recent years, however, understanding about the neurobiology of the disease has increased as genes and proteins that increase susceptibility to Alzheimer's have been identified and studied Selkoe This new knowledge is leading to earlier diagnosis, the development of better drugs that treat symptoms, and some hope that vaccines and other methods for at least slowing the onset of Alzheimer's will emerge.

Better management by the medical care system of a broad range of chronic diseases could also reduce the incidence of disability. Society's understanding of what the health system needs to do to encourage prevention and clinical care management of chronic diseases has improved tremendously in recent years. Despite this, the right formula has not emerged for setting incentives that will lead to widespread adoption of good clinical care management principles among the numerous medical providers who care for the elderly Wagner et al.

Increasingly, however, public and private payers are beginning to demand better clinical care management approaches for the chronically ill. Although Medicare has clearly improved the health status of the elderly through access to acute medical care Lubitz et al. Much more must be done to facilitate better clinical care management of chronic diseases Wagner et al. This could include better use of clinical preventive services to reduce the costs of Medicare Russell , thorough implementation of chronic disease management practices, and incentives to increase the use of behavioral interventions that could help patients quit smoking, better monitor diabetes, and promote physical activity.

Although Medicare acute care costs are positively affected by prevention efforts, there is little payoff to medical care providers who invest in preventive efforts. This lack of connection between Medicare prevention efforts and savings is a current barrier to better integration of prevention efforts into Medicare.

Although medical advances generate the most excitement, basic social and lifestyle factors might have the largest long-term impact on disability rates. Various studies indicate that having income above the lowest quintile, having a high school education or greater, not smoking, and exercising are among the most important determinants of healthy aging Strawbridge et al.

On the positive side, one factor that could lead to healthier aging among Baby Boomers compared to the current elderly is the changing life circumstances of childhood and adulthood. It appears that neurobiological circumstances in old age may be shaped in part by experiences during early, critical periods of brain development, and that many changes in function during aging show variability related to these early life experiences.

That is, childhood diseases, nutritional deficiency, poverty, and lack of education might be contributing to what is now viewed as normal aging. Childhood health problems have been linked to a variety of morbidities later in life, including arthritis, cardiovascular conditions, and cancer, even when socioeconomic status is controlled for Blackwell According to the Barker hypothesis, prenatal conditions can have a large effect on health in later life as well, with poor nutrition in utero related to increased cardiovascular disease, diabetes, and other ailments in later life Barker Many elderly alive today matured during the two world wars and the long depression period, when malnutrition and vitamin deficiencies were still common.

The Baby Boom cohort, by contrast, grew up among much better health, economic, nutritional, and educational conditions. Because of antibiotics and immunizations they will have been largely untouched by the ravages of childhood disease. Education is also strongly correlated with psychological function, health behaviors, and biological conditions Kubzsansky et al. Persons who are not high school graduates are at almost twice the risk for experiencing declines in functional abilities in older adulthood.

It is encouraging that national trends in educational attainment among the elderly are so positive, with future cohorts having completed many more years of schooling than the current elderly. However, even older adults without much formal education can benefit from programs and activities that keep their minds supple and active.

Trends in healthy behaviors are not as encouraging as the socioeconomic statistics. National trends in healthy behavior have been mixed, with stagnation in exercise, increases in obesity, and decreases in smoking. In , only one-half of all to year-olds and one third of all people aged 75 and older engaged in any leisure time physical activity each week. Twenty-four percent of people aged 60 and older are obese and current obesity trends among younger cohorts indicate that this number will only increase U.

Department of Health and Human Services Obesity is a risk factor in the elderly for arthritis, lung dysfunction, hypertension, diabetes, cardiovascular disease, and certain forms of cancer Kotz, Billington, and Levine Although many suspect that rising obesity rates will increase overall medical costs, it is unknown what effect this will have on long-term care expenditures.

Analysis of mortality statistics indicates that obesity has a much larger effect on life expectancy at younger than older ages, but future generations of elderly are likely to have a much higher rate of obesity than current generations.

Also, the health implications are unknown for overweight elderly who have been overweight for much of their adult lives Kotz, Billington, and Levine What can be done to change these trends? A sophisticated social marketing campaign might increase awareness and change attitudes about eating and exercising. In the past, successful such efforts made progress in increasing awareness about cardiovascular health risks and the importance of cholesterol monitoring and control of hypertension Shea and Basch ; Dustan, Roccella, and Garrison Better pharmaceutical agents that help control obesity also are likely to be developed in the coming years.

Communities need to provide more and better opportunities for health promotion for older adults. In , only 12 percent of adults aged 65 years and older participated in one or more organized health promotion activities U. Many communities also do not offer activity-friendly environments that encourage seniors to walk or engage in other physical activity.

On a positive note, many researchers have shown that it is possible to reach old age in a healthy condition; those with healthy habits have a very good chance of reaching old age without disability Vita, Terry, Hubert, and Fries and without accruing large health care costs Schauffler, D'Agostino, and Kannel ; Daviglus, et al.

Although research has shown that the lack of social relationships is a major risk factor for poor health, as significant as smoking or inactivity, few direct interventions to work on this issue have emerged. Studies suggest that mortality rates rise sharply at low levels of social connection, with death more than twice as likely compared to people with adequate social relationships Berkman and Syme Good social connections also affect mental health and cognition as well.

One study found that persons who had no social ties were twice as likely to experience cognitive decline compared to those persons with five or six social ties Bassuk, Glass, and Berkman The General Social Survey indicated that twenty percent of the elderly 6. Two million of them have no social network at all. Clearly, these elderly are at high risk for unhealthy aging. Opportunities for healthy aging currently are highly related to social and economic status. The inequalities that exist in society translate into health inequalities.

Receiving health insurance for the first time at age 65 will not eliminate the impact of years without insurance. Poor dental care as a child leads to lifelong increased susceptibility to many types of infection. Recent research has shown that lifetime differences in social and economic circumstances affect differences in mortality up to age 89 years Kubzsansky et al. Although research indicates that as a whole the elderly will be much better off in than they are today, closer examination reveals a significant minority of elderly—disproportionately women and minorities—in who could be left behind.

The fourth challenge related to meeting the long-term care needs of an aging population is quite intangible and is dependent on culture rather than public policy. The idea of elders as an economic burden or as frail and weak is a twentieth-century construct. An interesting book by Thomas Cole traces the history of society's views on aging Cole In ages when death struck randomly and evenly at all ages, people did not focus so much on a birth to death, linear view of life.

And, agrarian economies where the young, the middle-aged, and the old all play productive roles enhanced the sense of the value of all ages. So, in past eras life was viewed more as a circle—the Lion King image. But, since the Victorian Age and especially during the twentieth century, as more people have lived to old age, the linear interpretation of the life cycle has become dominant.

The past century's improvements in medical and economic conditions for older people have been accompanied by cultural isolation and a change in the conception of old age. Old age has been removed from its once spiritual location in the journey of life to being redefined as a medical problem. First, it is worth reassessing the responsibilities and assets of elders. All ages need roles in life.

According to Erik Erikson, the hallmark of successful late-life development is the capacity to be generative and to pass on to future generations what one has learned from life. More than half of all elderly volunteer their time. In the past few decades with the creation of National Senior Service Corps, the Foster Grandparent program, and the Faith in Action initiative, more opportunities than ever are available to elderly who want to contribute to their communities.

Half a million people age fifty and older have gone back to college Riley Surveys suggest that the year trend of a decreasing number of elderly working has reversed itself as Baby Boomers reconsider their financial needs for retirement as well as how they want to spend more than a third of their adult life.

In , the percentage of elderly who worked, nearly 13 percent, was higher than it had been in 20 years Walsh The young elderly people in their 60s have reported increased ability to work, with a 24 percent drop in the inability to work at this age; the percentage of elderly unable to work at age 65 in was higher than the percentage unable to work at age 67 in Crimmins, Reynolds, and Saito Most forecasters project this trend to continue as more elderly work longer for economic, social, and personal reasons, employers become more flexible and aware of the needs and benefits of older workers, and the labor market remains tight, with a smaller number of available younger workers.

Since the sheer size and energy of the Baby Boom generation has led to other dramatic social shifts, some experts see hope that a new imagery for aging is possible. Actual physical integration between the generations can take place too.

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Professional biography proofreading website In ages when death struck randomly and evenly at all ages, people did not focus so much on a birth to death, linear view of life. An interesting book by Thomas Cole traces the history of society's views on aging Cole It is encouraging that national trends in educational attainment among the elderly are so positive, with future cohorts having completed many more years of schooling than the current elderly. A few important principles that should guide reform debates emerge from the analysis presented here: Long-term care is an expensive item that most middle-class families are not prepared to pay If some type of insurance plan—whether voluntary or mandatory, whether public or private—does not begin to catch hold, the public sector is going to see how to write a paragraph topic sentence expenditures grow faster and faster The sooner alternatives to the current Medicaid-based financing system emerge, the less painful the how to write an apology letter for your girlfriend of the new system will be. How do assumptions about future disability rates affect the simulation results? Despite this, the right formula has not emerged for setting incentives that will lead to widespread adoption of good clinical care management principles among the numerous medical providers who care for the elderly Wagner et al. The other interesting forecast that emerges from the simulation exercise is that the percentage of people in the Tweeners category will not shrink, but will actually increase from 28 percent to 33 percent.
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Texas exes scholarship essay example Much more must be done to facilitate better clinical care management of chronic diseases Wagner et al. The federal Medicare program pays for approximately 24 percent of all long-term care costs Congressional Budget Office According to the Barker hypothesis, prenatal conditions can have a large effect on health in later life as well, with poor nutrition in utero related to increased cardiovascular disease, diabetes, and other ailments in later life Barker In conclusion the baby boomers have impacted Canada in multiple ways. Proceedings of the National Academy of Science;
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Esl research paper proofreading website gb These are just some historical events that could politically change the point of view of the boomers. In prior work, Singer and Manton estimated that a relative rate of disability decline of 1. One other key challenge in assuring community capacity is to recruit the required numbers of caregivers working in formal settings. The model uses a Monte Carlo simulation methodology. And private insurance would be paid for from private savings, which are in short supply for most middle-income elders. Tax deductibility for private insurance premiums clearly would expand the number of people who purchase long-term care insurance. A Reassessment of Future Economic Burden It is possible to construct a counter-case that is more optimistic about the macro seasoned administrative assistant resume of long-term care in the twenty-first century.
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Unfortunately, the largest after-tax price breaks would go to the most wealthy people who do not need insurance because they can afford to pay for long-term care from existing resources. Thevast majority of working age, middle-class people—who comprise the Tweeners—would experience between a 15 and 25 percent reduction in the costs of insurance premiums after tax deductibility.

While this would be a welcome incentive, past experience with lowering the marginal cost of insurance for middle class families suggests that most will not begin to purchase long-term care insurance unless a major portion of the premium is paid for. Bilheimer and Colby The most likely option for a public program for insuring long-term care would involve a voluntary-type program based on out-of-pocket payments for premiums similar to Part B of Medicare.

This type of program could offer graduated subsidies to make long-term care insurance more affordable for moderate-income people. In order to make the insurance affordable for most people, however, the subsidies would probably need to be large. While this type of program should lead to substantial reductions in Medicaid payments for Tweeners, the net public sector costs would likely be substantial.

Public offerings of insurance would avoid many of the marketing problems associated with private long-term care insurance and would create some healthy competition between existing private insurance policies and the new public offering. A public long-term insurance program with targeted subsidies would likely cause a much bigger expansion of insurance for middle-class families than would occur in a comparably scaled, tax deductibility program.

The third type of financing improvement would follow the logic of advocates for privatizing social security: Mandatory savings in private investment accounts could be required for all individuals starting at an age that would make annual savings affordable. Deborah Lucas presents a detailed plan for a mandatory savings approach to private financing.

However, the estimated savings rate for prefunding starting at age 55 is almost four times that of prefunding starting at age 35 and would also be quite sensitive to interest rates Lucas More analysis of these options—and others that might emerge—is needed to encourage some consensus about how to improve the financing of long-term care for the Medicaid Bound and Tweeners.

A few important principles that should guide reform debates emerge from the analysis presented here:. Long-term care is an expensive item that most middle-class families are not prepared to pay. If some type of insurance plan—whether voluntary or mandatory, whether public or private—does not begin to catch hold, the public sector is going to see its expenditures grow faster and faster.

The sooner alternatives to the current Medicaid-based financing system emerge, the less painful the costs of the new system will be. Perhaps consensus about which option is the best reform approach for long-term care financing can emerge only if there is consensus about the criteria for judging options. Unfortunately, the criteria tend to conflict with one another, forcing stark trade-offs. For example, one desirable criterion for assessing options is the extent to which individuals have free choice to select a method of preparing for their possible long-term care needs.

Options strong on this criterion tend to be weak on another desirable criterion: the assurance that a financing approach does not result in people becoming a public burden if they fail to prepare for long-term care needs. A third criterion also may conflict with the other two desirable features: the ability to maintain incentives to allocate scarce long-term care resources efficiently.

At the very least, debates about options need to make clear what criteria related to effectiveness are under consideration. While the Baby Boomers were growing up, the needs of young families were a high priority in community development, with particular concern for family-friendly housing, parks, and schools.

In , these children will start turning 65 in large numbers. Many predict that if communities want to be successful in caring for their aging population, they will have to make significant, yet certainly feasible, changes in housing, health care, and human services. In preparing for the needs of large numbers of elderly, it is crucial to think of the challenge as a community issue. If the care of the elderly begins and ends with entry into a formalized system that takes over when a person is almost unable to function day to day, society will face large service costs and will miss opportunities to help the elderly function as productive, independent citizens for larger portions of their elderly years.

A community's social and economic systems need to become attuned to arranging services to meet the needs of an aging society in natural, informal ways. Most Baby Boomers would like to stay in their own homes, or at least in their own communities, as they age. Nearly three-quarters of all respondents in a recent AARP survey felt strongly that they want to stay in their current residence as long as possible Bayer and Harper The image that most elders will move to a retirement village away from their communities is the exception rather than the rule.

In thinking about community capacity, three stages of community aging can guide planning: the healthy-active phase, the slowing-down phase where the risk of becoming frail or socially isolated increases, and the service-needy phase when an elder can no longer continue to live in the community without some active service in and around the home. Perhaps the most important challenge of the healthy active phase of aging is for a community to learn how to tap the human resources that elders represent in the community.

This is a phase where elders can be key volunteers to improve the life of many segments of a community. Healthy elders can be considered a potential component of the paid workforce if jobs can be structured to meet their changing preferences and capabilities. The second phase of aging, when elders begin to slow down and may face some challenges in doing the every day activities required of community living, represents a subtle challenge for communities.

Elders in this phase often need assistance with transportation to remain independent, and communities need to take the lead to develop affordable transportation systems U. Department of Transportation Safe and affordable housing options also are a priority for community capacity efforts. At this phase of aging, many elders want to move into smaller housing units that are more aging-friendly but still are affordable and integrated in the community.

It is important to begin developing such options on a large scale in the coming 10 to 20 years. In a community with five thousand projected elders, for example, a project with 30 units will not meaningfully attack the problem. Voluntarism is an important community need for elders who are mostly independent but slowing down Butler Volunteers can provide services in a manner that makes elders continue to feel connected to a community and not dependent on a formal care system.

And, volunteers often can act as preventive medicine, keeping away the effects of social isolation and keeping elders as active and engaged as possible. Volunteer capacity does not emerge without effort, however. Communities need to recruit, train, and support volunteers.

These caregivers also need support through training programs and respite programs. Many believe that additional financial assistance for family caregivers is needed as well Stone and Keigher Such efforts to support family care-giving also represent an important aspect of community capacity to support elders.

It is unclear whether such local care systems can emerge naturally through market forces or whether market failures will emerge to block the evolution of care systems that reflect the wants and needs of elders. Clearly, the large financing roles of Medicare and Medicaid give the public sector an interest in ensuring that adequate systems of care emerge.

How many people will require formal services in ? As discussed earlier in the paper, this is an unanswerable question in the year If efforts at healthy aging are successful and if informal caregivers and volunteers can help to meet the needs of elders, the total number of frail who need formal services in a community in could be quite similar to the number in , even though the number of elders will more than double.

Keeping the number of frail constant at levels must be the goal of every community to keep costs affordable. However, even if the aggregate number of frail elders stays the same or grows slowly, formal care capacity must be better structured at the community level. Importantly, most communities rely too much on nursing homes as the source of formal care, at least for Tweeners and the Medicaid Bound populations.

Sixty-seven cents of every public dollar supporting long-term care for the elderly is spent on institutional care Congressional Budget Office , despite the clear preferences of frail elders for services in the community. Why does this mismatch of dollars versus preferences happen? We have not developed social consensus about when and for whom community-based services should be supported with public dollars; therefore few public dollars are allocated to community-based services.

Recent court rulings support the idea that the disabled have a right to receive services in community settings Pear Such rulings are putting pressure on public programs to rethink the balance between nursing home services and community-based services. The challenge over the next 10 to 30 years is to develop new approaches to delivering community-based care. Home care, using a range of unskilled to highly skilled workers, represents the dominant type of community-based care.

But, this service type, relying on a one-on-one model, is expensive and creates challenges for providers to assure quality. New models, such as adult day services and housing-based services that can use one caregiver to assist more than one elder at a time, need to become more prevalent Feldman In addition, emerging technologies might increase the ability of one caregiver to meet the needs of two or three elders through enhanced ability to communicate and monitor a person's needs Gottleib and Caro One other key challenge in assuring community capacity is to recruit the required numbers of caregivers working in formal settings.

With changing demographics and a strong overall labor market, it is becoming increasingly difficult for home care agencies and other providers to find and retain qualified caregivers. New incentives and organizational structures will be required to maintain a stable workforce in long-term care settings. Finally, every community needs to think about what types of institutional long-term care should be available. Even if community-based services expand, the most frail among the elderly will sometimes require the high level of care that traditionally has been provided by nursing homes.

It is possible, however, to think about restructuring nursing homes to make their living environments and caring style more attractive to elders and their families Allen and Mor Assisted living is emerging as a significant option for many elderly—both disabled and nondisabled.

The idea of institutional care should not be considered as a static model that cannot evolve, improve, and become more responsive to the preferences of elders. Expansions in community capacity to care for elders need to be paid for in some way. In the case of formal services, the financing options discussed previously are the source of expanded resources.

In the case of community-based changes beyond formal services, the give and take of the political process will shape how high a priority health-promoting community programs become among the range of local priorities. Perhaps the most important challenge related to aging populations is the challenge of healthy aging. Healthy aging or successful or productive aging is the concept of keeping seniors disability-free and thus avoiding some of the need for long-term care Rowe and Kahn Keeping seniors healthy and functioning could have significant economic impacts Posner In addition to reducing long-term care costs, healthier elderly are more likely to be productive members of society.

In contrast to the scarce attention being paid to improving financing for long-term care, the healthy aging challenge has generated significant interest. Both national and cross-national studies indicate that the rate of disability in a population can be extremely variable.

Studies of elderly Americans with high, average, and low levels of physical activity have shown ranges in the onset of disability of up to ten years, with much lower lifetime disability among exercisers compared to sedentary people. Right now Americans spend 72 percent of their post years free of disability.

Our goal should be to match the Japanese, who spend 91 percent of their time past the age of 65 disability-free. For example, Japanese females at age 65 have an average life expectancy only 4 months longer than American females at age 65, but Japanese elderly women spend just 1. Although disability and disease were once thought to be commensurate with old age, the examples above, along with many others, have made it increasingly clear that for all but the most genetically programmed diseases, lifestyle choices, social factors, and the environment play just as large or larger roles than genetics in influencing health in later life.

Less than a third of the biological process of aging is attributed to genetics, and the potency of genes that affect aging declines even further after age 65 Finch and Tanzy Thus, society has the ability to promote successful aging and reduce and prevent disability among the elderly. Advances in genomics and medicine may represent the most straightforward strategy at least compared to changing behaviors and lifestyles to reduce disease and disability.

These investments should lead to advances in earlier detection of disease or genetic predisposition to disease, more rational drug design, and possibly even gene therapy. Future medical interventions might transform the initial stages of chronic disease—such as the onset of Alzheimer's or arthritis—into acute disease events that can be remedied or even prevented through vaccination after one or two visits to the primary care physician Singer and Manton Consider Alzheimer's disease alone; an estimated 14 million people in the United States could suffer from Alzheimer's in if today's prevalence rates remain constant.

In recent years, however, understanding about the neurobiology of the disease has increased as genes and proteins that increase susceptibility to Alzheimer's have been identified and studied Selkoe This new knowledge is leading to earlier diagnosis, the development of better drugs that treat symptoms, and some hope that vaccines and other methods for at least slowing the onset of Alzheimer's will emerge.

Better management by the medical care system of a broad range of chronic diseases could also reduce the incidence of disability. Society's understanding of what the health system needs to do to encourage prevention and clinical care management of chronic diseases has improved tremendously in recent years. Despite this, the right formula has not emerged for setting incentives that will lead to widespread adoption of good clinical care management principles among the numerous medical providers who care for the elderly Wagner et al.

Increasingly, however, public and private payers are beginning to demand better clinical care management approaches for the chronically ill. Although Medicare has clearly improved the health status of the elderly through access to acute medical care Lubitz et al. Much more must be done to facilitate better clinical care management of chronic diseases Wagner et al. This could include better use of clinical preventive services to reduce the costs of Medicare Russell , thorough implementation of chronic disease management practices, and incentives to increase the use of behavioral interventions that could help patients quit smoking, better monitor diabetes, and promote physical activity.

Although Medicare acute care costs are positively affected by prevention efforts, there is little payoff to medical care providers who invest in preventive efforts. This lack of connection between Medicare prevention efforts and savings is a current barrier to better integration of prevention efforts into Medicare. Although medical advances generate the most excitement, basic social and lifestyle factors might have the largest long-term impact on disability rates.

Various studies indicate that having income above the lowest quintile, having a high school education or greater, not smoking, and exercising are among the most important determinants of healthy aging Strawbridge et al. On the positive side, one factor that could lead to healthier aging among Baby Boomers compared to the current elderly is the changing life circumstances of childhood and adulthood.

It appears that neurobiological circumstances in old age may be shaped in part by experiences during early, critical periods of brain development, and that many changes in function during aging show variability related to these early life experiences. That is, childhood diseases, nutritional deficiency, poverty, and lack of education might be contributing to what is now viewed as normal aging. Childhood health problems have been linked to a variety of morbidities later in life, including arthritis, cardiovascular conditions, and cancer, even when socioeconomic status is controlled for Blackwell According to the Barker hypothesis, prenatal conditions can have a large effect on health in later life as well, with poor nutrition in utero related to increased cardiovascular disease, diabetes, and other ailments in later life Barker Many elderly alive today matured during the two world wars and the long depression period, when malnutrition and vitamin deficiencies were still common.

The Baby Boom cohort, by contrast, grew up among much better health, economic, nutritional, and educational conditions. Because of antibiotics and immunizations they will have been largely untouched by the ravages of childhood disease. Education is also strongly correlated with psychological function, health behaviors, and biological conditions Kubzsansky et al.

Persons who are not high school graduates are at almost twice the risk for experiencing declines in functional abilities in older adulthood. It is encouraging that national trends in educational attainment among the elderly are so positive, with future cohorts having completed many more years of schooling than the current elderly. However, even older adults without much formal education can benefit from programs and activities that keep their minds supple and active. Trends in healthy behaviors are not as encouraging as the socioeconomic statistics.

National trends in healthy behavior have been mixed, with stagnation in exercise, increases in obesity, and decreases in smoking. In , only one-half of all to year-olds and one third of all people aged 75 and older engaged in any leisure time physical activity each week.

Twenty-four percent of people aged 60 and older are obese and current obesity trends among younger cohorts indicate that this number will only increase U. Department of Health and Human Services Obesity is a risk factor in the elderly for arthritis, lung dysfunction, hypertension, diabetes, cardiovascular disease, and certain forms of cancer Kotz, Billington, and Levine Although many suspect that rising obesity rates will increase overall medical costs, it is unknown what effect this will have on long-term care expenditures.

Analysis of mortality statistics indicates that obesity has a much larger effect on life expectancy at younger than older ages, but future generations of elderly are likely to have a much higher rate of obesity than current generations.

Also, the health implications are unknown for overweight elderly who have been overweight for much of their adult lives Kotz, Billington, and Levine What can be done to change these trends? A sophisticated social marketing campaign might increase awareness and change attitudes about eating and exercising.

In the past, successful such efforts made progress in increasing awareness about cardiovascular health risks and the importance of cholesterol monitoring and control of hypertension Shea and Basch ; Dustan, Roccella, and Garrison Better pharmaceutical agents that help control obesity also are likely to be developed in the coming years.

Communities need to provide more and better opportunities for health promotion for older adults. In , only 12 percent of adults aged 65 years and older participated in one or more organized health promotion activities U.

Many communities also do not offer activity-friendly environments that encourage seniors to walk or engage in other physical activity. On a positive note, many researchers have shown that it is possible to reach old age in a healthy condition; those with healthy habits have a very good chance of reaching old age without disability Vita, Terry, Hubert, and Fries and without accruing large health care costs Schauffler, D'Agostino, and Kannel ; Daviglus, et al.

Although research has shown that the lack of social relationships is a major risk factor for poor health, as significant as smoking or inactivity, few direct interventions to work on this issue have emerged. Studies suggest that mortality rates rise sharply at low levels of social connection, with death more than twice as likely compared to people with adequate social relationships Berkman and Syme Good social connections also affect mental health and cognition as well.

One study found that persons who had no social ties were twice as likely to experience cognitive decline compared to those persons with five or six social ties Bassuk, Glass, and Berkman The General Social Survey indicated that twenty percent of the elderly 6. Two million of them have no social network at all. Clearly, these elderly are at high risk for unhealthy aging.

Opportunities for healthy aging currently are highly related to social and economic status. The inequalities that exist in society translate into health inequalities. Receiving health insurance for the first time at age 65 will not eliminate the impact of years without insurance. Poor dental care as a child leads to lifelong increased susceptibility to many types of infection.

Recent research has shown that lifetime differences in social and economic circumstances affect differences in mortality up to age 89 years Kubzsansky et al. Although research indicates that as a whole the elderly will be much better off in than they are today, closer examination reveals a significant minority of elderly—disproportionately women and minorities—in who could be left behind.

The fourth challenge related to meeting the long-term care needs of an aging population is quite intangible and is dependent on culture rather than public policy. The idea of elders as an economic burden or as frail and weak is a twentieth-century construct. An interesting book by Thomas Cole traces the history of society's views on aging Cole In ages when death struck randomly and evenly at all ages, people did not focus so much on a birth to death, linear view of life.

And, agrarian economies where the young, the middle-aged, and the old all play productive roles enhanced the sense of the value of all ages. So, in past eras life was viewed more as a circle—the Lion King image. But, since the Victorian Age and especially during the twentieth century, as more people have lived to old age, the linear interpretation of the life cycle has become dominant.

The past century's improvements in medical and economic conditions for older people have been accompanied by cultural isolation and a change in the conception of old age. Old age has been removed from its once spiritual location in the journey of life to being redefined as a medical problem. First, it is worth reassessing the responsibilities and assets of elders. All ages need roles in life.

According to Erik Erikson, the hallmark of successful late-life development is the capacity to be generative and to pass on to future generations what one has learned from life. More than half of all elderly volunteer their time. In the past few decades with the creation of National Senior Service Corps, the Foster Grandparent program, and the Faith in Action initiative, more opportunities than ever are available to elderly who want to contribute to their communities.

Half a million people age fifty and older have gone back to college Riley Surveys suggest that the year trend of a decreasing number of elderly working has reversed itself as Baby Boomers reconsider their financial needs for retirement as well as how they want to spend more than a third of their adult life. In , the percentage of elderly who worked, nearly 13 percent, was higher than it had been in 20 years Walsh The young elderly people in their 60s have reported increased ability to work, with a 24 percent drop in the inability to work at this age; the percentage of elderly unable to work at age 65 in was higher than the percentage unable to work at age 67 in Crimmins, Reynolds, and Saito Most forecasters project this trend to continue as more elderly work longer for economic, social, and personal reasons, employers become more flexible and aware of the needs and benefits of older workers, and the labor market remains tight, with a smaller number of available younger workers.

Since the sheer size and energy of the Baby Boom generation has led to other dramatic social shifts, some experts see hope that a new imagery for aging is possible. Actual physical integration between the generations can take place too. Surveys have shown that most older people prefer a mixed-age neighborhood over one restricted to people their own age.

Some community centers are integrating senior centers with child-care centers, facilitating cross-age interaction and at the same time conserving space and resources. Cultural change also is possible, in terms of one-to-one relationships. The needed cultural shift is for children and communities to find more enjoyment and pride in providing for the care of parents and neighbors.

The simple message—and the intangible goal—is to recognize the give and take of all parts of society. Anyone who has spent time caring for an elderly friend or relative recognizes that in the end, caregivers receive far more than they give in the relationship. Everyone benefits when the elderly can be integrated fully into a caring society.

The IADLs include light housework, laundry, meal preparation, transportation, grocery shopping, telephoning, and medical and money management. Thus, disability will decrease at an average annual rate, depending on age, of between 0. Knickman, Snell, and Hunt. Thus, including only one year of current income might have understated resources available for long-term care.

Income includes earnings, social security income, pensions, other annuities, and investment incomes. If a person is single, it is assumed the long-term care resources available include income over three years plus liquid assets. The PRISM simulates future demographic characteristics, labor force participation, income and assets of the elderly. The Long-term Care Financing Model simulates disability, admission to and use of institutional and home and community-based care, and methods of financing long-term care services.

The model uses a Monte Carlo simulation methodology. The current version of the model is the second major revision of the model that was developed jointly by Lewin-ICF and the Brookings Institution in In general, average wages are assumed to grow by 0. Mortality rates vary by age, gender, disability status, years since becoming disabled, and race black versus nonblack. In the Long-term Care Financing Model, disabled individuals age 65 and older are defined as those who are unable to conduct at least one instrumental activity of daily living or unable to conduct at least any one of five activities of daily living.

The disability prevalence rates used in the model were calculated using data from the National Long-term Care Survey NLTCS while assuming that the overall period during which an individual is likely to have a disability will remain stable. Taking an intermediate view of long-term disability prevalence rates, it assumes that disability will decrease at an average annual rateof between 0.

This rate isapproximately one-half the 1. Corea, and R. Foreman, On the other hand, if labor becomes more productive in the general economy, service costs could inflate at faster rates than average because productivity gains in the service sector often lag average gains in the economy. However, over the next thirty years it is possible that new technologies and new service strategies could improve the efficiency of the long-term care sector.

The assumption of 1 percent inflation above average inflation seems like a moderately—but not unreasonably— optimistic guess. This logic motivates a wide range of regulatory behavior ranging from social security to mandatory automobile insurance. Recent data does not seem to support these fears.

Average life expectancy at age 85 was six years in , and, by , had increased by less than four months U. Census Bureau Declines in disability, however, appear to be quite significant. National Center for Biotechnology Information , U. Journal List Health Serv Res v. Health Serv Res.

Author information Copyright and License information Disclaimer. Address correspondence to James R. Knickman, Ph. Emily Snell, B. The paper was written while Dr. The opinions and conclusions are the authors and are not meant to reflect those of the sponsoring institutions. This article has been cited by other articles in PMC. Abstract Objective To assess the coming challenges of caring for large numbers of frail elderly as the Baby Boom generation ages.

Study Setting A review of economic and demographic data as well as simulations of projected socioeconomic and demographic patterns in the year form the basis of a review of the challenges related to caring for seniors that need to be faced by society. Study Design A series of analyses are used to consider the challenges related to caring for elders in the year 1 measures of macroeconomic burden are developed and analyzed, 2 the literatures on trends in disability, payment approaches for long-term care, healthy aging, and cultural views of aging are analyzed and synthesized, and 3 simulations of future income and assets patterns of the Baby Boom generation are developed.

Principal Findings The economic burden of aging in should be no greater than the economic burden associated with raising large numbers of baby boom children in the s. Conclusions To meet the long-term care needs of Baby Boomers, social and public policy changes must begin soon. Keywords: Long-term care, financing, Baby Boomers, community-based delivery system. Definitions and Background Various aspects of economic burden are associated with an aging population: social security payments will increase, medical care insurance costs will grow, the burden associated with uncovered medical expenses such as pharmaceuticals will become quite serious, and long-term care costs will grow.

Open in a separate window. Table 2 Continuum of Long-term Care Services. Table 3 Population Needing Long-term Care. There are Figure 1. Economic Burden of Long-term Care: The Dire Case The argument that caring for an aging society could disable the American economy has been made by various commentators, perhaps most forcefully by Peter Peterson and others in the Concord Coalition Peterson Figure 2.

Figure 3. A Reassessment of Future Economic Burden It is possible to construct a counter-case that is more optimistic about the macro burden of long-term care in the twenty-first century. Table 4 Calculating Dependency Ratios. Source: Population estimates from U. In fact, more and more people from Baby Boomers 2 Pages. Millennials and Baby Boomers exhibit mutual traits, but through analysis and observation it is not difficult to see how dissimilar these two generations are. Millennials were pampered and praised during their childhood, whereas Baby Boomers had to learn from experience, through trial and error.

These people are called baby boomers because of the increased birth rate during this period. In the United States, there are about Every individual is unique in his own way. This makes him different from anyone else. Even brothers and sisters differ a lot. Many generations have been in existence Baby Boomers 7 Pages.

The Generation X and the Baby Boomers and are the most pervasive gatherings; be that as it may, the quantity of Millennials is keeping on expanding. This represents a one of a kind test to administrators as they endeavor to adjust the unusual viewpoints and Baby Boomers 1 Page.

Most often, people view the picture of baby boomers like a monolith-everyone is identical. But the truth is the generation of Baby Boomers are slightly distinct from each other. According to him, while he Finally, it peaked up to 4.

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Millennials were pampered and praised during their childhood, whereas Baby Boomers had to learn from experience, through trial and error. These people are called baby boomers because of the increased birth rate during this period. In the United States, there are about Every individual is unique in his own way. This makes him different from anyone else. Even brothers and sisters differ a lot. Many generations have been in existence Baby Boomers 7 Pages. The Generation X and the Baby Boomers and are the most pervasive gatherings; be that as it may, the quantity of Millennials is keeping on expanding.

This represents a one of a kind test to administrators as they endeavor to adjust the unusual viewpoints and Baby Boomers 1 Page. Most often, people view the picture of baby boomers like a monolith-everyone is identical. But the truth is the generation of Baby Boomers are slightly distinct from each other. According to him, while he Finally, it peaked up to 4. Therefore, from to , there were 77 million Are you experiencing academic anxiety?

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