Long-Term Care

Pursuant to a congressional request, GAO examined how the changing composition of the U.S. population in the twenty-first century will affect nursing home and home care services as well as the population available to pay for such services, focusing on projections of the: (1) disabled elderly population and its use of long-term care services; (2) number of home health aides required; (3) costs of future long-term care services; and (4) base of taxpayer or employed work force available to pay for such care.

GAO found that: (1) the population aged 65 or over is projected to increase to over 68 million in 2050 and the population aged 85 and over is expected to increase and make up nearly one-quarter of the elderly population by 2050; (2) long-term services included assistance with such basic activities and routines of daily living, as bathing, dressing, preparing meals, and housework; (3) the proportion of the elderly that is disabled is expected to grow, due to the changing age composition of the elderly population; (4) projections of the future disabled population varied due to variations in the definition of disability, different assumptions about the future prevalence of disability, and different mortality assumptions; (5) the number of elderly using nursing homes during the course of a year was expected to increase by 76 percent over the next 30 years; (6) due to lower birthrates during the past 30 years there may be fewer family members to provide care, resulting in an increased demand for paid home care services; (7) nursing home and home care services costs are projected to nearly triple to $120 billion by 2018; (8) maintaining current levels of services for the elderly population could require doubling the number of full-time equivalent home health aides; and (9) decreases in birth rates over the past 30 years indicated that there will be relatively fewer workers to help pay for long-term care costs when the elderly population reaches its peak.