Acute shortages of home health aides and nursing assistants are cropping up across the country.
Boston, Portland, ME May 1-May 15, 2017
Washington, April 28-29, 2017
Washington, June 1-5, 2017
CCRCs as destiny? Unlikely. Over the past few weeks, various statistics have caused me to roll my eyes (40% of doctors now consulting online -- huh?). But this one got my attention: the Wall Street Journal article about Continuing Care Retirement Communities (CCRCs). The article, which was about financial risk, cited an AAHSA estimate that "at least 745,000 older adults live in [1900 of] these communities", comprised of independent, assisted living, and nursing homes. Given the 39 million people over the age of 65, even if CCRCs double in capacity before 2020, they will reach a small percentage of that year's 55 million seniors.
Assisted living or nursing homes? Unlikely. Assisted living facilities, 39,000 of them serving 1 million residents, are now seeing the frail population that used to live in nursing homes and for various reasons -- state Medicaid funding cut-backs in nursing home payments coupled with a growth in Medicaid payments for home care -- the result is that nursing home beds are disappearing. But if you add everyone together, fewer than 10 percent of the senior population is in any of the above.
Retirement communities for the 55+? Not so likely anymore. Meanwhile, the love affair with 55+ communities has slowed to a low-growth crawl: as AgeLab's Joseph Coughlin's thoughtful article noted, growth in the previously popular retirement counties has stalled, right along with the economic flexibility of prospective 'retirees'. Home modification is in, moving is out. But today's boomer is tomorrow's senior (actually January, 2011, just 5 months away, when the first of the 78 million tip into a their demographic bracket.)* So what will happen to all these folks who want to age in place, mostly in the suburbs, in 10 years when the population of 75 and older will have soared, the population with dementia will have skyrocketed?
Which brings us full circle to...the CCRC. Within 10 years, the housing market will (hopefully) have recovered, new development with the services described in the Coughlin article will be ramping up again, and people will come to their senses and begin to back away from the oh-so-yesterday and lonely aging in place. And it will be in spite of the rise of home health and companion care, the evaporation of nursing homes, and the commitment of families. Instead, communities along the lines of CCRCs that are loaded with boomer-turned-senior-friendly technology, social connectedness, and educational opportunities will draw in a new wave of by then 75-plussers and beyond -- who look at their older friends and family in their homes, and say, not for me. But in the meantime, CCRCs have a decade to reinvent the services and cost models that will make their offerings appeal to more than 10% of the aging population.
*Beginning in 2011, 10,000 Americans will turn 65 every day, only half will maintain their standard of living in retirement, one in four will be dependent on government programs. Today, suburban populations are aging faster than those in the cities. Today there are 4.2 million people age 85 and up. Source: "The Futurist," Authors: Cetron, Davies; May-June, 2010