Putting Long-Term Care Front and Center

Panelists Discuss Long-Term Care Crisis

July 11, 2007

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“We need to place the kind of society we wish to live in front and center for this debate about long-term care, instead of focusing on budgetary limitations,” urged Judith Feder, Professor and Dean of the Georgetown Public Policy Institute at an event hosted by the Center for American Progress earlier this week.

The event, which unveiled a new report from Visiting Fellow Lisa Eckenwiler titled “Caring About Long-Term Care: An Ethical Framework for Caregiving” brought together an array of experts on care for the dependent elderly, including Robert Friedland, Director of the Center on an Aging Society at Georgetown University; Carol Levine, Director of the Families and Health Care Project at the United Hospital Fund; Robyn Stone, Executive Director of the Institute for the Future of Aging Services at the American Association of Homes and Services for the Aging; and Judith Feder.

The panelists emphasized that the long-term care industry faces an emerging crisis. The number of Americans over the age of 75 will more than double and the number of those over 85 will roughly quadruple in the first half of this century. By 2050, 80 million elderly Americans will overwhelm the nation’s long-term care services—up from the 34 million today who are already mostly underserved or worse.

This surge in demand is coupled with an absence of high-quality trained caregivers. Poor working conditions, combined with a negative industry stereotype and inadequate and misplaced investments in education and training, have driven health care professionals away from the long-term care field.

As a result, unpaid caregivers—primarily family members—currently provide a staggering 80 percent of long-term care. At least six out of 10 of these caregivers are also employed in the paid workforce, and 42 percent are over the age of 50 themselves.

Eckenwiler’s report examines these issues and lays out seven principles of ethical caregiving that can guide policymakers as they work to solve these urgent problems:

• An Ecological Ethic: Recognizing the interconnectedness of people, systems, and policies.

• Respect for Human Dignity: Respecting the unique worth of all people and their pursuit of a good life at all stages.

• Beneficence: Maximizing benefits, including health and security.

• Compassion: Demonstrating concern for the well-being of others, especially the vulnerable.

• Reciprocity: Appreciating and compensating those who give back to society.

• Temperance: Taking a long view rather than looking for short-term fixes.

• Social Justice: Treating all people fairly and equally and building just social institutions.

Panelists discussed possible solutions that would ethically address the long-term care crisis, including better integrated and more easily navigable service systems for patients and their families, investments in education and reward programs, and revamped immigration policies.

And despite the dour projections, panelists said that there is reason to be optimistic about the future of long-term care. Caregiving is a large source of future jobs, and with increased attention we can lay foundations that will reap great benefits.

For more information, see:

• Caring About Long-Term Care: An Ethical Framework for Caregiving

• Caring About Long Term Care event