How will the next president’s policies affect an aging population?

While the economy and the war in Iraq are major issues in the 2008 presidential election, they are far from the only issues important to voting Americans. The Assisted Living Federation of America (ALFA) has asked each presidential candidate to add the long-term care of aging Americans to the campaign agendas.

More than one million seniors live in 36,000 assisted living communities in the United States. Meeting the challenge of caring for these seniors every day gives assisted living providers a window into the future needs of an aging population—a population that is growing exponentially.

The number of Americans with long-term care needs will more than double between 2000 and 2050 according to federal government estimates. This enormous demand poses two critical questions:

• Will we have enough caregivers to provide high-quality services?

• Will older Americans be able to afford the care?

Social Security, Medicare, and Medicaid
When the Social Security program was created during the Great Depression, the life expectancy of the average American man was 58 years, which meant he would likely die before he became eligible to collect. Today, thanks to dramatic improvements in living conditions and healthcare, the average American man will live to be almost 78, the typical woman will celebrate her 80th birthday, and many millions more will live far longer. In fact, the fastest-growing U.S. demographic is adults over 85 years.

Public programs intended to ensure the safety and security of seniors have failed to keep pace with either the market or the needs of this aging population.

Social Security, Medicare, and Medicaid have played a vital role in seniors’ financial security, but these important safety net programs are only part of a very complicated puzzle for Americans planning for long-term care, whether for themselves, their parents, or other family members.

Public programs intended to ensure the safety and security of seniors have failed to keep pace with either the market or the needs of this aging population: Medicare does not cover any assisted living services. And except for some modest state waiver programs, Medicaid does not pay for assisted living either. Medicaid will pay for nursing home care, which has resulted in seniors being prematurely pushed into skilled facilities at taxpayer expense when their needs could be met at an assisted living community at half the cost.

In addition to efforts to make long-term care affordable, Americans need to take more personal responsibility by saving for their future long-term care needs and purchasing long-term care insurance. To that end, ALFA supports innovative policy proposals such as the Community Living Assistance Services and Supports Act (the CLASS Act) which would create a new national long-term care insurance program financed by voluntary payroll deductions. These sorts of innovative solutions can only be achieved with presidential leadership.

Recruiting quality caregivers
This spring, a retired school teacher—the first of the 77-million-member baby-boom generation born after World War II to qualify for Social Security—collected her first check. By the end of our next president’s second term, these first-wave boomers will be turning 70, creating new challenges for our society that go far behind the fiscal soundness of Social Security.

“What will the next president do to encourage young people to pursue long-term care as an attractive career track?”

Finding the staff to care for this wave of aging Americans will be particularly challenging. Over the past several years, assisted living providers faced an increasingly tight labor pool. Meeting future demand for workers must be viewed within the context of broader policy considerations, such as immigration and education. ALFA is eager to learn how presidential candidates’ policies will affect senior living’s labor pool.

For example, what will the next president do to encourage young people to pursue long-term care as an attractive career track as they enter the workforce?

The assisted living business has experienced a remarkable evolution and success over the past 25 years. Assisted living is now the fastest-growing long-term care option in the United States. National and state consumer surveys consistently show an astonishing 90% satisfaction rate. Long-term care options will continue to evolve. The baby-boom generation has changed every aspect of culture and will redefine retirement as well. Boomers are accustomed to independence and freedom of choice and will put their own stamp on the consumer-focused flexibility of assisted living.

The Democratic and Republican presidential candidates must address the complicated health, medical, housing, financial, and social issues of an aging population because long-term care is not a Republican or a Democratic issue; it’s an American issue.

Richard P. Grimes is President/CEO of the Assisted Living Federation of America (ALFA), which represents companies operating professionally managed assisted living communities for seniors. ALFA serves as the “voice” of assisted living and advocates choice, quality care, and accessibility and portability of long-term care for all Americans. ALFA’s efforts “raise the bar” for operational excellence among its member companies. For more information, visit

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