Aging in America: Limits to life span and elderly care options

Expanding longevity among the elderly and fertility decline are contributing to an aging US population. The number of persons 65 years or older is projected to double from about 32 million in 1990 to 66 million by 2030; the elderly proportion is expected to increase from 13 to 22 percent over the same period. Chronic illness and functional disability afflicts a significant proportion of older persons. An estimated 80-85 percent of people over age 65 have at least one chronic illness, and nearly one-half of older people report that chronic illness limits their activity to some degree. Altogether, about one-third of the population over 65 may need some kind of medical or social assistance. This paper discusses the three primary modes of care available to older persons: (1) the informal network of the family, (2) the more formal arrangements of home and community care, and (3) the institutionalized care of nursing homes. Of particular policy interest are the questions: Who provides the care? What type of care is available? Who receives the care? How much does each type of care cost? and Who pays? The current patterns and costs especially of long-term care provide a framework for planning future options. A discussion of research and policy recommendations concludes the paper.