Single payer and the pending boomer caregiving crisis

Posted by Don McCanne MD on Tuesday, Jan 12, 2016

Long-term care must become a more prominent part of the single-payer campaign

by Henry Moss, PhD, January 11, 2016

We are facing a perfect storm. AARP’s Public Policy Institute points out that as boomers age into their 80s, there will be a sharp drop in available family caregivers due to the “birth dearth” following the postwar baby boom.  At the same time, longevity is increasing due to effective treatments of heart disease, lung disease, diabetes, cancer, and other conditions.  A longer life, however, will likely mean more years with severe disability for boomers due to the secondary effects of increased obesity, including high blood pressure, high cholesterol, and inflammation due to metabolic disorders.

These secondary effects include damage to brain blood vessels and a likely increase in the incidence of dementia, including Alzheimer’s disease.  We already know that the prevalence of dementia will grow due to the sheer size of the boomer cohort.  In addition, however, it now appears that a recent steady decline in the incidence of cognitive impairment and dementia have ended and are starting to reverse. Dementia is by far the most care-intensive of conditions.  More years with dementia (and other disabling conditions fed by the effects of obesity, including mobility disorders) will mean more need for 24/7 care in the face of declining numbers of family caregivers.

Hence the perfect storm.  Hence the “2030 crisis.”  2030 is when boomers start becoming the “oldest old” in large numbers.