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| | The Best of CommonWealth Beacon OPINION | | (Illustration via Pixabay by geralt) |
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What totally predictable crisis will start in just five years? The doubling of the need for elder care. And Massachusetts is not prepared for it. |
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A dangerous demographic cliff lies just ahead: There’s been a lot of chatter about the vast demographic bulge that we call “baby boomers” passing 65; but the real news is that the oldest baby boomers will begin celebrating their 85th birthdays in 2031. |
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The Census Bureau projects that, nationally, the number of people 85 and over will double from 2030 to 2050. Here in Massachusetts, the University of Massachusetts Donahue Institute projects that our 85-plus population will expand by about two-thirds – a smaller increase because we’re already one of the older states. |
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Eighty-five is the magic age when older adults face dramatic increases in their chances of physical and cognitive disability. |
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This means we will need a lot more elder care. By 2034, according to the Bureau of Labor Statistics, we will need 740,000 more home health and personal care aides nationally than are working today. And that’s when the need will have just started growing. |
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Finding the appropriate care is already extremely difficult, whether that's patching together a schedule of family members helping out, hiring home health aides, or finding an appropriate assisted living or nursing home placement. Many families feel particularly desperate when an elder who was unexpectedly hospitalized is about to be discharged and they’re faced with the Hobson’s choice of either taking mom home and caring for her themselves or placing her somewhere that feels inadequate. |
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To be sure, Massachusetts is working to improve care for our older citizens. Partly in response to nursing home deaths during the COVID-19 epidemic, Massachusetts passed a 2024 law that will improve nursing home care – if it's enforced. Unfortunately, while Massachusetts does evaluate nursing homes, facilities are rarely penalized for providing inadequate care. |
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Further, the Massachusetts Executive Office of Health and Human Services commissioned a 2025 study of possible funding mechanisms for long-term care services, partly modeled on one offered in the state of Washington. Known as the WA Cares Fund, it provides all state residents with $36,500 to spend on care needs in defined circumstances. |
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What’s more, the Healey administration has released a ReiMAgine Aging 2030 plan for older residents. But it only looks ahead five years, stopping just when the need for elder care will begin growing. |
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The Massachusetts House recently passed bills championed by Rep. Thomas Stanley to begin licensing for home health agencies and establish a caregiver commission to focus on supporting family caregivers. The commission would be one of many that have been established to improve nursing homes, assisted living facilities, senior housing, and rest homes. |
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All these have good aims. But they work piecemeal in an effort to improve what’s happening inside each individual institution. The real problems lie in the lack of coordination. |
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