Aging in Place: A Policy Approach for Aging Well

Aging in Place: A Policy Approach for Aging Well

FS185E
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Cate Clegg-Thorp, MPH, University of Washington School of Public Health, Health Policy Center, Patricia Lichiello, MA, University of Washington School of Public Health, Health Policy Center, Michael Kern, MPA, William D. Ruckelshaus Center, Washington State University Extension and University of Washington Evans School of Public Policy and Governance
The population of Washington State is aging. By 2030, nearly 20% of Washington residents will be age 65 and older; in rural communities nearly 30%. Are we prepared to meet the health care needs of our aging population? The William D. Ruckelshaus Center and the University of Washington Health Policy Center partnered on baseline research to examine this question and others. They inquired about types of health care providers for older adults in Washington, current and anticipated supply-and-demand for this workforce, and policy approaches to address capacity gaps. This fact sheet offers a summary of the research findings with an overview of key policy concerns regarding older adults' access to health care services, and a community-based approach for supporting both eldercare service providers and the adults who receive their services. A companion fact sheet, Washington State’s Eldercare Workforce, offers an overview of the growing demand for health care services for older adults in Washington State and a set of tables that provide an inclusive and extensive definition of the health care workforce that serves them.
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The William D. Ruckelshaus Center and the University of Washington Health Policy Center recently partnered on baseline research to examine a critical policy concern facing Washington State today: Are we prepared to meet the health care needs of our aging population? As the baby boom generation advances into its elder years, Washington State is witnessing a striking increase in its older adult population. Policy makers and other stakeholders, including the Ruckelshaus Center and the Health Policy Center, are asking important questions about the health system’s ability to support this demographic shift. Their joint research project focused on one such question: What is the capacity of Washington’s health care workforce to meet current and future demand of the state’s older adults?

The partners’ baseline study was designed to discover, assess, and aggregate generally available information and data about:

  • Types of health care providers for older adults in Washington State
  • Current and anticipated supply and demand for this workforce
  • Policy approaches to address capacity gaps

Research activities included in-depth interviews with key stakeholders in health care for Washington’s older adults, detailed reviews of 50 health care workforce-related websites for applicable information and data, and aggregate analyses of all collected information and data.

This fact sheet is a product of the study. It presents an overview of key policy concerns regarding older adults’ access to health care services, and it describes a community-based approach for supporting both the service providers for this population and the adults who receive their services. A companion fact sheet, Washington State’s Eldercare Workforce, offers an overview of the growing demand for health care services for older adults in Washington State and presents a broadly inclusive definition of the health care workforce that serves them—the eldercare workforce. The companion fact sheet, and the interview script used in the study research, are available from the Publications page of the William D. Ruckelshaus Center’s website at http://ruckelshauscenter.wsu.edu.

The “Age Wave” and the Eldercare Workforce

In 2011, the first of America’s baby boom generation reached age 65 and our population saw the early ripples of an “age wave” breaking on its shores. These “boomers” will continue to reach age 65 and beyond through the year 2030 (Kinsella and He 2009). Washington State is no exception to this trend.

Today, 14% (about one in seven) of the state’s residents are 65 and older. By 2030, with the addition of 700,000 more older adults, that proportion will increase to 20%, or one in five (Washington State Office of Financial Management 2013).

As the population age wave continues, it raises immediate concerns among stakeholders about providing care to older adults. Among these concerns are uncertainty about the capacity of the health care workforce, as measured by its supply and training, to provide services to this growing elder population; how to pay for the increased health care services this population needs; and how to provide these services most effectively and efficiently to support healthy aging for greater numbers of older adults across their elder years. The sooner we prepare for these challenges, the more effectively we can address them.

Aging in Place: What Is It and Why?

Policy makers, health care practitioners, community-based organizations, and other public and private stakeholders in providing care to older adults have been watching Washington State’s age wave with some apprehension. They are grappling with how to meet the health care and social service needs of these new older adults, both now and over the long term.

One contemporary policy approach increasingly favored across the nation is called “aging in place.” The Centers for Disease Control and Prevention (CDC), the nation’s lead public health agency, defines aging in place as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level” (2014a). Aging in place is a key policy focus in Washington State.

Policy makers and other stakeholders point to aging in place as a fiscally responsible approach to supporting the health status of older adults as they age. Analyses conducted by private and public-sector researchers show that the costs of health-care-related services are directly related to the setting where an older adult receives them. Nursing home care, which is considered to be “institutional” care, can cost on average $86,000 per person per year. Comparable care provided in an assisted living facility costs $60,000. In a person’s home or other residential setting, such as an Adult Family Home, comparable care costs $23,000 (McGill 2013).

In Washington State, Medicaid is the primary public health insurance program that helps finance care for older adults who have income restrictions. The program currently serves about 96,000 older adults (Henry J. Kaiser Family Foundation 2014). Since the mid-1990s, Medicaid has been increasingly structured to explicitly increase the availability of services that support aging in place and to encourage their use.

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Copyright 2015 Washington State University

Published September, 2015

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