A study published this month in the Annals of Internal Medicine suggests the country's health care system is getting worse rather than better at dealing with patients in the last year of life. The number of U.S. residents who experienced pain in the last year of life increased by nearly 12% and reports of depression and periodic confusion during that period increased by about 26% between 1998 and 2010, according to the study.
A new study from UC-San Francisco predicts the long-term care industry will experience substantial growth in coming years but notes that more people are leaving long-term care jobs than entering them.
A report titled, " A Shattered System: Reforming Long-Term Care in California," from the state Senate Select Committee on Aging and Long Term Care said California's fragmented system for caring for aging residents needs to be overhauled soon. The critical assessment makes several policy recommendations, including consolidating programs and improving workforce and training efforts.
"A lot of us have been yammering about all this for decades," said Bonnie Burns, veteran training and policy consultant for California Health Advocates, a not-for-profit advocacy and education program for Medicare and long-term care.
"We have a huge number of people heading into the part of their lives when they're going to need long-term care and we're really not ready for it," Burns said.
Ten thousand people a day will turn 65 over the next 17 years in the U.S., according to Pew Research Center projections. By the year 2030, 24% of California's population will be 60 or older.
"It's not like anybody didn't see this coming," Burns said. "But everybody's been kicking the can down the road for years."
The comprehensive 211-page state Senate committee report makes several concrete suggestions for improving California's long-term care system, but the committee does not suggest how the state might pay for making changes.
Gov. Jerry Brown (D) has repeatedly demonstrated resistance to new spending and many legislators agree with him.
Sen. Carol Liu (D-Glendale), chair of the committee, said she's confident legislators and the governor are willing to talk about ways to pay for improving the system.
"The state budget is finally getting better, and recent forecasts from the Legislative Analyst's Office indicate that revenues for the upcoming fiscal year will be even larger than anticipated," Liu said. "And most forecasts expect the economic recovery to continue for several years."
"I think there is room for discussion about implementing the recommendations. We are all getting older, and we need to have an honest talk about how to improve services to our aging population," Liu said.
While all Californians face similar challenges involving health care for themselves or family members as they age, the hurdles for low-income people tend to be higher and more numerous than those for middle-class and wealthy people.
"Upper- and middle-income families already have more options to provide care for their aging family members. The harder burdens fall on the poor, and that's not right," Liu said.
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New Reports Shine Light on Long-Term Care Problems