Several years ago, my mom received news that changed our lives forever — she was diagnosed with multiple sclerosis and early-onset Alzheimer’s disease. When her condition began to rapidly deteriorate, I requested a change in orders from the Marine Corps and returned home to San Diego to take care of her. At only 65, she made the decision to move into an assisted living facility. She will require long-term care for the rest of her life.
My mom is a retired public school teacher and we are fortunate that between her disability pension and our savings, we can afford her care. But many San Diegans do not have these options. Today, 42% of the San Diego senior population does not have enough income to meet basic needs, as measured by the California Elder Economic Security Standard Index, let alone the cost of long-term care. By 2050, more than 13 million Americans will be living with Alzheimer’s Disease, creating a crisis within a crisis.
A recently released report from the San Diego Seniors Community Foundation found that San Diego’s senior centers are understaffed, underfunded, and ill-equipped to meet the needs of the region’s growing senior population. Unfortunately, this is only the tip of the iceberg when it comes to San Diego’s looming senior crisis.
In the next ten years, one in four San Diegans will be seniors — more than 1.2 million people. Nationally, 20 percent of the U.S. population will be 65 or older by the year 2030. And more than half of all seniors — tens of millions of Americans — will require long-term care.
Long-term care refers to a range of health-related services that support individuals who have escalating needs, from assistance with bathing to medication management. Currently, the vast majority of long-term care is provided by family or friends who provide unpaid support. Other options for long-term care are residential care communities, nursing homes, and home health agencies. Most of these providers are for-profit institutions.
Today, the cost of long-term care in San Diego can range from $1,500 to more than $10,000 per month. Some adult day health centers are publicly funded, but they are often overcrowded and offer limited services. Medicare and private health insurance do not cover most of the costs of long-term care. To qualify for long-term care through Medi-Cal, an individual must meet poverty criteria, which requires seniors to spend down nearly all of their savings before receiving care.
At a time when reforming our national health care system is top of mind, the impending crisis regarding the lack of affordable long-term care has not yet been made a priority. An urgent, nuanced conversation about how to provide quality long-term care for those who need it is well past due.
It’s time for Congress to step up and do something. We can start by expanding Medicare and Medicaid coverage to ensure that it includes long-term care. And while we must ensure that everyone has access to affordable health coverage, caring for our aging population should not just be a facet of the health care debate.
The local senior population stands to double in the next decade, and with rents on the rise and affordable housing in critically short supply, the number of unsheltered seniors is also expected to rise dramatically. This is unacceptable. Congress must make historic federal investments to increase the availability of affordable and supportive housing for seniors nationwide.
Congress should also provide tax breaks or vouchers to support families who choose to take care of their loved ones at home, providing a benefit to caregivers who today are mostly unpaid. An estimated 75 percent of unpaid caregivers in the United States are women, and more than a quarter of them are forced to reduce their work hours or give up their jobs entirely, impacting their current and future financial stability.
No American should have to worry about what will happen to them in old age or if they become seriously ill, or how they will afford long-term care for a loved one. It’s time for us to recognize and prioritize the impending long-term care crisis. Let’s have that conversation here in San Diego before it’s too late.
Janessa Goldbeck is a Democrat running for Congress in the 53rd District in central San Diego County. A native San Diegan, she is a small business owner and Marine Corps veteran. Holly Yang, MD, contributed to this op-ed and is a San Diego-based hospice and palliative medicine physician.