HEALTH NEWS

How Should Countries Care for Their Aging Populations?

Written by Roberta Alexander on August 1, 2017

aging population

Have you noticed more older people around lately?

If you have, it’s not your imagination.

The baby boom generation, which has bent all sorts of metrics out of shape, is now bringing its outsize numbers to the issue of aging.

“It started seven years ago, 10,000 baby boomers turn 65 every day, and this will continue for another 15 years.”

That statistic comes from Chris Orestis, executive vice president of GWG Life and a 20-plus year veteran of the insurance and long-term care industries.

He is also the author of two books: “Help on the Way” and “A Survival Guide to Aging.”

Best places for seniors

The potential problems caused by such a spike in a population that needs more services encouraged a group of researchers to see how the United States compares with other countries.

The interdisciplinary team, led by Dr. John Rowe, developed a new global aging index that is an evidence-based metric that tracks and analyzes data from countries with older populations.

Rowe, who is a professor of health policy and aging, health policy and management at the Mailman School of Public Health at Columbia University, discussed the project with Healthline.

Western Europe is well ahead of the United States in coping with an aging population, he said. That’s because when the United States had a post-war baby boom, Europe had a baby bust.

“Several of the countries we wanted to study have age distribution now that the U.S. will have in 25 years,” Rowe said. “How well did they adapt?”

At this point, the data show that the five countries in the index coping best with their aging populations are: Norway, Sweden, the United States, The Netherlands, and Japan.

New strategies needed

Countries need to look at the big picture, Rowe said.

“Now that previously unimagined numbers of older persons are living longer, it is critical that we shift from our prior sole focus on the characteristics of individuals and their immediate environments to one that includes a strategy for the entire society,” he said.

The areas that are being measured include productivity and engagement, which measurers connectedness within and outside the workforce.

The index also looks at well-being, which measures the state of being healthy, as well as equity, which measurers gaps in well-being and economic security between the haves and the have nots.

Other issues include cohesion across generations and social connectedness, as well as security, which measures support for retirement and physical safety.

“Failure to adapt to aging is a risky strategy for a country,” said Rowe. “A country that neglects to develop effective policies will be left with a society rife with intergenerational tensions, characterized by enormous gaps between the haves and the have-nots, and unable to provide needed goods and services for any of its members — especially a progressively older and more dependent population.”

This scenario is avoidable with proper preparation, Rowe said.

All this data has tremendous policy implications for the United States.

Focus on long-term care

But it is on a personal level that most decisions about retirement are made, such as where to live.

Publications such as AARP The Magazine regularly have features on Ten Best Places to Retire, Places to Retire under $100 a day, or Best 10 Quirky Places to Retire.

But Orestis, the insurance expert, told Healthline there are more compelling issues than geography, notably the need for long-term care insurance.

“Starts with the simple fact that in this country, people ignore long-term care,” Ortestis said. “And families don’t want to discuss this.”

“Look at the numbers,” he urged. “At least 70 percent of those over 65 will need some type of long-term care.”

As difficult as it may be to think about, many seniors might need to move into assisted living.

“People find themselves having to become experts in a crisis,” Orestis said. “And it’s complicated.”

Can you afford it?

People think they can rely on Medicaid, he said. That was created to cover the economically disadvantaged, people with disabilities, and children.

“Now it’s devolved into long-term care payer,” he said.

But Medicaid has stringent rules and requires a loss of autonomy, he said. For instance, there are strict financial limits to be eligible for benefits. Also, there is no choice given about the location of the facility to which someone is assigned. Not everybody is willing to accept such a passive role.

Nevertheless, Orestis said, “There’s a whole cottage industry grown up to help middle class people game the system.”

And the availability and quality of facilities for aging people depend not only on what the market will bear but also on national policy. Is quality care a priority? Do people with low incomes have options that preserve their dignity?

The newly developed index demonstrates that “the United States — despite general problems with inequity and social cohesion — has done well in keeping older Americans financially secure, productive, and engaged,” noted Dana Goldman, PhD, distinguished professor and Leonard D. Schaeffer Director’s Chair at the University of Southern California Schaeffer Center for Health Policy & Economics and a member of Rowe’s interdisciplinary team.

But as the population continues to age, will we be ready?

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