We see them everywhere – at restaurants, gas stations, post offices, on the road driving vehicles, at the park, at malls, golf courses, and so on. They are those who belong to the Silent Generation (people born in the years 1925-42) and the early wave of the Baby Boomers (the Baby Boomer generation was born in the post-World War II years, between 1946 and 1964). They have worked hard, paid taxes, brought forth innovation in science and technology, developed competitive industries, protected the country from threats of harm, contributed to the nation’s success and established America as a global leader. Now, people from these generations are aging, leaving the workforce and drifting into retirement, and this trend poses challenges for the United States of America, particularly with regard to caregiving.

In the natural course of a human life cycle, depending on where they fall in spectrum of the Silent Generation or Baby Boomers, these individuals are now either out of the workforce, or planning retirement. In spite of their age, some of the members of the Silent Generation and early Baby Boomers are still employed (and some would continue to remain to be so) either by choice, or due to necessity. The younger Baby Boomers are still in their 50s or early 60s, and hence still could be considered very much a part of the current workforce going into the foreseeable future. Yet, we know, that at some point in the next decade or so, a vast majority of the remainder would likely leave the labor force.

Advancements in science and technology, over the years, have resulted in longer life span of the people in America. Medical innovation has introduced the cure for many diseases and presented us with more knowledge of what is good and what is bad for human health, enabling people to choose a lifestyle favorable to a longer life. At the same time, improvements in housing and transportation have increased the quality of life. The life expectancy in the United States was around 47 years in 1900.[i] Now, it is 78.6 years.[ii] People are living longer, and I consider that to be a blessing overall.

However, it is a known fact that an aging population poses some serious challenges for America. Public policy experts have long discussed the implications of an aging population, particularly with regard to labor force. The fertility rate in the United States has been on a downward trend, with the year 2016 marking the lowest rate of reproduction since the Centers for Disease Control and Prevention (CDC) started recordkeeping in 1909.[iii] An aging population, coupled with falling fertility rate, would cause an imbalance in the economy in the form of a lack of taxpaying workers to keep up with rising expenditures, especially when it comes to Social Security and Medicare.

The detailed picture is more complex. For example, to simply say that an aging population would lead to need more health care services is an oversimplification. An aging population would lead to an increased need for specialized geriatric care, a health care workforce that is knowledgeable about and sensitive to the requirements of senior citizens, dementia-friendly communities, retail establishments and a hospitality industry that can cater to the elderly population, and more.

As more and more people age and retire from the workforce, they experience diminished levels of independence. Yet, the pressure to stay independent may force senior citizens to perform tasks that may pose difficulties for them. For example, with age, people may experience deteriorating vision and physical changes that may impact their ability to drive. But the desire and necessity to remain independent, and lack of caregiving resources, may push senior citizens to operate automobiles, even when it is not safe for them to do so. According to CDC, one in six drivers in the United States is 65 years or older, and older adults are more than twice as likely to report having a medical issue that would make it difficult to travel, when compared to drivers in the 24-64 age group. Furthermore, CDC states that four in five older adults take one or more medications daily, and physical changes combined with side effects of medications can adversely impact their ability to focus on driving safely. Data shows that in 2016, almost 290,000 older adults were injured and over 7,400 died in traffic accidents.[iv]

Driving is just one of many daily activities that become difficult, over time, for a senior citizen. Depending on age and the combination of physical and mental health, eating, bathing, walking around the residence, or even opening a can of food and reading the label on the medicine bottle may all be impacted. Growing volume of television commercials promoting specialized walk-in showers, medical alert systems, power chairs that help people climb stairs, etc., clearly suggest that there is a growing market of products that cater to the needs of the elderly.

While commercial products for the elderly are intended to make life easy, it cannot replace the need for human touch. In the old days, as is often said, people had large families, packed with children. Simple observation of the society around us, as well as data from various sources, would reveal that the concept of large families is dwindling. In my view, a family is a person’s support system. But as the family size grows smaller, because of low fertility and a whole set of other factors, the entire country is impacted. Most importantly, if affects the senior citizens by posing new challenges to caregiving.

“Caregiving” is not simply supplying a senior citizen with the necessary nutritional and medical needs, along with physical support services required to sustain a healthy and hygienic life. Proper caregiving must also include attending to the emotional needs of recipients. However, with shrinking family size, the responsibility to fulfill all of the above needs may fall on a paid professional, rather than a member of one’s family. It is not unusual to find elderly individuals or couples whose children may be residing in other cities or states, or have professional and other family obligations that prevent them from caring for an elderly parent, even part-time or intermittently.

Caregiving also has opportunity costs. A family caregiver may have to take time off from work or other income-generating activity, thus creating economic burden on the caregiver. Caregiving by family members may require significant travel depending on distance between the caregiver and the recipient, increase stress levels, create the necessity for one to gain knowledge about issues such as dementia, and more. Not everyone can cope with the responsibilities of caregiving. As a result of the challenges of caregiving by members of one’s family, industries providing at-home, community-based and institutional care, in exchange for out-of-pocket payment or reimbursement through private insurance or government programs have risen.

Whatever the arrangement for caregiving may be – by members of one’s family or paid professionals – the elderly remain vulnerable to threats of abuse. “Elder abuse” can take various forms – physical, mental, financial, etc. – and can happen anywhere from institutions providing medical care to one’s own home. This is an issue of growing concern and continues to draw the attention of medical and law enforcement professionals, as well as family and friends of elderly people nationwide.[v]

As the population ages, caring for the elderly becomes a greater challenge. There is no one solution. We must evaluate family structures, analyze the advantages and disadvantages associated with caregiving by family members, assess the various community-based and institutional settings available to people needing care, examine the workforce of medical professionals and paid caregivers, implement protections to prevent abuse, and understand the overall socioeconomic implications of an aging population.





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