Just one of my four grandparents died at home and it’s only now as an adult with my own aging parents that I can recognize how odd that was. Thanks to caregivers, long-term care facilities, healthcare professionals and medical researchers, people are living longer, even with chronic illness and disabilities. But over the last hundred years, alongside advances in medicine, death itself has moved away from home. Most people today die in hospital.
Due to the aging boomer generation, end-of-life infrastructure, from assisted living and long term care facilities to acute care hospitals, will drastically change in the coming decades. Boomers have very different expectations for end-of-life care than the reality currently available and they’re about to have a big, outsized influence on what it means to be aging, elderly and dying a good death.
Although all of us will eventually experience aging personally—and its inevitable conclusion—it’s still very taboo. Businesses and governments have been warned about the implications of the aging baby boomers but few have done much about it—the thinking seems to be “we’ll deal with it later”. Later has arrived. Thanks to boomers and millennials, there will be a nearly crippling need for facilities, caregivers as well as in-community support and resources over the next 40 years.
In just ten years, aging boomers will drive a 75 percents spike in the number of seniors needing nursing homes. By 2060, when the youngest millennials will be 64, the number of Americans 65 and older will double to over 98 million, rising to 24% of the population, a trend mirrored in Canada, the UK and Europe. Add a huge spike in memory care to meet the needs of patients with dementia or Alzheimers, which could triple by 2050, and countries around the world will be facing a new boom: one that’s greying and has walkers.
Even today there’s a huge disconnect between reality and what people truly want for their remaining years. 80% of Americans would prefer to die at home, yet only 20% do so; 60% die in acute care hospitals and 20% in long-term care facilities. The statistics are similarly grim in Canada: 70% of Canadians would prefer to die at home or in hospice, yet 70% of Canadians die in acute care hospitals not designed for end-of-life care.
For many governments, keeping seniors active and healthy is key to managing the impact on healthcare. Encouraging aging citizens and their families to craft sensible plans to “age in place” is also important. What does aging in place look like? Seniors who want to stay in family homes should be encouraged, adding chair lifts, grab bars in bathrooms and expanding doorways for walkers and wheelchairs.
It’s unlikely that gaps in end-of-life infrastructure can be filled in time. Strong, comprehensive community support and resources will be needed, from wide, well-maintained sidewalks suitable for walkers and wheelchairs to local clinics and in-home caregivers. Support for family caregivers will need to be considered by both employers and governments. More than two thirds of caregiving for ill and elderly citizens is unpaid today and that number is rising. A big reason that seniors can’t stay in their own homes? A primary caregiver, usually a spouse or child, falls ill themselves. If the need for assisted living or long-term care facilities arises, patients and their families must consider location, quality, suitability, cost and availability.
The challenges of aging baby boomers followed by the echo-boom will result in a complete transformation of end-of-life care and healthcare systems worldwide.