Study points to long-term care crisis

Level of caregivers will not meet patients’ needs

The 21st century will bring greater numbers of people affected by chronic conditions and more people in need of chronic care — many of them elderly, according to researchers from the Institute for Health & Aging at the University of California, San Francisco. The findings, outlined in the 76-page chartbook Chronic Care in America,1 indicate the number of potential family or friends who can act as caregivers will not rise to meet the need, opening the door for private duty professionals:

• One in five of the nearly 50 million disabled people in America needs help with basic daily activities, such as bathing, walking, and preparing meals. Fifty-eight percent of these people are 65 years old or older.

• In 2020, there will be 12 million people age 65 and over with a limitation in a major activity due to a chronic condition.

• Based on current trends, by 2020 up to 14 million elderly will need long-term care — double the seven million who need long-term care today.

• By 1970, there were 21 "potential caregivers" (defined as people age 50 to 64) for each "very elderly" person (age 85 or older); by 2030, there will be only six such potential caregivers for each very elderly person. By 2050, there will be only four potential caregivers for each very elderly person.

• By 2030, unless new systems of care are created, chronic care alone is projected to cost the United States $798 billion (in 1990 dollars) in direct medical and nursing home costs.

The study was supported by a grant from the Robert Wood Johnson Foundation in Princeton, NJ.


1. Hoffman C, Rice D, Sung H-Y, et al. Chronic Care in America: A 21st Century Challenge. Princeton, NJ: The Robert Wood Johnson Foundation; 1996. For a free copy of the 76-page chartbook, contact: The Robert Wood Johnson Foundation, P.O. Box 2316, Princeton, NJ 08543-2316. In addition, the publication is available on the foundation’s World Wide Web home page at http://