California faces soaring demand for long-term care services, with a senior population expected to surge 90% by 2032, according to a new study by AARP.
The number of seniors age 85 and over -- those most likely to need long-term care -- will grow by 78%, significantly faster than the U.S. average, the report said.
Most people in that demographic category live below 250% of the federal poverty line and will probably qualify for need-based long-term care and other forms of public support, AARP researchers predicted.
"This will have significant ramifications in the future, because older people of modest income are most likely to rely on publicly funded long-term care," the report said.
California is preparing to meet the demand, said Anthony Cava of the state Department of Health Care Services. In July, the state passed a "Coordinated Care Initiative" that integrates medical, behavioral and long-term care for dual-eligible Medicare and Med-Cal beneficiaries.
"The state is coordinating care among our most frail individuals to improve the lives
of those who need long-term care and their family caregivers as well as to reduce
costs," he said.
Californians aged 65 and over have higher than average rates of disability. Nearly 11% have physical problems that make it difficult to care for themselves, the fourth highest rate in the U.S., according to AARP.
The study by AARP's Public Policy Institute compared California with other states and found it has relatively high costs for long-term care. The average daily rate for a private nursing facility was $213 in 2011, compared to a U.S. average of $193.
Californians also pay more for assisted living, adult day care and home health aides, the study found. Family caregiving is relatively rare in California, according ot he report. The state has the nation's lowest number of family caregivers, at 109 per 1,000 population, AARP said.
Meanwhile, only 44 out of 1,000 Californians over age 40 have long-term care insurance.
California spends a greater percentage of its Medicaid funds on in-home and community-based long-term care, which costs less than nursing homes, according to AARP. The state ranks sixth in the nation for public spending on nursing home alternatives, with 55% of Medicaid going to home and community-based care.
Across the U.S., "the number of older people and adults with physical disabilities receiving home and community-based services is increasing at a greater rate than the number of people living in nursing homes," AARP said. "However, publicly funded nursing facility expenditures remained nearly twice as high as home and community-based expenditures."
California ranks 43rd in the nation in availability of nursing home beds, with 29 per 1,000 residents. California nursing homes also are more crowded than the national average, with 85% occupancy statewide.
California also ranked higher than most other states for nursing home patients with pressure sores, physical restraints and hospital admissions, according to AARP.
More than 30% of California's seniors are non-white, reflecting a national trend that will change the way long-term care is delivered, AARP said. "By 2060, it is projected that 46% of the age 65-plus population will be people of color," the study said.
"The growing ethnic and racial diversity of the older population has enormous implications for meeting diverse long-term care preferences, addressing the role of paid and unpaid caregivers, providing services with cultural sensitivity and training the paid workforce in cultural competence," the study said.