Effects of Changes in Household Structure and Living Arrangements on Future Home-Based Care Costs for Disabled Elders in the United States
In this chapter, we projected numbers of activities-of-daily-living disabled elderly and yearly payments and workdays of home-based care for them by age, gender, race, and living arrangements from 2010 to 2050 for the United States (with low, medium, and high scenarios). The chapter focused on how changes in household structure and living arrangements may affect future home-based care costs for disabled elders based on census micro datasets, the National Long Term Care Survey data and the ProFamy extended cohort-component method. The results showed a remarkable acceleration in numbers of disabled elderly aged 65+ after 2020 with a much faster increase in disabled oldest-old aged 80+, such that after 2030 they outnumber the disabled young-old aged 65–79. Increases in yearly workdays and payments of home-based care for disabled elders will dramatically accelerate after 2020, especially for the disabled oldest-old. We also discussed similarities and differentials across racial groups and genders and the policy implications of future trends in home-based care needs and costs for disabled elderly.
