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Highlighting the Cost
of Elder Care


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Policymakers and the seniors housing community have an opportunity to develop new solutions for the growing number of middle-income seniors who won’t have enough savings to meet their housing and personal care needs.

Caroline Pearson, SVP
Health Care Strategy

By 2029, the number of Americans age 75 and over who don’t have enough money to pay for seniors housing out-of-pocket but are not poor enough to qualify for Medicaid will grow from 7.9 million to 14.4 million. The growth of this so-called “forgotten middle” will transform how society accommodates the health care and housing needs of seniors. Sixty percent of them will have mobility limitations, 20 percent will be high needs—meaning they have three or more chronic conditions and one or more functional limitations—and 8 percent will have cognitive impairment.

These are just some of the results of a pioneering 2019 survey conducted by NORC with funding from the National Investment Center for Seniors Housing & Care. Survey data revealed that:

54% of middle-income seniors will not have enough assets to cover the projected average annual costs of $60,000 for assisted living rent and other out-of-pocket medical costs in 2029.

Yet, the burgeoning forgotten middle poses big opportunities for the seniors housing and care industry. It also highlights the need for government agencies and private sector companies to come up with innovative options for middle-income seniors.

Currently, the nation’s growing senior population is increasingly dependent on family and friends for care. According to a 2018 poll on long-term caregiving by The Associated Press-NORC Center for Public Affairs Research (AP-NORC Center), 40 percent of Americans have experience providing long-term care to an older family member or friend. About one-quarter spend as much time providing care each week as a full-time job. In addition, 8 in 10 pay for caregiving costs out of their own pocket, with 13 percent spending $500 or more a month—a significant burden for the majority of caregivers who have incomes of less than $50,000.

One improvement that could help caregivers is to make in-store shopping easier. In a NORC survey for AARP, nearly one-third of America’s unpaid family caregivers said that navigating traditional stores posed a challenge for them and their loved one, due to a lack of accommodations, inconvenient hours, and few transportation options.

Ninety-three percent of caregivers reported needing to shop for the person they care for, most often for groceries, followed by household basics, toiletries, prescription drugs, and other health products.

For convenience, 84% of caregivers end up shopping online, despite the fact that 82% would prefer to shop in-store.

Potential solutions include longer store hours, dedicated parking spots for caregivers, ample reserved seating for loved ones, and wider aisles that accommodate wheelchairs.

Many caregivers are young adults, and a 2018 AP-NORC Center poll shows that they feel stressed out by caring for their older loved ones. The survey, funded by The SCAN Foundation, revealed that a third of American adults under age 40 have already cared for an older relative or friend, and another third expect to do so within the next five years.

Three-quarters of younger caregivers spend less than 10 hours a week providing care, compared to most caregivers over age 40 who provide at least 10 hours of unpaid care a week. Even though they devote fewer hours, younger caregivers are more likely than older caregivers (80 percent versus 67 percent) to say their care responsibilities are at least moderately stressful.