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Build a Strong Long-Term Care System

America's long-term care system is not just broken — it doesn't exist.

Americans age 50-plus and others in need of long-term care face a patchwork of public and private services, costly institutional care and unpaid family caregivers. Today many older adults are often pushed into costly nursing homes — the only form of long-term care automatically covered by Medicaid — even though the vast majority would prefer to live independently in their homes and communities.

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The COVID-19 pandemic has raised alarms about the safety and quality of institutional care. Residents and staff of nursing homes and other long-term care facilities have accounted for more than 40 percent of all U.S. COVID-19 deaths. Even before the pandemic, the Government Accountability Office found more than 80 percent of nursing homes were cited for infection-control deficiencies.

Unfortunately, options such as home and community services are often unaffordable and not available through many state Medicaid programs. While unpaid family caregivers allow millions of older adults to live safely at home, instead of in costly nursing homes, these family members need more support.

Challenges ahead

The age 85-plus population — those most likely to need assistance with daily activities — is projected to more than triple between 2015 and 2050, making the need for an effective long-term care system even more important.

Our elected leaders must rethink institutional care to improve the safety and quality of nursing homes and other long-term care facilities and protect residents against sickness, neglect and isolation. COVID-19 has shown that few facilities are prepared with adequate staffing, resources and proper infection control.

At the same time, state and federal officials must increase access to the home and community care that older adults prefer. They also must do more to support the 48 million unpaid family caregivers who make it possible for their older parents, spouses and other loved ones to live at home.

AARP guiding principles

As you consider a candidate, keep in mind AARP's priorities for long-term care. AARP is asking Congress and state lawmakers to:

  • Improve care in nursing homes and other long-term care facilities, especially amid the COVID-19 pandemic, by:
    Ensuring regular, ongoing testing and adequate personal protective equipment (PPE).
    Creating transparency through public reporting of cases and deaths in facilities; discharges and transfers; and the spending of federal funds.
    Requiring access to virtual visitation.
    Improving residential care through adequate staffing, oversight and access to ombudsmen.
    Stopping attempts to provide blanket immunity for long-term care facilities related to COVID-19.
  • Expanding access to home and community services that allow older adults to live at home, reducing the need for costly taxpayer-funded nursing home care.
  • Providing greater support to unpaid family caregivers to make it easier for older adults to remain in their homes and communities.

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