Trends Impacting the Demand for Long Term Care Workers: Addressing Changing Settings of Care

Presenter: Susan Chapman, PhD, RN, University of California, San Francisco
Co-Authors: Charlene Harrington, PhD, RN, FAAN, Robert Newcomer, PhD"

Changing in demographic trends, consumer preferences, disability, and retirement will impact the demand for long-term care services. Greater demand for services in less restrictive settings of care, including assisted living and home and community based settings, will impact the type of worker needed and training of long term care workers.'

An estimated 69 million Americans will be age 65 or over by 2030. Factors that address how much and what type of long term care will be needed include disability rates, retirement, family demographics, and consumer preferences. The elderly increasingly prefer less restrictive long term care in assisted living and home and community based settings. The recent Olmstead Supreme Court decision mandates that states provide options for long term care in less restrictive settings. Changes in the supply of services reflect those changes in demand. There has been a 57% growth in assisted living facilities over the past decade. Available data indicate that home and community based care was provided to 2.1 million participants in 2001. There are currently about two million professionals and paraprofessionals working in long term care settings some estimates are that a million new workers by the end of this decade. Those new workers will increasingly be needed in home and community settings as well as in the more traditional nursing home settings.

Recommendations: It will be important to match the training, education, and supply of workers to the settings with increased demand. Policy makers, states, and educational programs need to focus recruitment and retention resources on all settings of care and may need to address the need for new types of long term care workers.