Americans should expect an enormous shortage in caregivers for older people in the coming decades, with a dearth of friends and family members available to care for the baby-boom generation as it ages, according to a report released Monday by AARP.
However, Utah a demographically young state is projected to have among the nation's highest ratios of potential caregivers for each elder in both 2030 and 2050.
The report, "The Aging of the Baby Boom and the Growing Care Gap," projects that nationally by 2030 there will be only four potential caregivers available for each person 80 or older, down from a high of more than seven in 2010. By 2050, when boomers are between 86 and 104, the ratio will drop below 3 to 1.
In 2030, Utah will have 5.8 potential caregivers defined as those ages 45 to 64 for each elder, the report estimates, a ratio that is topped only by Washington D.C., with 6.4 potential caregivers.
Utah's ratio is projected to slip to 3.4 possible caregivers per elder by 2050, but it remains in the top four, lower than only Washington D.C., Louisiana and New York. The state's ratio was 8.3 in 2010.
Currently, about 14 percent of potential caregivers provide care for someone 80 or older, 9 percent care for someone 60 to 79, and 7 percent care for someone 18 to 59, said Ari Houser, one of the authors.
The "2030 problem," as researchers have defined it, stems from a combination of factors, including the large number of baby boomers, the fact that boomers had relatively fewer children than earlier generations, and increased longevity for both men and women.
In 2010, the United States had 78 million baby boomers, or people born between 1946 and 1964. About 60 million will still be alive by 2030 and about 20 million by 2050, according to projections AARP used from REMI, a company that does economic modeling.
There are 42.1 million adults in the United States caring for friends or family members. Nearly two-thirds of those caregivers are women, and more than 80 percent of the people they care for are over 50, according to the report, which defined the "average" family caregiver as a 49-year-old woman who works outside the home and spends about 20 hours a week caring for her mother without pay.
But two decades from now, there will be far fewer of these caregivers available, and more need for them.
"It's a wake-up call for aging boomers," said Lynn Feinberg, a senior strategic policy adviser at the AARP Public Policy Institute and an author of the report. "We're really moving toward an uncertain future, as . . . relying on our family and friends to provide long-term care isn't going to be realistic anymore."
Baby boomers caring for friends and family have been "the cement" of long-term care in recent years, Feinberg said, adding that their unpaid care was estimated to have been worth the equivalent of $450 billion in 2009, more than the cost of Medicaid and approaching the cost of Medicare.
But as later cohorts reach caregiver age, they will not be able to provide the same level of care, the report predicts.
To make up for this, the country needs policies that would provide for better support for caregivers and more affordable options for home care, Feinberg said. A federal commission on long-term care is expected to come up with recommendations this fall.
Women in particular will be affected, as they typically live longer, but men have been catching up, the report said.
In other countries with high proportions of older people, more has been done to prepare for their long-term care, said Robyn Stone, senior vice president for research at Leading Age, a national association of aging-services providers.
Our country is sort of a muddling-through country, and we tend to respond more to crisis situations than long-term planning," she said. "We're right now in the kind of halcyon days of caregiving because we have a lot of caregivers. . . . How do you get policymakers to respond to something that's not till 15 to 20 years from now?"