Foundation Work in Long-Term Care

Health foundations have invested in services, research, and advocacy to improve the financing and delivery of long-term services and supports. This article describes some of the broad array of approaches they have taken—in such areas as aging in place, assisted living, "culture change" in nursing homes, quality improvement, augmenting the workforce, and paying for care.

Over the next 25 years, the nation’s elderly population will grow rapidly, with the greatest increase coming among those over the age of 85. Additionally, the number of people over age 65 is expected to double, from 35 million to 71 million, between 2000 and 2030. People are living longer, but often with one or more chronic diseases. The country is also becoming more diverse. By 2030, the proportion of the elderly population who are African American will double; it will triple for Hispanics.

Ten million elderly and disabled people currently use long-term care services. Their care accounts for more than 10 percent of national health expenditures, or about $200 billion a year. As the population ages, the demand for affordable, high-quality long-term services and supports will increase. And gaps in the current system will only worsen if no action is taken.