A new study from the Johns Hopkins Bloomberg School of Public Health highlights a growing challenge in the United States: how we care for an aging population so people can successfully age in place — that is, remain living independently in their own homes as they get older.
The Aging Population Is Growing Fast
By 2034, for the first time in U.S. history, there will be more adults aged 65 and older than children under 18. This shift creates unprecedented demand for long-term services and supports — commonly called LTSS — which includes paid and unpaid help with daily needs like bathing, transportation, meals, and basic health care at home.
Current Services Aren’t Enough
The study finds that the current system of long-term care in the U.S. has some major gaps that make it hard for older adults to stay independent:
- High costs: There’s no national long-term care insurance system, so many families pay out of pocket or rely
on unpaid family members.
- Unequal access: Geography, finances, and family situations affect who gets care — and who doesn’t.
- Limited workforce: There simply aren’t enough trained caregivers, geriatric specialists, and home health aides to meet rising demand — and many struggle with low pay and high turnover.
Family Caregivers Carry the Load
Most long-term care support in the U.S. comes from family members and unpaid caregivers, who often provide care with little training or formal support. The study highlights that while states are beginning to introduce supportive policies, these efforts aren’t yet widespread or deeply funded.
Technology Offers Promise — With Caveats
Innovations like telemedicine and remote monitoring can help caregivers and health professionals stay connected and support older adults at home. However, access to these tools is not equal — especially in rural areas — and concerns about privacy and affordability remain.
Financing Long-Term Care Is Fragmented
Programs like Medicare don’t cover long-term care services beyond short-term post-hospital stays, and Medicaid coverage depends heavily on income and state rules. This leaves many middle-income families stuck — too wealthy for Medicaid, but unable to afford private care.
What Needs to Change
The study concludes that supporting aging in place will require:
- Better support for caregivers
- Investment in home-based care infrastructure
- Affordable services and policy reform
- Collaboration across health, social, and community systems
In short, without meaningful changes to how long-term care is structured and funded in the U.S., many older adults may face barriers to living independently, and caregivers may continue to be stretched thin.
Advance Your Career in Geriatric Care Management
