Published Date: November 24, 2022

Summary: Authors provide Legacy Health Endowment with a report understanding the basic challenges facing the middle class regarding long-term care in the rural California Central Valley.

Some key data points include:

  • California’s older adult population (ages 60 and above) is expected to grow to 10.8 million people, or 25% of the state population, by 2030.
  • An estimated 7.09 million adults (1 in 4) in California are living with a disability.
  • The 65+ population in Merced County is expected to grow 159% and 110% in Stanislaus County from 2019 to 2060.
  • 7% of people aged 65 to 79 living in Merced and Stanislaus Counties live alone, compared to over 46% of individuals ages 80 and older. In comparison, 32% of individuals aged 80 and older live alone statewide.
  • Unpaid labor provided by family caregivers is estimated to amount to $470 billion nationally and $63 billion in California.
  • In California, one in four family caregivers provided 20+ hours of care per week, yet only 1 in 11 received any payment. At In-Home Support Services (IHSS) wage rates, this amounts to at least $315.80 in unpaid wages per week or $16,421 annually.
  •  On average, family caregivers spend approximately $7,000 annually in out-of-pocket costs that account for 20% of their incomes. In a 2020 survey, 67% of caregivers reported using their own money to help provide care.

Findings: Authors report that our long-term care system leans heavily on Medicaid (Medi-Cal in California) and the heroic and often unrecognized work of unpaid family caregivers. California’s long-term care system is fragile, and for the middle class that is aging in place, it is teetering on the verge of collapse. If we do not address the long-term care needs of the growing aging middle class, families young and old will be impacted both emotionally and financially. Without a long-term care infrastructure, most Americans face high costs, undue burdens, and threats to their well-being in older adulthood.

This study uses California Health Interview Survey (CHIS) 2020 data.

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