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Reimagining the Risk of Long-Term Care.

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    U.S. long-term care policy overlooks "next-friend" risk, the burden of caring for others. This informal caregiving structure harms families, especially vulnerable groups, threatening their financial security.

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    Area of Science:

    • Public Health
    • Social Policy
    • Risk Management

    Background:

    • U.S. long-term care policies inadequately address family insecurity from prolonged illness and disability.
    • The aging population and rising disability rates exacerbate these long-term care challenges.
    • Current policies focus on "care-recipient" risk (needing care) but neglect "next-friend" risk (providing care).

    Purpose of the Study:

    • To analyze the dual risks associated with long-term care: care-recipient risk and next-friend risk.
    • To critique how U.S. law and policy have inadvertently increased next-friend risk.
    • To propose a paradigm shift in long-term care policy by reframing next-friend risk as a social risk.

    Main Methods:

    • Qualitative analysis of U.S. law and social welfare policy.
    • Examination of the structure of long-term care systems, emphasizing informal caregiving.
    • Application of risk theory to conceptualize long-term care responsibilities.

    Main Results:

    • U.S. long-term care policy primarily addresses care-recipient risk, neglecting the significant "next-friend" risk.
    • Policies reinforcing informal caregiving have expanded next-friend risk, imposing financial and nonmonetary harms.
    • These harms disproportionately affect vulnerable populations, including women, minorities, and the poor.

    Conclusions:

    • The current long-term care system, reliant on informal caregivers, creates substantial insecurity.
    • Recognizing next-friend risk as a social risk, akin to care-recipient risk, is crucial.
    • Reimagining long-term care through a risk-theory lens can fundamentally alter policy approaches and enhance family well-being.