Reimagining the Risk of Long-Term Care

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.