Why More Seniors Will Start Spending Their Final Days at Home

Seniors—the fastest-growing U.S. age demographic—are poised to make up more than 20 percent of the population by 2029. And they’re moving to the driver’s seat of care.
Now, they’re demanding elder care more rooted in empathy and designed on their own terms—and in their own homes.
Historically, healthcare providers have fallen into a trap of medicalizing old age so much that they recommend continued treatments even if the ultimate outcome remains the same. Physicians have been hesitant to have difficult conversations with their patients about realistic end-of-life care options. Important questions—like what metrics patients use to measure quality of life—have gone unasked.
Now, the winds are changing direction. Providers are getting more comfortable with having productive, uncomfortable conversations with their patients about their realistic end-of-life care goals. They’re talking with patients to determine whether additional care makes sense, or whether the focus should be on simply maximizing the comfort in their final days. Simultaneously, seniors’ expectations about their own care is changing. They want to remain in their homes and avoid unpleasant, and often traumatic, medical procedures—even if they may prolong their lives.
Providers’ near-term investment plans are mirroring this trend.
In BDO’s Candid Conversations on Elder Care, we worked with NEJM Catalyst to survey healthcare executives, clinical leaders and clinicians at nearly 500 organizations about the outlook for elder care investment and innovation as they work to meet the changing needs of the fastest-growing U.S. age demographic.  

As our study shows, we’ll see greater investment in home health, palliative care and geriatrics, along with a move away from facility-focused models. Part of that includes improved training for physicians to have these important conversations about end-of life care. Another piece of that means hiring or training more on-staff geriatric caretakers to identify health risk factors for seniors before they evolve into greater health problems.
And there’s yet another, blurrier piece of the puzzle that must be considered.

With the continued convergence of the healthcare supply chain, new types of entities—for which we don’t yet have names—will form, and providers will need to create and fill new types of roles. The healthcare organization of the future will rely more on technologies like robotics, virtual reality, telemedicine and wearables. Healthcare’s workforce will need to evolve to meet the new risks associated with such technologies and to fully capitalize on them in a way that maximizes high-quality, safe innovation around patient care.

Join us in our conversation on the future of elder care.