Long-term supports and services planning for the future: implications from a statewide survey of Baby Boomers and older adults

Gerontologist. 2014 Apr;54(2):297-313. doi: 10.1093/geront/gnt094. Epub 2013 Aug 29.


Purpose of the study: Little is known about adults' future planning for long-term supports and services (LTSS), and no studies have examined how LTSS planning compares between Baby Boomers and their parents' generation. The primary aim of this study is to examine the potential influences of birth cohort and gender on LTSS planning. Drawing on Andersen's Behavioral Model of Health Services Use, birth cohort and gender are viewed as predisposing characteristics, and several additional predisposing, enabling, and need characteristics are included as independent variables.

Design and methods: Cross-sectional design; data obtained from a statewide survey of 2,522 randomly selected Baby Boomers (born between 1946 and 1964) and older adults (born before 1946).

Results: Two thirds of respondents expected to need LTSS, but few reported saving for such services. Controlling for other independent variables, compared with older adults, Baby Boomers were significantly more likely to plan to move to an apartment, live in a retirement community or assisted living, and live with an adult child. Conversely, women were more likely than men to report planning to use specific LTSS such as homecare, but specific LTSS plans did not vary by birth cohort.

Implications: Policymakers and providers should prepare for a shift in community planning to accommodate the changing plans and expectations of Baby Boomers, large numbers of whom plan to age in existing homes and retirement communities, or live with adult children, with increasing demand for informal family support. The LTSS industry should also adapt to meet the need for formal services, which will likely continue to grow.

Keywords: Home- and community-based services; Housing; Long-term care; Medicaid/Medicare; Nursing homes; Public policy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Assisted Living Facilities / organization & administration*
  • Connecticut
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Health Services / statistics & numerical data*
  • Health Services Needs and Demand*
  • Humans
  • Long-Term Care / organization & administration*
  • Male
  • Middle Aged
  • Population Growth*
  • Population Surveillance / methods*
  • Retrospective Studies
  • Social Support
  • Time Factors