Will there be affordable long care facilities for us in the next 20 years?

I envision groups of friends getting together and moving into one large house together, sharing expenses, helping each other through illness (and death) and perhaps sharing the cost of an in-house nurse to assist everyone in the home who needs assistance. I do not plan on my children helping me at all in old age even though I watched over my Mother since my dad died when I was 19 years old and until Mom died when I was 51. Most of my friends remained single and have no children. I think we are all going to have to stick together and help each other when we are old and failing. Retirement communities and assisted living are way too expensive for most of us.

I have installed a good bit of aging related features in both of my houses. Lowered counters to wheelchair height, stair lift stems on staircases, walk-in bathtubs, walk-in showers with shower benches. Extra large size to accommodate lift or other bath aids, heavy duty hand grips in showers and tugs, height adjustable shower heads. Hope to age in place. Long term budgeting for in-home help.

Around the table one night, I asked Hubs & teens what to do when Dad & I can't cut our own toenails anymore... or need loads of care. Ha! Hubs has magical thinking that foreign handmaids will appear to meet his needs (& obviously cash to pay them). Daughter says that's our problem & plans to move... very very far away. Son is studying physics & hopes to study engineering too. He said robots will do it.

So that's our plan. Robots. Programmed to cut toenails, plus drink service for Friday happy hour :)

Some countries are doing it right. Japan for example. There a private nursing home is $25,000/year. Japan has a economy on the same level as ours. It's a matter of values. They value the elderly. In the US, the elderly are disposable.

There will be paid options, perhaps even more costly than now.  Whether or not the level of care will remain the same, deteriorate, or get better may probably depend on how many people can actually afford the expensive facilities.

I noticed something interesting a few weeks ago when I was checking out companies.   I don't know if this is a trend or not, but suspect it might be, or may become so.

I discovered that one nationwide home care agency is owned by an LLC, which also owns another company in the general geriatric medical and care field.   This could make more cash available for purchasing home care and related companies, creating more competition.    But the LLC ownership obviously means that the individual partners are looking for returns, now and in the future. 

What I think really needs to happen is more focus on caring at home, with funds allocated for retrofitting homes which may have been designed for much younger occupants.    And that depends a lot on who's elected, whether or not a strong consumer lobby can successfully lobby Congress, and whether or not the institutional lobby will out maneuver the citizen lobby.

Another focus that needs to be strengthened is the family and extended community one, to help support aging in place.   There's a vast difference between the senior centers in this area.  A few are outstanding.  In my father's community the SC had a registered dietician and social worker on staff, plus two small buses for transportation.    My community finally got a bus last year, but only for 3 hours per day.

The kind of system libraries have, facilitating  lending of books to other  libraries, would be helpful.   And the less experienced senior centers could learn from the more experienced ones.

AARP considers itself an advocate for improved issues of senior living.    The field could use more advocates, but those focused sincerely on potential patients as opposed to increasing their share of the market.

What I would, and plan to do, is start retrofitting to adapt to age limitations.   I'm using bookcases to store canned goods which used to be stored in the basement so I don't have to go up and down to get food.    I'm planning (emphasize "planning"!) to downsize to eliminate the amount of "stuff" to clean.   

Later this year I'm going to have the electrical system upgraded to add more outlets so I have some on each side of the rooms, to eliminate connecting cords and potential trip hazards. 

In a rather unpleasant task, I'm pulling up all the carpeting to eliminate vacuuming and dust.     

These are just for starters.

I am questioning the advice to bring in immigrants in order to fill the gap, why is it supposed to be okay to offer low pay and treat employees like crap as long as they are desperate enough to take it? When did the role of nursing - true hands on caring for people and not highly advanced trauma or surgical care - become such a disdained and undervalued occupation?

68 year old Boomer here......and the short answer is a resounding "NO". Unless Congress comes up with a plan that began yesterday we will be in dire straights.
Medicare is a godsend to most (as long as you have the finances to support it), but those with no resources have Medicaid to foot the bill which government pays for exclusively. Not always the best of care. We could stop with removing the tax cap so everyone at all income levels would be contributing which would add a substantial boost....but that's just for starters. Seems government is sleeping at the wheel when it comes to long term planning. As for me, my plans are to move into a retirement manufactured home park because of the affordability and leaves me with remaining assets to simply enjoy life. Don't want my kids to have the burden of taking care of me....I will spend down my money and then check out. We'll see how that goes : )

What to do with all the elders as the Baby Boomers continue to age is a huge impending crisis. Free college for all! Forgiveness of federal student loan debt! are getting far more media attention (and congressional interest) than the impending elder crisis.

From what I am seeing out there I think we may be seeing the last generation willing to do any caring in the home. I think affordable is the word here. I expect that in a future (I will not live to see) we will have a much more socialized medical system because we will HAVE to have it. It is not affordable today, and it will only be worse in the future. I can't even imagine, but our parents couldn't imagine the future we live in today, either.

I won't get into it here, but I honestly don't think we're going to have to worry about it too far into the future. Beyond that, robots could be a very real and convenient possibility. There are great strides being made on that end. Look at all the AI stuff going on which is not necessarily a good thing. Unless we do get a socialized model of long term care, I don't know if it will ever be affordable unfortunately. As far as me, I've told my family once it gets to the point where I am no longer useful and just taking up space put me down like a horse or grab the nearest pillow. ;)