By Shakima Tozay DSW, MSW, LICSW, CCM & Dulcy Stout MSW, LCSW, CCM
Proactive care planning is essential, especially for community home care. Professional case managers must empower older adults and caregivers with knowledge and tools to make informed long-term care (LTC) decisions before crisis strikes. Let’s start today!
Research on advanced care planning shows that as many as 70% of adults aged 65 and older will require long-term care services in their lifetime. Despite this concerning trend, many adults still do not adequately prepare for the possibility of needing care as they age. They may avoid essential conversations about their future healthcare needs with family members or simply believe that it won’t happen to them.
A national survey by the University of Michigan revealed that 57% of older adults don’t believe they will need long-term care, and 48% are unsure how to plan for it. This often results in delaying action until a crisis happens, leading to reactive problem-solving. Lack of careful planning can seriously affect their social, emotional, physical, and financial well-being. For instance, older adults are more vulnerable to social isolation, grief, and loss due to health changes and declining independence, often living on fixed incomes after retirement. Therefore, early planning by older adults and their families is crucial.
Why Proactive Planning for LTC Matters
The standard approach to LTC planning is reactive, waiting until services are urgently needed. Understanding the facts about aging in the U.S. is key to recognizing why proactive LTC planning is important now more than ever.
Key Insights
- According to U.S. Census data from 2020, the fastest-growing group of individuals in the U.S was Americans 65 and over, representing 1 in 6 Americans (16.8%), and this number is expected to increase to 23% of the population by 2050 (Caplan, 2023).
- About 63 million Americans provide unpaid care to loved ones in 2025 (Caregiving in the U.S., 2025). This represents a 45% increase in just ten years.
- More than half (56%) of Americans turning 65 will encounter a disability severe enough to need long-term care and support (Rubin, 2022).
- The number of individuals with Alzheimer's is expected to continue increasing, largely because adults aged 65 and over are the most at risk (Alzheimer's Association, 2023)
- The demand for care in residential settings is projected to grow exponentially over the next decade, as the number of nursing home residents could increase by over 75% to 2.3 million residents by 2030 (Rubin, 2022).
In addition to knowing the facts, we must also understand the complexity of the circumstances surrounding LTC. Emotions like sadness, anger, and fear play a crucial role in informing the LTC planning process because they provide insight into an individual's values, preferences, and decisions. Balancing objective criteria, such as staff-to-resident ratios and safety measures, with lifestyle preferences like social activities and amenities in assisted living facilities, is ideal when planning for future needs.
We also know a reactive approach has many disadvantages, primarily stress. Stress narrows focus, intensifies emotional reactions, and interferes with effective communication, all of which are vital when choosing a home away from home.
Thus, this approach does not allow adequate time for vital conversations about the feelings associated with changes in one’s health, needs, and level of functioning to occur between older adults and their support systems. It’s also risky because needed services may not be immediately available.
Finally, LTC is expensive. Those who have not planned are often shocked by the cost. Financial planning, including consulting with experts, like social workers, nurses, elder law attorneys, and financial advisors, can ensure resources and benefits are known, accessible, and used wisely.
How Social Work Professional Case Managers Can Help
As social workers and professional case managers working in a large healthcare system, the majority of calls we (Shakima & Dulcy) receive from older adults and their family members are for long-term care services. For example, a daughter calls panicked, because her father’s health is declining, it’s too unsafe for him to remain home, and she’s unsure what resources are available. Or we see families overwhelmed about how to care for their loved one who is cognitively impaired and living alone.
If you’re a professional case manager, with a background in social work, you're already familiar with the diverse settings we work in, from clinical to community organizations, and the wide range of people we serve. When it comes to older adults and their families, our role in proactive care planning is crucial. This includes services like:
- Information and referral for in-home and residential long-term care needs
- Biopsychosocial-spiritual assessments to determine history, needs, and the best care approach
- Care coordination and management
- Addressing non-medical social needs such as food, finances, transportation, housing, safety, and mental health
- Resource navigation to help older adults access community resources like their local Area Agency on Aging
These are just a few strategies we use to support older adults and their families. Another impactful way we can make a difference is through education. Offering classes or seminars on proactive care planning not only provides valuable information and resources but also empowers older adults and their families to make informed decisions about their healthcare. Whether virtual or in-person, these educational settings create a safe space for older adults to learn, ask questions, and engage with their peers.
That’s why I (Shakima) developed a curriculum focused on long-term residential care planning, an often overlooked need for older adults and their families. Stay tuned for more details in Part 2!
What’s Next
This 3-part series is all about the power of proactive long-term care (LTC) planning.
In Part 1, we (Shakima and Dulcy) dive into why it's so crucial for older adults and their families to start planning early, especially from the perspective of professional case managers in healthcare.
Part 2 is all about action! We share 7 steps to create an educational program, drawing from our own experiences as group facilitators in a large healthcare system.
Finally, in Part 3, we reveal the results of our educational program, sharing valuable insights, lessons learned, and the amazing positive changes we've seen in our participants' lives.
If you're a professional case manager looking to develop effective educational programs and measure their success with older adults and families, this series is for you!
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Author Bios: Dr. Shakima (Kima) Tozay is a Licensed Clinical Social Worker and Board-Certified Case Manager with over 18 years of experience in clinical, administrative, and leadership roles in social work, working with diverse groups across the lifespan. She currently serves as the Primary Care Social Worker within a large healthcare system. Kima holds a Doctor of Social Work in Organizational Leadership from the University of Alabama. She earned her Master of Social Work and Bachelor of Interdisciplinary Arts & Sciences from the University of Washington, Tacoma Campus in 2009 and 2006 receptively. Her research and passions center on patient advocacy, implementation science, quality improvement, and program development at the intersection of improving the patient experience in healthcare. Kima lives in the Pacific Northwest, in a charming rural town known for its rich Scandinavian history and its origins with The Stillaguamish, a Coast Salish tribe. Kima enjoys family road trips and walks on the beach.
Dulcy Stout is a Licensed Clinical Social Worker (LCSW) with nearly 20 years of experience in the field of social work. She holds a Master of Social Work (MSW) degree from the University of Tennessee Health Science Center and is a Board-Certified Case Manager (CCM). Dulcy has expertise across various domains, including trauma, mental health, and medical social work. In her current role within a large healthcare system, Dulcy works closely with patients to address their non-medical needs. She conducts comprehensive psychosocial assessments, provides advocacy, and offers case management services to improve patient’s overall well-being. Dulcy resides in the Pacific Northwest, where she enjoys spending time outdoors. Her coastal hometown is situated on Possession Sound with the Cascade Mountains to the east and Olympic Mountains to the west. During the wet, cold winters, Dulcy enjoys crocheting and reading.