GAO Report Finds Millions of Seniors Are Not Getting the Homecare They Need

WASHINGTON—According to a new report on the unmet needs of seniors across the United States, four out of five seniors who needed a home-delivered or congregate meal in 2021 did not receive one; and over 3.6 million, or 18%, of low-income older adults were food insecure.

Commissioned by Senator Bernie Sanders (I-Vt.), Chairman of the Senate Committee on Health, Education, Labor, and Pensions (HELP), and released in mid-June by the Government Accountability Office (GAO), the report comes as Sanders is working to reauthorize the Older Americans Act (OAA), which has provided essential nutrition, social, economic and health services to millions of vulnerable seniors for nearly six decades. First signed into law by President Lyndon B. Johnson in 1965, the OAA was last reauthorized in 2020 and will expire on Sept. 30, 2024.

The GAO report also found that more than one in four seniors, about 18.9 million Americans, have difficulty with at least one activity or instrumental activity of daily living, such as shopping, housework, dressing or bathing. Sixty percent of older adults who struggle with one or two activities of daily living were not receiving any help in 2020—up from 47% in 2012.

“It is unacceptable that in the richest country in the history of the world, so many seniors are struggling to get by, too often going without the care and nutrition they need,” said Sanders. “The good news is that we have a very effective piece of legislation on the books to address the urgent unmet needs of vulnerable seniors: the Older Americans Act. The bad news is that funding for critical nutrition and homecare services provided through the Older Americans Act has not kept pace with inflation or the growing senior population. It is time for that to change. These services not only save lives, ease human suffering, and improve the quality of life for seniors, they save money. It is time for Congress to substantially increase funding for the Older Americans Act.”

According to an analysis of Medicare claims, receiving home-delivered meals is associated with a 31% reduction in hospitalizations, 25% reduction in nursing home use and 13% reduction in emergency department use. Older adults who receive a congregate meal are less likely to be admitted to a hospital or have an emergency department visit than those who do not receive a meal.

Nutrition programs established by the OAA are able to feed a senior for an entire year for the same cost as one night in the hospital. Malnutrition among seniors costs the U.S. over $50 billion each and every year. OAA-funded prevention programs have also been estimated to reduce the number of falls by seniors by up to 55 percent and reduce annual health costs by up to over $900 per participant. Falls by older Americans—which often take place during basic daily activities—result in $50 billion in medical costs each year, the majority of which is paid by Medicare and Medicaid.

In March, Sanders led the HELP Committee in a hearing on the OAA and in May he led 38 senators in a letter to the Senate Appropriations Committee requesting to double funding for the OAA, to $4.6 billion, in Fiscal Year 2025.

Read the full report, here.