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Older adults aren’t too happy with the healthcare system and many think it doesn’t meet their needs and preferences, according to a new survey.

The results of the survey, conducted by The Harris Poll, were published Tuesday, and were released by Age Wave and The John A. Hartford Foundation.

Four in five adults aged 65 and older said that the system isn’t prepared to handle the changing needs of Americans in their age group. In total, only 11% said the US healthcare system deserved a grade of “A.”

Results show that older adults want solutions such as affordable care interventions, developments to prevent or reduce cognitive decline, and healthcare professionals who understand what matters to them when they discuss care options.

“Older adults are stuck in a health care system that is not responsive to their goals and preferences. Boomers want health care that maximizes their health and ability to function, and they want their providers to listen to them,” Terry Fulmer, president of The John A. Hartford Foundation, said in a statement. “It is not too late to pivot to age-friendly care, which prioritizes the needs and desires of older adults in their care plan. There are many innovative approaches to help older adults live every year to its fullest, not just increase the number of years they live.”

In fact, 94% of respondents said it was more important to maintain a positive quality of life than to live longer. Three in five said their providers ask about what matters to them. Only 40% said they’re regularly screened for cognitive health and 45% said their mental health needs are addressed. They’d like to see more healthcare professionals trained in geriatric care as much as they’re trained in pediatric care. 

About half the respondents said their primary care provider does not coordinate care with other providers, and 56% said it’s confusing to navigate the health insurance system.

Overall, 68% of respondents said they were concerned about not being able to afford future health and long-term care needs and 80% said the government should make Medicare cover long-term care.

Respondents said they want to see more age-friendly care, more support to combat social isolation, more caregiver support, more more medical breakthroughs to end diseases such as Alzheimer’s, and a plan to finance long-term care and reform nursing homes.