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March 01, 2006

Hail to the Caregivers

Today is all about getting reacquainted with my computer after a near week at my mother's house and a day or catching up. Mom lives in Sun City, Arizona and has been providing at home care for her husband, who is significantly older and in failing health, for several months now. There's a lot to that story, but it's probably boring for most who aren't actually part of it, so I'll skip to the larger social issues.

Of all places in the country, one would think that the greater Phoenix area would be awash in services for the elderly. And while there are some, there aren't nearly as many as I expected. So arranging to have help at home, even just to try and hire a maid service, has been difficult. There is a growing number of assisted living type facilities, but still very few custodial centers. Those facilities that are available are run by large corporations, and I know from prior work that those corporations are now and will be in the future very profitable. Still, they are corporations - businesses - and they run along business models. It costs money to be there, the staff aren't sharing equally in the financial success of the facility, many of the residents don't have someone watching out for them to be sure they are treated well, etc. These facilities are designed for people who can still largely take care of themselves and perform most of the Activities of Daily Living (ADLs) on their own. But as folks get older, as various and sundry ailments take over and diminish the capacity to function or perform the ADLs, then what? Very few places are set up to care for this segment of the population, leaving the two choices of paid in-home care, and the much more prevalent informal in-home care provided unpaid by stressed out family members trying to balance that care with a job or raising a family or both. This is a big problem in society that is still mostly hidden but really needs to come out and be the subject of a wider discussion.

Most seniors don't have the kind of assets to buy in-home care. It costs $10 per hour during the daytime, $17 an hour for nights - or at least it does in Sun City. Do some quick math and you find this service weighs in at around $3,000 per WEEK. Medicare does NOT cover this kind of care. Only Long Term Care Insurance will, and then only part of it. Even if one has money, it doesn't take long to completely deplete a lifetime of savings at that rate of expense.

The implications across our society and economy are huge and disturbing. Last week, there was a report speculating that by 2015 (that's less than 10 years from now) health care costs will account for as much at 20% of our total Gross Domestic Product. $1 in every $5 will be spent on health care services. 1 in 5. How long can we do that?

The baby boomers - the group that begins with those born in 1945, begin to be eligible for Medicare in 2010. Groups like AARP have been trying to years to educate the pre-retirement set about the kinds of care Medicare does not provide. And still not enough people have Long Term Care insurance, which like most other insurance, is one you can't buy once you need it. You have to buy it early and carry it a long time. It provides at least some financial assistance for either institutional or at-home care.

But the fact is that as long as we as a society are loathe to allow the life cycle to come to its natural end without medical intervention, we will have a ever-large percentage of our population consuming large dollar amounts worth of medical care and related care services with no real restorative effect. It's long past time we came to grips with this contradiction and started providing for it, planning for it, and having mechanisms in place to care for the elderly who can no longer care for themselves. It's time we educate mid-lifers to anticipate spending their final years somewhere other than in their own homes. Time we started to really develop well-trained and well-paid caregivers so that we can feel good about entrusting our parents to them (this argument parallels nearly exactly the need to better pay our teachers so we can entrust our children to them... another post).

Fortunately for my mom, she now has a rotating group of in-home caregivers, both to just be with her husband so she can move about the house and do things, or leave the house to do things, or just get some sleep, and to help with light housekeeping chores. It's those people I want to salute in this message. So here's to Dan, and Don, and Luce, and most of all, Magda, for choosing this line of work, for your patience, your cheerfulness, and your help. Thank you. And to all the caregivers out there who toil without notice, without pay, without appreciation or recognition, a shout-out to you. Make your work known, and know that some of us out here do understand how hard it is, how much you give up to do it, and how important you are.

Posted by cageyer at March 1, 2006 09:40 AM

Comments

Posted by: Mikey at March 5, 2006 09:49 PM