Caring for Our Parents: Inspiring Stories of Families Seeking new Solutions to America’s Most Urgent Health Crisis – Part 2
Gleckmen says that the challenges facing Boomers are even worse than for today’s elderly. Boomers’ futures will be defined by three factors:
1) the vast number of those born between 1946 and 1964,
2) their rapidly increasingly life expectancy, and
3) profound changes in the nature of families.
Let’s look at that latter point. He says that we Boomers will begin to need assistance in a nation where half of women are unmarried, a third of children are born out of wedlock, and millions of adult children live far from their parents. In such a society, who will meet the unprecedented demand for the informal unpaid care that has been the bedrock of our long-term-care system? And if that free assistance is not available, who will pay for the care of these Boomers?
Gleckman says that Boomers have made more money than other generation in history, but have spent nearly all of it. Largely abandoned by the traditional pension system that supported their parents, yet unwilling to save for their own old age, the postwar generation will simply not have the economic resources to pay for both healthy retirement and ever more costly long-term care. This in the midst of an economy that is growing more slowly than before. As Boomers retire there will be fewer people to replace us, so the total number of Americans working will barely increase.
By 2030, more than 71 million Americans will be sixty-five-plus—almost twice as many as today. By mid-century, nearly 90 million (one in five) will reach that age. And the old-old will be the nation’s fastest growing age group. Today fewer than 6 million Americans are 85-plus, but by mid-century, 21 million will reach that age. As many will be 85 in 2050 as were 65 in 1930. Statistically, 85 will be the new 65. As a result more than 20 million seniors will need some long-term care by 2050, twice as many as in 2000. Six million of them will suffer severe disabilities. And, to add injury to insult, family caregivers will be older. Many 70-year olds will be caring for 95-year-old parents.
More than 14 percent of the postwar generation is divorced and almost that many never married. Therefore, more than one in four are heading into their sixties with no spouse to assist them in their old age. It’s also less likely that our kids will be there for us, partially because we have had fewer children. The typical Boomer mom averaged fewer than two children, compared with nearly three for her mom. And 40 percent of children born in 2007 were delivered to unwed mothers. What are the chances that, as adults, they will care for fathers or grandfathers they barely know? And even if these adult children have the inclination to help, will they be able to? Today nearly two-thirds of our children have jobs outside of the home and experts expect the number of working women to continue to grow. For them, caring for parents will be an even greater financial burden than it is for us today. Yet by mid-century, the elderly and disabled will need at least twice as many direct-care workers as they have today.
As much as I enjoyed this book, I was left with a profound sense of “now what?” Gleckman effectively points out the problems. He offers few solutions. Probably because there are few. If anything, this book points out the need for outstanding research and many small pilot programs before we attempt to change the entire American health care system in one fell swoop. We also need a good chunk of Reagan patriotism and responsibility. The naked truth is that government will not be able to solve this problem. It will take individuals, families, communities, and churches to assume more responsibility and demand less nanny care. Can we do it? Will we?
Labels: Baby Boomers, eldercare, long term care
Thursday, July 23, 2009
Caring for Our Parents: Inspiring Stories of Families Seeking new Solutions to America’s Most Urgent Health Crisis – Part 1
Howard Gleckman has written a captivating book that will challenge, inspire, and disappoint those of us caring for our aging parents, especially those of us who are Boomers. The book is readable and enjoyable, while at the same time providing lots of statistics and data in a very readable form.
The first half of the book tells compelling stories of how a variety of families are coping with eldercare needs using nursing homes, home care, family care, hospice, adult day care, and other solutions. He discusses the financial and practical challenges they face, including compromises that are forced by government rules and reimbursement. The thing that struck me the most in these chapters is the incredible lack of creativity and flexibility in all government reimbursement systems. Despite personal preference or financial common sense, the government has rules and people without personal resources are stuck. It’s a perfect reminder of what we’ll face if the government takes over even more of our care. The stories also point out what most of us doing eldercare already know: the ideas of the Boomers are not necessarily the ideas or preferences of the elder generation. What makes sense to me isn’t how my mom wants to live out her life. It’s not just me….
The second half of the book is chock full of statistics. Gleckman’s data is well documented in endnotes, but his style is conversational, even when discussing complex information, so even if you don’t like numbers, you’ll appreciate his interpretations. The net effect of these data was to make me realize how very serious our eldercare problems are and are becoming. And there really isn’t an answer. As an example, he notes:
“In 2005, America spent more than $200 billion for nursing home care, and other long term-care services. About half of that, or more than $100 billion was paid by the government, through our tax dollars. Most of the rest was financed by individual families, out of their own pockets. A small amount – less than ten cents out of every dollar – was covered by private insurance…. How much is $200 billion? Nearly $2,000 for every household in the nation.”
But the needs aren’t evenly distributed. “Three out of ten seniors will never require [eldercare]… “…two out of every three will need some period of personal assistance in their old age. About 17 percent will require help for a year or less, and many of them will get by with relatively little aid from family members or friends. However, more than half will need care for at least a year, and one our of every five will need help for five years or longer. Women are far more likely to need long-term care than men and the odds are nearly twice as high that they’ll need it for five years or more.”
Researchers estimated that 42 percent of sixty-five-year-olds will have no long-term care costs before they die and about 20 percent will have less than $10,000. However, about one out of every six will generate costs in excess of $100,000 and about one in twenty will incur expenses of more than $250,000.”
The cost of a nursing homes averages “$78,000 a year and home health agencies charge close to $20 an hour for aides.”
“Fewer than 7 million people have private long-term-care insurance…. Americans seem unable—or unwilling—to build up a financial reserve for their old age… Before the real estate and stock market collapses of 2008, the median net worth of all those over sixty-five, including their home, was somewhere between $110,000 and $150,000.”
He evaluates Medicare, Medicaid, pensions, retirement, long term care insurance, reverse mortgages and concludes – sadly – that there really are few good answers for today’s elderly. And the challenges are even worse for Boomers, whose future will be defined by three factors:
1) the vast number of those born between 1946 and 1964,
2) their rapidly increasingly life expectancy, and
3) profound changes in the nature of families.
Tomorrow we’ll look at his assessment of the Baby Boomer generation.
Labels: aging parents, Baby Boomers, eldercare, long term care