28 July, 2007

Wrenches in the gears of life

I received an email from someone noting I hadn't written anything in a while. Here is why and some rumination on it. I've been helping the friends I am staying with deal with some things, which has left us all with a serious lack of clarity. My friend was forced to move her mother into an assisted living facility due to her steepening decline from dementia. Between moving her out of the apartment and into her new room, my friend had to move her mother into her home because her mother had taken to wandering at night. In the midst of all that my friend's husband contracted a staph infection in one leg and was hospitalized for a week while I took care of her mother at home. I now have an intense respect for those who care for the elderly. I might add, and my friend would tell you herself, that her mother is not the sweetest woman in the world, to put it mildly. Suffice to say our collective karma is squeaky clean thanks to her and these last few weeks. The husband is on the mend and doing well-ish and her mother is getting acclimated to her new surroundings, obsessing and complaining about a lot of it.

A few things to note from all this...The Boomers growing older, living longer, and with "golden years" vastly different than their parents' generation. Meanwhile, Americans are saving less, faced with rising housing, food prices and gas prices (in a car-dependent country), the numerous difficulties with the health care system, etc. When you spend a majority of your paycheck on the rent, when the cost of a higher education pushes it out of some families' reach, when you have to move because you can't afford to fill your gas tank to drive to work, how do you pay to take care of mom and dad when they can no longer take care of themselves? My friend and her mother are lucky. Several years ago, in a fit of good sense, her mother bought a long term care insurance policy. If she had not, her daughter tells me, her late husband's pension and her Social Security check would not be enough to afford the facility she moved into this week; it is specifically designed for dementia care and is split between four wings to allow the residents to progress through the stages until such a times as they need invasive nursing care. Her room, including meals, management of her medications, activities, and housekeeping will cost about $4000 a month. My friend looked at several facilities, some less expensive. She noted that one $1000 a month facility smelled terrible and that even one $2000 a month facility was simply not acceptable to her. There were some within each price range that were more than adequate in general, but this was the best for her mother. However, what about those without insurance, pensions, or adequate Social Security income? What about somebody just scraping by? I can only guess they take their parent home and hope for the best; hope they can manage the growing list of meds and dosages; hope they can figure out how to keep their mother or father safe and at home while they are at work; hope that their energies and sanity hold out.

A tip to those of you pursuing a law degree: elder care will be the next hot area of law that needs to be filled. My friend was referred to a lawyer who specializes in elderly issues. She has more business than she can handle. She helps families negotiate things like Veterans' Administration benefits. Speaking of the VA, they are hardly forthcoming with those benefits. My friend was lucky that the manager of the dementia care facility asked if her mother or her mother's spouse was a veteran. Turns out there is a sizable benefit for veterans and their spouses who can no longer care for themselves to pay for in-home care or assisted living. However, after months of searching for just such a benefit online, my friend hadn't come up with a thing. In addition to not being forthcoming with the existence of the benefit, everyone she has spoken to has warned her the tons of paperwork involved are ridiculously complicated. Again, luckily she can spend the $300 to hire legal help. And again, what about those who can't?

Much like the $1000 anti-biotic my friend's husband was prescribed, the world shouldn't work this way. If this is the most powerful country in the world, what does it say that we can't find a way to adequately care for our elders across the board. There are tangential issues here, sure. We are removed and, in my opinion, phobic about the aging process and death in this society. Living in Morocco, with families where three generations in a home is still common, the process of life, beautiful and ugly, is immediate and real. There is a tangible segregation of the elderly here and a generally accepted lack of respect. Instead of being seen as experienced, knowledgeable, and someone worthy of respect, and elderly person is likely to be seen as slow, dull, a dinosaur lurching toward the grave. Perhaps this will change with my mother's generation, perhaps not.

So what's to be done? Much like with the issue of child care, elder care will require changes to the broader society and issues directly related to the issue. More transparency on issues related to benefits and how to apply for them and flexible work schedules for those caring for elderly parents. The solutions will only be found when we deepen the conversation, but with about 78 million Baby Boomers set to change the face of this country as they age, we have to start now.

I remember asking people in Damascus about the then newly-opened retirement home in Mezze, the first of its kind there.

"It's for people who do not have families," I was told.


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