Tuesday, 22 November 2011

The elderly dilemma: Medicare-Medicaid fail middle class families

By ASK Peter a Question
CHICAGO, November 21, 2011- Today, I placed my mother in a nursing home.  She is 96 years old  has been living with me for the past six years.  Almost three years ago she broke the same hip twice within six months, which rendered her semi-invalid.  She is also sliding into dementia.  She was extremely adamant that she would never go to a home.
She is one of those tough hard headed Sicilian women.  
I hired caregivers.  They are wonderful women.  I am profoundly grateful to the three of them.  They took care of her as if she was their own mother.  They also took care of my house as if it were their own.  
It was expensive as sin.  They were in my home from 8:00A.M. to 10:00 P.M. seven days a week.  Her money and my own ran out.  Over the past two years it has cost me over 170 thousand dollars to care for her at home.
I was almost on the verge of bankruptcy and losing all I had worked for.  It is extremely difficult not to get mad or bitter.  It is even harder not to cast blame.  You just have to accept the reality of the situation and deal with it.
I am not complaining.  I am not looking for a pat on the head, an atta-boy, sympathy, empathy, or a boost to my self esteem.  This is not a rant, rage, or slam against the the government, politicians, or special interest lobbys either.
This was an unforeseen or unintended consequence of the Medicare and Medicaid acts.  No one anticipated so many would need so much assistance while preferring to  stay in their own homes or with their loved ones. 
During the last years of the Bush administration and 2008 campaign for president much was made about baby boomers who would have to take care of their elderly parents and the early boomers who would be turning into the elderly themselves.  Especially people who did not want to live out their lives in nursing homes.  
When the election was over so was the lip service. The nursing home industry has a very well funded lobby on the federal and state levels.  Most of the social services for the elderly are geared towards nursing homes.  This is not a good or bad thing.  It is not liberal, conservative, or any other political persuasion.  It is not evil or greedy.  It is a fact of life. 
This is a class issue.  A middle class issue.  If you are poor or wealthy, one way or the other, your needs will be taken care of.  If you are middle class you face the very real possibility of financial ruin if you or your loved one wants to remain at home and needs constant care for years.
When you ask so-called elderly experts for advice you never get straight or understandable answers.  If you put ten of the so-called experts in a room with a clock and asked them what time it is, you would get ten different times and a fight.  This is not a good situation.
The laws, regulations, and qualifications regarding home health care entitlements are confusing, contradictory, arcane, vague, and sometimes, arbitrary and capricious.  
By the time I actually learned what my mother might have been entitled to, I was almost broke.  It was too late. 
There should be advocacy groups to lobby on behalf of people who need care and want to live at home or with their loved ones.  The process should be made easier, understandable, and more transparent.  
If it is true that home assisted care is less expensive than nursing homes, than it would make perfect fiscal sense to change the senior entitlement programs to make it easier for people to stay at home or with their loved ones.  Without breaking the bank or fearing loss of all they have.
If you are of the baby boom generation you or your parents may soon be faced with tough choices.  Confusing choices.  Expensive choices.
You must prepare for the unexpected.  The only way to do that is to change the policies and make it easier for people to stay home and receive care if that is what they want.  This should be a front burner issue as the numbers of people who will fall into this category are huge.
This is one issue that will not go away.  It is not an issue based on opinions, morality, social, cultural, political, or religious beliefs, like other hot button wedge or litmus test issues.
Large numbers of people face the real threat of being semi or fully immobilized or living with dementia or Alzheimer's disease, which is striking people at earlier ages.  Care givers and supplies are expensive, even on a part time basis.  Money goes fast.
We need to have a change in senior politics and policies to level the playing field with the nursing home lobby.  Again, they are not evil people.  They are just doing what all special interests do.  Advocating for their industry.
We are facing another election cycle.  This is one issue that affects all middle class families.  It should be a high priority and part of the debate, conversation, meme, narrative, or whatever you want to call it.
If something is not changed, large numbers of us, or our children, will be faced with severe financial burdens or the dilemma of making quality of life choices that satisfy no one.
Peter Bella is a retired Chicago Police Officer, freelance writer, freelance photographer, and consultant.  He is a passionate cook and eater.  He likes to be the sharp stick that pokes, annoys, and provokes.  His opinions are his and his alone. 
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