Lynn Hallarman, MD, former director of palliative care at Stony Brook University Hospital, writes for The New York Times about the value of paid caregiving. What’s most important for aging Americans is to have a caregiver who knows how to keep them safe and properly cared for. And, that should be valued as health care.
Many children of aging parents cannot be there with their parents towards the end of their lives. Consequently, nearly half of people turning 65 today will need a paid caregiver to remain in their homes and communities, to live independently and with dignity. But, the cost is prohibitive for many. It can easily be $4,500 a month.
Health insurance rarely covers caregiving services. Long-term care insurance tends to be extremely costly and usually only covers a portion of an individual’s home care. There’s also almost always a waiting period that can easily be three months or longer. So, insurance is generally not worth the investment.
What’s as concerning is that paid caregivers tend not to earn a living wage; they also need better benefits and better training. We need more paid caregivers to provide direct care to older adults so that they can age in place.
Today, states are left to bear a lot of the burden of providing home and community-based care to their Medicaid population. Hallarman believes a national partnership is needed. Funding for community-based services for older adults is critical.
Older people in their last years of life tend to need a wide range of direct-care services. They might need help preparing meals, bathing, moving from one place to another, going to the toilet. It is hard and tiring work. It can also be extremely physically demanding.
Medicare covers hospice services for people deemed to have less than six months to live, who opt for comfort care. Hospice services are generally not provided 24 hours a day. But, Medicare hospice covers care from a home health aide and others to ensure that patients are pain-free and living comfortably.
A good caregiver is going to take note of increasing confusion in an older person, pain and whether and what the person is eating. The caregiver should be clipping toenails and checking for bedsores. We need to value caregivers for the extraordinarily challenging and important health care work they perform.
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