An article in The New York Times by Reed Abelson and Jordan Rau captures the plight of family members caring for aging parents in the US. The journalists profile several individuals who are managing care for parents and grandparents, with cancer, dementia and other complex conditions. One woman sums up the situation with these words: “The health care system for the elderly is neglected, broken and inadequate to meet any demands, even the basic needs.”
To be clear, if you are not eligible for Medicaid, your long-term care costs could be exorbitant. Medicare does not cover long-term care. For many people, long-term care costs are unaffordable. Even with Medicaid, it can be hard to get long-term care.
Medicaid should be picking up the costs of long-term care for people with low incomes. But, eligibility requirements are restrictive, and even when people meet them, there can be long waits to get needed care. There are not enough health aides, so agencies will hire anyone who is willing to take on this role. When aides don’t show up, replacement aides are hard to come by.
To keep costs down, often children of aging parents bring their parents in to live with them. And, while that makes it easier to ensure they are getting needed care, it can keep them from working outside the home. In some cases, older adults cannot be left alone. To make ends meet, adult children are forced to institutionalize their parents so they can work outside the home.
Single adults, living alone and needing to care for aging parents, are in a particularly difficult bind. They lack a partner to share the work of caring for aging parents, while earning an income to sustain themselves. Unless they are wealthy, they have few options when their aging parents develop dementia or otherwise need ongoing help with activities of daily living and are in need of fulltime care.
A 60-year old actor from Topeka, Kansas explains that it cost $8,000 a month to provide just eight hours a day of care for her mom. That cost is not sustainable for the vast majority of Americans with limited savings. Then, her mom fell, broke her sacrum, got 100 days of Medicare rehab and was once again left without a viable care plan. Her daughter and her siblings cashed out her life insurance policies to pay $65,000 for a year of nursing home care. Medicaid eventually picked up some of those costs after her mom spent down more of her assets. Now, her mom has died and the state is asking for almost $20,000 back.
A California professor and his wife had a plan for his mom, one that would not destroy his own retirement savings. But, his mom lost some cognition after a stroke. The least expensive way to care for her was at an assisted living facility, costing $4,500 a month. His mom only gets $1,500 a month from Social Security and has no other funds to cover these costs. He negotiated with the assisted living facility and launched a GoFundMe campaign. But, in his 60’s, he’s figuring out what new work he can do to pay the balance of his mom’s monthly bills.
A 60-year old retiree from Greenville, South Carolina explained that her mom, was getting terrible care in an independent living facility. No one was engaging with her. Before long, her mother got sick and needed a wheelchair to get around in her assisted living facility. The assisted living facility cost $8,000 each month and was quickly depleting her $120,000 in savings. She had no additional financial support beyond $2,500 a month in retirement income. Her daughter and son-in-law were unable to get away until she died.
A 55-year old college professor from Vermont found a new home for her family so that she could move her mom in to live with them. Her mom had been in California, where she could not drive any longer or otherwise adequately care for herself. Her mom had dementia. Adult care was extremely costly. Moreover, her mom became violent. No nursing home would take her. She was sent back to live with her family, who had to give her drugs to calm her. She died soon after.
Here’s more from Just Care:
- People with both Medicare and Medicaid can get Traditional Medicare at little cost
- Medicare and Medicaid: How they work together
- Seven questions you should be asking this Medicare Open Enrollment period
- 2023: Five things to think about when choosing between traditional Medicare and a Medicare Advantage plan
- If you need long-term care services, how will you get them?
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