“Among the Very Ill, Confusion About Life’s End”

There’s a compelling article published in a recent “New Old Age” blog in the New York Times.  It’s about the “unwillingness of older Americans to ponder, discuss and plan for the end of their lives remains an enduring frustration for health care professionals.”

The article’s author concludes:

“But the findings make sense, in a way. Why would patients feel any urgency about discussing or documenting their decisions about the end of life if they think that’s going to be an instantaneous or two-day process? Or if they have no idea what might occur? Apparently, they don’t.”

Here’s a link to the article:

http://newoldage.blogs.nytimes.com/2012/06/04/among-the-very-ill-confusion-about-lifes-end/

The New Old Age: Caring and Coping
Among the Very Ill, Confusion About Life’s End
By Paula Span
New York Times
June 4, 2012, 6:00 AM

“Should You Purchase Long-Term-Care Insurance?” (WSJ)

Caregivers may want to consider purchasing long-term-care insurance for themselves. The Wall Street Journal recently asked two financial planners if people should purchase long-term-care insurance. Here’s a link to the “yes” and “no” responses:

online.wsj.com/article/SB10001424052702303425504577352031401783756.html

Should You Purchase Long-Term-Care Insurance?
Wall Street Journal
May 14, 2012

Let me know what decision you make!

“Seeking the Line Between Grieving and Depression” (WSJ)

There’s a good article in today’s Wall Street Journal (wsj.com) about whether grieving people are clinically depressed.  The article centers upon the experience and thoughts of Johns Hopkins professor Kay Jamison, who has written about her struggles with bipolar disorder and also lost a spouse.  Ms. Jamison compares grief and depression — both of which she has suffered.

Here’s a link:

blogs.wsj.com/health/2012/05/07/seeking-the-line-between-grieving-and-depression/

Health Blog
Seeking the Line Between Grieving and Depression
Wall Street Journal
By Shirley S. Wang
May 7, 2012, 4:06 PM

Discovering The True Cost Of At-Home Caregiving (NPR story)

Yesterday, NPR had a terrific series on caregiving called “Family Matters.”  One segment was about the true cost of at-home caregiving.  Here’s a link to the story:

www.npr.org/2012/05/01/151472617/discovering-the-true-cost-of-at-home-caregiving

Discovering The True Cost Of At-Home Caregiving
by Marilyn Geewax
Morning Edition [4 min 6 sec] Part of the Family Matters series
May 1, 2012

The transcript is copied below.

Robin

————————

Walk through any nursing home, and your first thought might be: “I need to take care of Mom myself.”

Few people want to turn over a loved one to institutional care. No matter how good the nursing home, it may seem cold and impersonal — and very expensive. But making the choice to provide care yourself is fraught with financial risks and personal sacrifices.

Those who become full-time caregivers often look back and wish they had taken the time to better understand the financial position they would be getting themselves into.

“I used to hear about people saying, ‘Oh you know, we’ve got to put our parents in a home; we can’t deal with it anymore,’ ” said Yolanda Hunter, 43, a Maryland resident who is struggling with her decision to drop out of the human resources field to become a full-time caregiver for her grandmother. “And I used to think: ‘Oh, how cruel are you?’

“You know, but now? I understand,” she said.

Hunter belongs to one of three families being profiled in NPR’s eight-week series, Family Matters: The Money Squeeze, which airs each Tuesday on Morning Edition. Each family is struggling with how to afford care for an older generation. The do-it-yourself approach is both common and costly.

Caregiver advocacy groups say Congress needs to be doing more with tax credits and Social Security benefits to help financially support those who choose to care for the elderly.

The demands for such assistance may grow louder, given the demographic changes coming in our aging society.

Nearly 10 million people over the age of 50 are caring for their aging parents, according to a study conducted by the MetLife Mature Market Institute, in conjunction with the National Alliance for Caregiving and the New York Medical College. The number of caregivers has more than tripled over the past 15 years.

That increase reflects medical advances and the resulting increase in human longevity. As the average age of death has moved from 68 in 1950 to nearly 79 now, the ranks of the elderly have grown. Today, about 6 million U.S. residents are over 85.

As a result, the personal cost of caring for the elderly at home is rising —in terms of lost wages and diminished pension and Social Security benefits, the MetLife study concluded.

Studies estimate that 2 out of 3 informal caregivers are women, many of whom are middle-aged mothers with children or adult children living in their households.

The cost of putting a parent into professional assisted-living care can be daunting. MetLife says that kind of care averages about $42,000 a year. A private room in a nursing home averages more than $87,000. But the cost of keeping a relative at home can be very high too.

The MetLife report said that for the typical woman, the lost wages due to dropping out of the labor force because of adult caregiving responsibilities averages nearly $143,000. That figure reflects the wages lost while not working — typically for about five years — as well as lower wages after returning to the workforce with rusty skills. When foregone pension and Social Security benefits are counted, the out-of-pocket losses roughly double.

“Family caregivers are themselves aging and yet are providing care at a time when they also need to plan and save for their own retirement,” MetLife said. The people who drop out of the workforce “can jeopardize their future financial security,” the study concluded.

Hunter has discovered just that. She quit her job to become an in-home helper for her 89-year-old grandmother, Ida Christian, who has Alzheimer’s disease. Christian lives with her daughter, Geneva Hunter, 66, who runs secretarial operations at a Washington, D.C., law firm. Yolanda Hunter has an apartment a few minutes away from her mother and grandmother.

Like many other caregivers, Yolanda Hunter thought the “job” of watching over her grandmother would not last all that long. Her thoughts at the time she quit her job: “I can do this for a year, help settle things down, try and take the pressure off a little bit,” she said.

Her goal was to find a good home nursing aide to help her grandmother so that she could jump back into the workforce. But two-and-a-half years later, it “didn’t quite work out that way,” she says.

Although Christian’s savings are enough to provide a modest salary for her granddaughter, the amount is not great enough to allow Hunter to prepare for her own retirement.

So Hunter had to switch gears again and begin trying to re-enter the labor market at a time when nearly 13 million other people also were seeking work.

As this year began, she said she recognized that “I desperately want to get back to work, because I’m mentally tired and I feel — unless I win the lottery — I feel like I’m missing out on so much in terms of my future and making sure I have a stable future.”

But then again, “there’s that part of me that is very, very torn about leaving her, because no matter how compassionate the next person may be, they’re not going to do the extra things that you’re going to do,” she said.

Some women’s groups say Congress should expand tax credits available to people with dependent relatives and create “caregiving credits” to limit the Social Security penalty for time spent out of the labor force to provide family care.

The Caregiver Credit Campaign, an advocacy effort, says such help is warranted because without voluntary caregivers, “hundreds of billions of government dollars would be spent on alternatives like institutions.”

An Indiana University report says “informal caregivers provide service that would otherwise cost the Medicare system $375 billion a year.”

Meryl Comer, president of the Geoffrey Beene Foundation Alzheimer’s Initiative, knows about the financial penalties of caregiving. At age 50, she was a journalist, living in a Maryland suburb outside of Washington, D.C. Then her husband, age 58 at the time, was stricken with early-onset Alzheimer’s.

She quit her job to become his at-home caregiver. Then her mother got Alzheimer’s too. Now, 18 years after quitting her outside-the-home job, she continues to care for her husband and elderly mother.

She argues that corporations should do more to help their employees handle adult-care needs while staying on the job.

“How do we do provide flex time for people who are taking care of their parents?” she asked. “The human resources policies [for caring for the elderly] need to mirror the child-care policies,” she said. “If corporations want women to be productive in the workforce, they have to make some accommodations,” such as allowing them more flexible schedules, family-leave time and telecommuting opportunities.

Comer said corporations have come a long way over the past 30 years in terms of responding to the needs of working mothers with young children. “Now they have to do the same for the other end of the age spectrum,” she said.

Economic Impact of Caring for Relatives (NPR interview)

NPR had a terrific series of interviews yesterday on caregiving.  One interview was with Cheryl Matheis, senior vice president for policy for AARP.  Here’s a link to it:

www.npr.org/2012/05/01/151745673/caring-for-sick-or-elderly-is-tough-on-the-wallet

Workers Turned Caregivers Lose More Than Wages
Morning Edition [3 min 7 sec] May 1, 2012

The average age of a caregiver is 49 years old.  In the interview, Ms. Matheis says that the “when a worker has to leave their job to care for a relative, they lose on average $325,000 in lifetime income — from lost wages, Social Security and pensions.”

A transcript is copied below.

Robin

—————————

STEVE INSKEEP, HOST:

As I was listening to David Greene there, I was writing down little phrases that I heard about Yolanda’s situation. It takes over your entire life, she said. And David pointed out that her career is on hold, that she’s burned through her entire savings. We’re going to talk a little bit more about the economic impact of caring for relatives with Cheryl Matheis. She’s with the AARP, vice president for policy. Welcome to the program.

CHERYL MATHEIS: You’re welcome.

INSKEEP: Wow. Difficult subject to discuss, here. What is the economic impact on people when they make this momentous decision to be the – almost the sole caregiver of someone?

MATHEIS: It’s actually huge. People who go through what Yolanda went through, essentially, when they have to leave their jobs, they lose, on average, about $325,000 in lifetime income from lost wages, lost Social Security and lost pensions.

INSKEEP: Even if they’re only off for a year or two, they…

MATHEIS: Well, that’s the average of what they lose. But remember, the older they get, the harder it is to get back into the workforce.

INSKEEP: Now, how sympathetic are employers in this situation?

MATHEIS: Well, I think employers are starting to wake up to this. But think about it: In 20 years, we’re going to have twice as many older people as we have now. So the average worker is going to end up being a caregiver. And if the employer doesn’t figure it out, they’re going to lose a lot of employees. And it costs the employee, but the employer loses a lot when their employees leave or when they are absent a lot. The average caregiver is 49 years old. That’s somebody who’s been in the workforce for a while and knows a lot about the organization and has a lot of skills that are hard for an employer to replace.

INSKEEP: If you are doing something that, in theory, might save Medicaid money – keeping your parent out of a nursing home – is there a way to get compensated from the government?

MATHEIS: Well, that’s hard. You can’t actually get compensated by the government, but there are some projects available now in Medicaid, including some through the new health care law, that help people get services in the home, services in the community. Those are things that can help people stay in the workforce and keep their older relative able to stay at home, so they don’t end up having to go into a nursing facility, which generally people don’t want to go into.

INSKEEP: Let me come back. At the beginning, you mentioned how many more senior citizens there are going to be, and presumably, how many more millions of sons, daughters, grandsons, granddaughters who may be caring for them. Do you think, broadly speaking, that employers and government officials get the scale of that problem?

MATHEIS: No. I don’t think they get it. I think they’re starting. I think people are starting to wake up to it, because right now, baby boomers are starting to turn 65. And at this point, we have 40 million people who are 65 or older. In 20 years, we’re going to 72 million, and those people are going to have to stay in the workforce because people are living longer, they’re healthier longer and they need to have the income that longer work provides. So I think employers are starting to realize it. But it’s something that everybody needs a wake-up call about.

INSKEEP: Cheryl Matheis is senior vice president for policy at AARP. Thanks very much.

MATHEIS: You’re welcome.