Some think of the generation of Baby Boomers (78 million people were born into this category) as being healthy and independent. But is this accurate? Are Boomers more healthy or less so than their parents’ generation? And how do these facts affect the Boomers’ adult children, and even grandchildren?
According to the Journal of the American Medical Association, or JAMA, “Despite their longer life expectancy over previous generations, US baby boomers have higher rates of chronic disease, more disability, and lower self-rated health than members of the previous generation at the same age.” For example, JAMA reports that Boomers have higher rates of obesity, high blood pressure, diabetes, and need for multiple medical professionals to address their health needs. This indicates more chronic illness that will require care. How aging adults get that care is our concern.
Long Term Care
With a Boomer generation with the reputation of being somewhat rebellious, and independent thinking, few in it seem to clearly reckon with the idea of losing their independence. But that is what happens. Online resources are full of stories about how difficult it is for those with young children of their own to also take on the burden of caring for aging parents. The younger offspring are sometimes shocked to discover that Medicare does not pay for any kind of long term at home, the very sort of care that would actually keep an aging parent from needing a hospital or nursing home. Families must often shoulder the burden of care, whether paid if there are resources to do so, or give the care themselves if adequate funds are not available. It is very expensive to pay privately for home care.
Real Life
Here is an example. Grandma, age 76, lives alone in her small, cramped home. She is disabled by numerous chronic health conditions, and has been trying to manage them without help over the last two years. She can’t walk more than a few yards without holding onto something. She can’t bathe safely by herself. Her hands don’t grasp well any longer due to arthritis and pain. She has trouble dressing herself, cooking, and using the bathroom. She has managed healthcare in a plan that does have a home health care component. She spoke with her doctor about getting a helper at home. As long as she can get out the door, even crawling, she is not considered “home bound” and no help is available at all from her health plan. It does seem irrational that the health plan will pay for surgery if she falls and breaks her hip but not for anything that would keep her from such a fall at home. She can’t afford to pay for a helper at $45 per hour, the local going rate, out of her own pocket.
What Family Must Do
Grandma has no capable family nearby. One grandchild lives 3 hours away. Others are also elders and have their own health issues. So helping Grandma will take coordination of efforts by many, each doing a little to pitch in. Here is their family’s plan.
Granddaughter will make a monthly trip to spend a day to assist with chores Grandma can’t do well or at all: shopping, meal preparation, laundry and house cleaning. Two capable siblings can help her walk around outside, with a walker, each on a different day, so she is not so confined. Their health issues will not interfere with that small chore, even if they are also older. Fortunately, they’re more steady on their feet than Grandma. Those with means will pitch in and hire a home caregiver to help Grandma with her bath, the most dangerous activity she does, three times a week. They all agree that Grandma needs either a smart watch that will call for help if she falls, or another wearable device that has that function. Those on the list of whom will be called have agreed to receive any emergency information.
When There Is No Family
The worst off Boomers are those who have no family, or none nearby or trustworthy. They have no one who can provide the hands-on care they need to stay in their own homes. They may have to spend down all their assets to then qualify for Medicaid. It will pay for a nursing home and that’s about it.
The Need To Plan
For anyone who has aging parents with multiple chronic illnesses, such as cardiac disease, diabetes, high blood pressure, obesity, and chronic pain that interferes with their daily lives, it is essential to look ahead. You need to come up with a plan. How would we, as a family, care for this person if they become unable to manage at home without help?
Sometimes, families start a savings plan to pool resources so they can pay for care at the aging parent’s home. It makes sense to have funds in reserve for this purpose even if collected a little at a time over years. Others agree to rotate with personal care, sharing the physical tasks with siblings or friends. For others, there is no alternative to the aging parent running out of assets and having to live in a nursing home.
The Takeaways
Multiple chronic diseases, taken together, often lead to the need for long term care. Most aging loved ones want to stay in their own homes, sometimes making family promise they’ll never “put me in an old folks home”. Sounds nice, until you have to do the actual work yourself to keep them safe in their own home. It can involve heavy chores with personal care. If you aren’t interested in that labor yourself, have a meeting with all concerned and figure out how to avoid the thing you promised you’d never do—put them somewhere outside their own home. Loss of independence has its price.
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