A few weeks ago, my mother turned 102. After the celebration, she kissed my cheek and said, “You are a good daughter.” I always feel guilty when she says that because I’d promised myself, years ago if she lived long enough to need round the clock care, I’d refuse to allow her to age in place. Fortunately, she knew nothing of my decision and decided to move to assisted living on her own. Being a Latin, I suspect she was too proud to accept a reversal in our caregiving roles. Whatever her reason, I honor her for being a good mother and allowing me the freedom to live my life.
Callous as my early decision was, I believed it to be the right one. By her mid-seventies, my mother was beginning to need help. The doctor wanted me to push her to exercise, change her diet and remind her to take her pills. Whenever I did, the two of us exchanged heated words. I couldn’t imagine how she’d react to losing her dignity: to a time when I would bathe her and change her diaper. That she chose to move into assisted living made it easier for the pair of us to go on loving one another without resentments. My job now, and it is an onerous one, is to be vigilant about the quality of her care. I’m lucky. From the start, the staff at her facility has been kind to her. After 15 years of living among them, they no longer see her merely as a patient. They call her “mama.” Their affection, I am certain, is one reason for her extended life.
The other day, a retired woman, considerably younger than I, said she wasn’t sure she could rely on her children to provide home health care for her, should she need it. Nor was she certain she would want them to. Wise mother, I thought. The sooner she plans for her coming dependence, the greater her chances of having some say about her future. One asset I suggested she consider was long-term care insurance. A little extra money would help at a time when she would need extra care.
Surprised, the woman said she assumed Medicare and Medicaid would pay the bills. Her assumption is common but wrong. In most cases, Medicare won’t. Medicaid will after you’ve exhausted your money. To confuse the two entitlements is to learn a bitter lesson when a person’s back is already against a wall.
Given the explosion of the elderly in this country, I’m doubtful enough help exists to accommodate everyone who desires to age in place. One home help agency reported it had 14 million registered consumers but only 11 million home care aides. (“Who Will Care For You When You Are Old?” by E. Tammy Kim, Bloomberg Businessweek, Feb. 12, 2018, pg. 51.)
Congress shows no appetite to increase spending on either Medicare or Medicaid. That means compressed wages will make it increasingly difficult to find home help. Given that reality, my advice to anyone is to plan for their frail years. Of course, the wealthy, or those who have children who are saints, or those planning to die young, needn’t bother.
(Originally published 7/25/2019)