The coming crisis of seniors taking care of seniors
As the leading edge of the baby boomers begin to turn full retirement age in seven to eight years, a new problem this country has never seen before will begin to emerge.
In fact in the early war baby crowd it already has. It is the problem of large numbers of senior citizens, taking care of older senior citizens, their parents.
While this situation has always existed, the longer life people enjoy now and the pure numbers of people that will be living will make it more and more tricky to get through those times without difficulty.
The war babies and boomers have enjoyed uprecedented attention over the years. Whole industries have changed because of them. When they were babies fortunes were made on selling their parents baby food, toys and clothes. When they were teenagers, even the powerful auto industry changed as they matured because they wanted muscle and sports cars. As they reached middle life, health and fitness became huge businesses, along with the vanity industries. And now as they all turn into seniors, that market will change too, with youth products, independent living and conveniences catering to them ever increasing. Along with that, they, being the single biggest influential and political force in the country, will also pull their parents and their children into their old age with them.
That's because the boomers will be taking care of older parents, while their children will be paying taxes, social security and other costs of their own parents getting old. It will all become much more complicated than it is today. In effect, to parody Hillary Clinton's observation about children, it will take a village to care for seniors in the future.
That means the planning is extremely important. Many people often use the phrase, "I'll cross that bridge when I get to it," but in this case that will be impossible. If planning and execution of principles and specifics are not done years in advance, there will literally be no bridge to cross when the time comes.
A number of issues need to be addressed. Obviously finances are one area: financial independence is surely one thing, when lost, will cost many older people their dignity. Another is health care. No matter how healthy people are in their old age, costs will almost always go up, particularly the closer they get to passing on. Next is facing the inevitable. Parents who may not die may face a myriad of choices in care and housing. True some people can stay in their home until the day they die, but others will have to have other alternatives. Knowing the resources available for this and all other alternatives is an important part of being a child taking care of older parents. Finally there is the final curtain. Most people seldom know what their parents really want for final rites. Often, it can be overheard at funerals, someone who was closed to the deceased saying, "This isn't at all what he wanted for a funeral."
War baby and boomer children tend to refrain from asking their parents questions about their lives. They don't want to pry; they feel that it might be too snoopy or parents might get upset and feel like the children are trying to take away their independence. But asking questions is necessary; knowing the truth is important.
Financial concerns. Here are some facts that can startle, but can move people to action. First of all, at the present time the median annual income among households headed by someone 70 or older is under $19,000. The median net worth of those same households is around $135,000. To someone who is 16 or 17 years old right now that seems a lot of money. To those 35 and above it neither figure sounds like much at all.
But it isn't all about how much is coming in or how much people have in the bank. It is also about what their needs are, how they manage it, crisis that arise and problems that crop up. Much of the time children of seniors don't even realize there are problems with their parents finances. In some ways boomers are as "up in the night" about how well their parents are doing financially as their 16 year old son or daughters are about their parents finances. Children also need to understand that often seniors are vulnerable to attacks on their finances. For instance, 26 percent of Americans that are victims of fraud each year are over the age of 60. And when it comes to being taken in by con artists on the phone 61 percent are over the age of 60.
Of course asking direct questions about finances can be tricky, so one of the best ways to see if an older parent is having problems is to watch for some signs that generally reflect changes in their habits. If parents never failed in the past to get new glasses when they needed them or go to the dentist when they should, but suddenly stop, it could mean they are having financial problems. Another sign of this is problems with utilities. Are they getting "pink slips" from the power or gas company or have they even had one or more of their utilities shut off at one time or another? Look for life-style changes too. If they used to make a trip to Wendover three or four times a year to play the nickel slots suddenly comes to a halt, maybe they are having a hard time making ends meet. Basically if they stop doing something they really like to do that they did in the past on a regular basis, ask some questions.
The medical problems. Medical concerns are not confined to maladies and conditions parents may have. Little can be done about that except to help parents through treatments and make sure they follow regimens that doctors and other health care providers suggest. The big problem often has to do with finances once again.
What is available from Medicare? What is Medigap insurance? If someone needs a great deal of care, does everything they own have to be sold before any government programs take over? And what about expensive hospice care?
Most people don't know that Medicare comes in three parts: Medicare A, B, and C.
Medicare A usually covers hospitals. It can also cover some kinds of short stays in nursing homes, home health care, and some kinds hospice care. It may pay for some services in an assisted living facility, but not for the stay itself. This usually kicks in at 65, although some younger people do get on it for certain kinds of disabilities and diseases. It can be applied for after a person is 64 years old, based on a certain month period. Depending on the length of the stay and other circumstances there are deductibles that need to be met; deductibles may be based on length of stay.
Medicare B is part of the plan that pays for services. It includes paying for some out patient services, some doctors services, lab fees, possibly some prescriptions and for medical equipment the person may need. Generally this pays for 80 percent of approved services, so this means doctor bills and bills for other services will come in.
Medicare C is a supplement that people can buy to supplement the other two sections of the plan. Enrollment in C is contingent on being enrolled in A and B as well. Some of the coverages in this play depend on the locality of where the person resides. Some may be HMO based while others may be fee for service plans.
Another kind of insurance is Medigap. This is totally private insurance that helps to cover things that the original medicare plans don't. It may be used to cover high cost items or to plug the holes when bills start to appear. Some even help with prescription drugs and other kinds of outpatient care.
Medicaid is for low income people over 65 or the disabled. There are restrictions on this program and the programs vary from one state to another because they are a joint program of the federal government and the state where the person lives. Coverage also varies for the same reason.
However, it isn't all finances and insurance. It also consists of keeping seniors as healthy as possible by paying attention to a seniors overall health, by picking the right providers and by being able to communicate with those providers.
First of all, help seniors pick their regular care doctor carefully. They should be able to pick a physician they are comfortable with. Many of course have had the same doctor for years, but should they relocate, they may need to change. Also remember that doctors are people. Their lives move on just like everyone elses; they retire, they quit, they die. Usually someone else will take over their practice, but just don't let a senior pick that person because he is taking the reins from "Dr. Smith."
A doctor's attitude about age is important. Just because a doctor is older doesn't mean he has more empathy with a senior, just as just because one is young they have less. Get a doctor who doesn't think old means necessarily worn out. Doctors who are trained in geriatric medicine are often the best, but the senior must be comfortable with the physician.
When visiting doctors patients and their caregivers should be communicative. That doesn't mean listening to the doctor and doing exactly what he or she says. It means bringing along information including doctors the person has seen (if it is the first visit) medications the person is on and all the health concerns the person is experiencing. Most importantly ask questions; pointed ones. Be sure concerns are addressed. If a doctor does not want to address a specific problem, maybe a change of doctors or a second opinion is in order. Don't accept a problem as just being "old age" unless it is explored completely.
Part of all of medicine nowadays is prescriptions. It not only tends to be one of the most expensive part of health care for seniors, but it also is the part that affects them every single day. Know the medications the senior is on and the doses. Watch those doses. Sometimes it is easy to get two different pills mixed up, much less the six or seven most seniors have to take.
Finally know what the senior wants should they not be able to take care of it themselves and secondly, always be prepared to act. Make sure to have a list of what the person would like done should they lose the ability to direct their own care. It is best this comes in the form of a living will or a power of attorney. The power of attorney also helps with financial concerns and business dealings.
Everything that has been written here is much more simplistic than real life will ever be. The crisis of seniors taking care of seniors who in turn are being cared for by their children is a very real future, one that planning and foresight can make easier but never simple.