Posted on 10/22/2011 4:28:52 AM PDT by Kaslin
Last week, the Obama administration dropped one of the signature provisions of its healthcare plan. The CLASS Act (Community Living Assistance Services) was intended to provide affordable insurance for long-term care to individuals who, because of infirmity or age, could no longer care for themselves. But the reality that not enough healthy Americans would sign up to make it self-supporting finally doomed the program.
Many opponents of Obamacare will no doubt cheer this turn of events because it confirms the view that we cannot afford to, in essence, nationalize health care. I agree --but I also recognize that the problem that the CLASS Act was trying to address is a legitimate concern for which we now have no workable solutions.
The nation faces a looming crisis in caring for the elderly, whose life expectancy often exceeds their ability to live independently. Millions of Americans need long-term care, but we currently have no system that adequately provides it a cost that most Americans can afford.
This topic holds more than public policy interest for me. Three years ago, my then-87-year-old mother came to live with me when it became clear that it wasn't safe for her to continue to live on her own. Although in good health, my mother is virtually blind and quite frail. She values her independence, prepares all her own meals, has excellent long- and short-term memory and follows the news avidly. But without daily assistance, she could not shop for food, get to the doctor or clean her own living space.
Last week, however, her situation changed dramatically. After returning from a doctor's visit, my mother fell on the last step of a steep climb down from the car to our home. I was just a few feet away from her when I heard her hit the floor. In that instant, her life and future changed dramatically. She broke her hip -- the scourge of the elderly -- and within 24 hours had undergone partial hip replacement surgery. Three days later, she was released from the hospital.
Medicare provides coverage for up to 100 days in a rehabilitation facility so long as the patient needs daily services that can be provided only by a doctor or nurse or is receiving the rehabilitation therapies provided and making progress. But when the 100 days are over, the patient is on his or her own. My mother is now in an excellent rehabilitation center in Boulder, Colo. -- but it's unclear what will happen when she's released.
If you're very wealthy and can afford upwards of $60,000 a year in private, long-term care, the alternative of an assisted living facility is available. But what if you don't have those means? I would gladly take my mother back into my home, but I don't think it's feasible for her to continue to live there. If we can manage to get her down those same steep stairs and into the house again, she'll be trapped there indefinitely, unable to go to the doctor, grocery or anywhere else except to the hospital if she falls and injures herself again. And she'll need someone with her 24 hours a day.
Since my mother has never owned a home or any other assets -- only a meager Social Security and Veterans' pension and the help I've provided since my father died -- she is eligible for Medicaid. And unlike Medicare, Medicaid does provide coverage for long-term care. But having visited the local facilities that accept Medicaid, I can tell you the decent ones have long waiting lists -- a year or more -- and the ones that don't have waiting lists break a daughter's heart. I simply cannot imagine putting her in one of these crowded, dreary, hopeless places.
Currently, 40 million Americans are age 65 and older, and of these, nearly 6 million are 85 years of age or older. One in 5 elderly Americans are currently considered dependent, but the proportion will grow to nearly 40 percent by 2050. We continue to expand the frontiers of life expectancy, but we have yet to figure out how to care for our ever-growing population of older Americans.
The administration's failure to come up with a feasible plan to solve the problem is no cheering matter. We must find a way -- not only for our parents but for all of our sakes.
ping
If you want to believe the affluent Ms. Chavez couldn’t install a ramp, go right ahead. It’s easier than moving. I’d sooner do either than consign my mother to a nursing home.
There’s an old saying in Europe, about the dog having innumerable reasons to assault its own mother (or words to that effect).
Yeah, long term care policies are very good. My sister has one. They usually recommend you get one by the time you’re 50...problem is with diseases like MS, you’re often diagnosed much younger than 50 and once diagnosed, or even being tested because of neuro problems, you won’t qualify for coverage.
It would make a killer mini-series.
I’ve been wondering for ages why more homes are not designed with this sort of thing in mind. If you’ve found/built the home you mean to die in why not make some architectural provision for this sort of thing?
In those damn McMansions there is certainly space for an elevator. I notice the front door is usually up a flight of narrow brick steps but the garage door entrance is easy enough. Even if one thinks one is gonna live forever one might make provision for that busted leg or two.
Even disabilities aside, you would think it obvious to make access easier and front doors wider with furniture moving in mind.
Thanks for that, too, Big_Harry. My own town (DFW area) has a really great Senior Center that has lots of activities. He’s hung out up there one day so far and didn’t really like it much. Lots of folks there, however. He isn’t from here, and it will take a while for him to get accustomed to it and meet new people, but I have faith that when he gets in the routine, he’ll eventually look forward to it.
I’ll check out some of the other resources, also. It’s just like having another kid around for me. My 3 kids are very far apart in age and I’m in my 50s. I’ve been raising kids my entire adult life. ;-) My husband and I do get out sometimes, tho. Dad can be left alone at home for an evening or a day. No more driving, though.
It sounds like you have it under control. Enjoy your dad while you can.
*hat tip* Sir...
Thank you for your kindness.
There is an older saying "No amount of reality will convince the lunatic"
Have a lovely evening ma'am.
But bathrooms are the worse. We often have to gut and rebuild. There is no way to get a wheelchair into your average bathroom which means that you have to get one of those "potty chairs". Talk about being stripped of your dignity.
I think there is a market for homes that are built to be handicapped friendly. And I think it is going to grow.
I’ve often wondered if handicap-friendly design and contracting was a profitable specialty.
I’m sorry to hear that. I know that MS is a nasty disease. My cousin’s son was diagnosed with MS about 2 years after he finished college and it is really debilitating.
I hope and pray for a good breakthrough in the treatment of MS soon.
As for Chavez (presuming you aren't!), she kept her mother until it became inconvenient to do so. Mom with mobility, acceptable. Mom with not so much mobility -- adios.
But of course she doesn't say, Mother, you're more bother than you're worth to me. She says, Mother, you'd be trapped here. I set you free!
It’s hard to find a residential elevator under $10k, or even a dumbwaiter (which for all other purposes is much better!) but the expense is not too outrageous, considering the alternatives.
People put on additions for teens these days, for home theater, for man caves and lap pools and so forth. They say it enhances the home value, which often is simply untrue. But then they balk about making it more accommodating to the elderly.
The elevator is problematic, anyway. You need to run it by code enforcement, and there are different systems to choose from, and installers limited to a handful. But any decent contractor can make an addition on very little footprint, widen some doors, add a ramp. An accessible shower, a laundry sink with jets, a toilet — not a budget killer, and way cheaper than Shady Pines.
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