Was having a discussion with some friends while playing games last night about elder care here in the states. One who lives in VA and is Korean asked how my LO was doing, and I mentioned they were in a NH. Granted, I know he grew up with his grandmother in their home when his grandpa passed. So knew we would have differing views, but he did bring up an interesting points that got me thinking.
Why exactly should the government be responsible for a person if they have family that is still alive? Should the government become the solution for poor planning? Where does the money come from to care for the elderly? At the very least he thought I was paying for my LO’s care, when I told him I do not this shocked him.
He asked how I went about it, and I told him I had to do the ER leave and refuse to take them home method. Which brought up the following point that hit me hard for a second, “So if you tried to place her without the ER would it have been possible?” In truth I do not think it would have been, they did not meet the requirements listed. We went on for a tad but essentially we went back and forth and I explained my reasoning for doing what I did, it was simply impossible for my LO to stay home, and I refused to give up my life to care for them.
Which saying out loud and not in text form does not come off as right, but that was the reasoning behind it. If they had money I would have gladly put in the time to find aides and allow them to stay home, but they didn’t and getting Medicaid to cover supervising care for safety is not exactly possible, not without me giving up some of my personal time to watch them.
My friend knows I make good money, and brought up a fair point if someone in the family has the money to provide care why should the burden be put on local and/or federal government to supply care if the family could supply the care? I get it is a cultural difference but their views got me thinking, we started to ask our other friends the same question.
We got interesting responses but it seems generally though those of us from the west, fell into the camp that burden to care for a family member should not fall on the family if they choose to do not so. While our friends that are from Asian or Latin cultures had strong feelings about taking care of family no matter what.
It was interesting because it seems both sides had a differing view of personal responsibility, on one hand in the west I would say our personal accountability is more so geared towards ourselves and our own I guess nuclear family, while the other side it extended to their entire family or at the very least to grandparents and parents.
I know this is a weird and slightly out of place, but just got me thinking being as this is a global forum I do wonder where people fall.
Suppose you belong to a family that looks after its own, would never place the burden of care on the state, considers it unethical and immoral to do so - but makes an absolutely crap job of it? Where does that leave you? Hidden in the bosom of your family, tied to your armchair to stop you wandering and covered in pressure sores, that's where.
It happens here too. A woman so proud of meeting her 'no nursing home promise' admitted she left her late 90s parents in their chairs (recliners?) in an upstairs apartment while she went to work. Left drinks & sandwiches within reach. Cleaned them up when home.
Yes she was reported.
"There is no such thing as society. There are individual men and women, and there are families." - Margaret Thatcher.
"If Margaret Thatcher wins on Thursday–
– I warn you not to be ordinary
– I warn you not to be young
– I warn you not to fall ill
– I warn you not to get old." - Neil Kinnock, then leader of the Labour Party.
No prizes for guessing who your Korean friend would have voted for, then!
(Mrs Thatcher did win, by the way. Which is why you've probably never heard of Neil Kinnock.)
One set of answers:
a) In all countries with a reasonable average standard of living and adequate health care, people are living far longer than they used to. The ways of the past were based on shorter lives.
b) In most countries in the past, and more recently in lower-income countries, the in-home care was nearly always done by women. Their care was ‘free’. That was women’s role, their work options were less, so losing their potential income mattered less, and they weren’t given other choices. In countries like the USA, this is not now the case.
The other set of answers:
c) We pay taxes to the Government, which should cover the costs of people in need. If they don’t cover the costs, Governments needs to reconsider its priorities and its tax structure.
d) Our many communities (government, churches, medical professions, families) have not come to consider the ethics of keeping so many older people alive artificially with such low quality of life. Or the ethics of spending tax payers’ funds on this, rather than other priorities for younger people whose lives can be ‘turned around’ - in part so that they can also pay taxes, rather than spend expensive time in jail.
"Governments needs to reconsider its priorities and its tax structure."
IF ONLY that could be true! There is so much waste, and despite being subject to voters' action, legislators can get away with it ....and still get paid.
Your (d) observation is so, so, so true, and sad, when quantity (duration) if substituted for quality.
I think the issue of "younger people whose lives can be ‘turned around" might be more controversial. When I worked in the Juvenile Court, and also based on comments from a friend who was a visiting nurse through the city education system, I was surprised how many people aren't interested in "turning around" their lives.
They just didn't have the family support needed, or they lacked confidence in themselves, or a lot of other reasons.
There is no all right way or all wrong way, just different ways...
Issues around childrearing, affording education & housing, caring for elders affect us all. They change too.
Two centuries ago my people had 10 or so kids, unmarried aunts or grands minded the babies, older kids cared for the younger kids, by 12yrs they were off to work, the old or infirm moved in with relatives. 50 was OLD.
These days- if I quit my paid job to care fulltime for old & infirm relatives, it would leave my children without.
The simple answer is I have to use the help of non-family helpers.
It's maths: The base of support differs.
There are just not 10 adult kids + offspring to support 2 elders..
it's 1 to support many on top!
"Our government sees no problem printing MONEY to finance whatever wild hair they get up their butts,..."
If you want to read something unsettling if not shocking, read the FARS (Federal Acquisition Regulations) , the requirements and guidelines for federal procurement.
https://www.acquisition.gov/browse/index/far
When I worked for an agency that received federal funds, I had plenty of time before our project went online, so I read the entire manual. I was shocked at the special interest clauses buried in the rules, which had nothing to do with federal procurement, but did have cushy provisions for various legislators' home states. It wasn't hard to conclude that these pork barrel projects were buried in something most people never read.
It was really disgusting to see how legislators can manipulate legislation and get what they want. But it's not surprising.
By that time, the senior and family are fully primed to think that the government will just subsidize the level of care a senior and their family are now expecting.
To be frank, culturally it is simply too long an explanation.
Care for our elderly and how good it is when provided by our government is again a whole other issue.
I think I would simple say to my Korean friend: "Hon, you have 1,000s of generations of doing things a certain way. We have not quite so many, but we have a few generations of doing it a whole other way. Far be it for me to even begin to try to explain the differences in our cultures. Not for elder care. Not for marriage. Not for child rearing. Not for politics. And not for anything else".
Then I would smile sweetly and offer tea.
I do agree that is just not how it works here and it is interesting to me to see how it works elsewhere.
Our government sees no problem printing MONEY to finance whatever wild hair they get up their butts, so they can ALSO finance old folks' lives in care as needed.
Old folks lives are valuable, no matter what you or anyone else may think, and whether they saved 'enough' to finance their old age at ASTRONOMICAL costs is neither here nor there, really. It's like asking if a $250,000 bill for a surgery in a hospital is fair, and whether you should be expected to pay it b/c the hospital billed you for it and you didn't have insurance? If you aren't expected to pay IT b/c you can claim indigence, then by God, I should not be expected to pay for long term care at $12K or more PER MONTH in a SNF if I don't have the funds to do so either.
As proven countless times when it comes to spending money on the people government will always count pennies. Aren't we shooting future gens in the foot if we try to bleed the stone dry now. Costs are only projected to go up. I fall in your camp I will not give up my income to pay for my LO's care I will rather share the cost across the board of tax payers but on the same token I do know that is not viable long term.
Jokes aside this is a complex subject and coupled with the end of life thread it got me thinking. As per example my LO is in SNF, and supposedly they bill medicaid little over 5k a month, and my LO is 66 and has no underline health issues so 10 to 15 years, so anywhere from 600 to 900k. I has got me thinking where exactly does the money come from.
Also the point of inherentiece is interesting, cause that was something that was brought up. I was shocked how alone I was when it came to a parents wealth should go towards their care, many did feel that a parent should be able to pass on that wealth especially properly. Granted, many of my friends come from older money and not no one else is going through what I am since we are younger, many of us are not even 30 yet, oldest is 32. Will be interesting to see to see if their position changes as their parents age.
Point of SS is also a fair point and brings up a concern I have, birth rates are lower and with us living longer that means larger costs. Can our government sustain this? Not sure tbh.
Saving for retirement is also memed on in our group. Many live in the moment, saving for the possibility to be able to do things as you are older just does not make sense to many in my circle. As they say "Why would I want to do things when I am a washed up 60 year old."
I am a little obsessed about savings, investing, property etc... I hate spending money I still drive the same used 08 civic even though I make good money. So I also get a lot flake. It does seem saving is not something that is relatively common anymore. Either by choice or inability.
There is definitely a group that the government would do well to step up some really helpful end of life care. However, the government is not good at doing it, are they?
(That reminds me-of you caregiving your veteran father.)
The Vietnam Vets really got shafted and didn't get the respect they were due. It wasn't their fault that we got mired in an unsolvable situation.
I pay BIG taxes in NJ. Property, Sales and income tax. Our lottery is suppose to support Seniors and schools. So there is money there to help those who don't have money for care.
I don't feel qualified to judge other people's morals, or ethics when it comes to caring or not caring for their elderly family members.
However, it did seem right, loving, and honorable that my friend's siblings each contributed to their mother's care in an AL home, but there were 5 of them.
That describes only one situation. My view from my tiny life is limited.
I would need to think more about this question/discussion.
Have you seen this documentary about the Korean Pastor who has saved many abandoned babies? A culture that values seniors, or at least wants to save face by providing care to seniors in the home, is also a country that has few supports in place for single mothers. Including access to birth control to prevent the pregnancy in the first place.
It is very easy to pick and choose our morality and ethics. I have reached the age where I have observed that when an action can be seen by others, like senior care, it will be judged by others, at times quite harshly. But hidden actions seem to operate on a different scale.
I am Canadian and one of the differences between our two countries are social programs, such as 12-18 months maternity leave (federal), subsidized daycare (Provincial) in some provinces, healthcare and some publicly funded spaces in nursing homes, (Provincial). We pay higher taxes to afford these programs.
I am in BC and there are large Asian populations in SW BC. Within these Asian communities there are nursing homes, where the staff speak the language, food and culture are respected. An elderly Aunt chose to move into a Chinese nursing home, as it had the best reviews. She was not Chinese. Although South Asian families may live in mutligenerational homes and keep their seniors at home, it is not easy.
Another issue in Southern Ontario and BC, is that the cost of housing is through the roof. If a family has a mortgage, both parents need to work to cover the cost of housing. My house, which would be a family home in what used to be a low cost of living community would easily sell for $650,000. The value has doubled in 3 years. Although it is a family home, and large at 1800 sq/f with up to 5 bedrooms, there are stairs to enter it and the bathrooms are not accessible to someone in a wheelchair or using a walker.
Back to when a person starts working.
People do not think about what happens in 30, 40, 50 years.
So people starting do not save for retirement.
So many take it that Social Security IS their retirement fund. It may have been when people had a much shorter lifespan. We now live more years retired then we worked.
It is unfair, irresponsible for a parent to assume that it is their child's responsibility to care for them when they get older. If that means application for Medicaid then so be it.
I have saved for my retirement. I have planned and IF and or when I need care I can afford it part in thanks to the insurance I am currently paying for. (would I like to do other things with that money...you bet I would)
I want to make the choice to stay in my home or if necessary I want to pick where I will have to go in order to be cared for safely. I do not want my family having to make that choice nor do I want a Court appointed Guardian making that kind of decision for me and I sure as heck do not want Medicaid to select where I have to go.
This is not to say ALL places that accept Medicaid are substandard but I want the right to chose.
I will say that a caregiver in a facility is not going to treat Ms. Smith in bed A any differently than Ms. jones in bed B simply because 1 happens to be on Medicaid. The food for Ms. Smith and Ms. Jones is going to be the same, the shower they get is the same, electricity is the same, the water the same......
You must have some fun game nights.
What do you do for a serious discussion?😉
As to whether or not government should "become the solution for poor planning", I think first, and I write this nicely and not to be critical, you're assuming "facts not in evidence", specifically that poor planning is or was involved. I think that's a contemporary view, arising from a variety of life changing situations over the years.
Additionally, I'm not sure how much any level of government should be a "solution" for poor planning, for a variety of reasons.
In addition, some people don't know how to plan, not only for elder years, but also for daily life. That's not a criticism though; it's an observation. Some people can be geniuses but have little or no ability to manage finances.
I don't have supporting data, but I do think that's true as society becomes more oriented toward possessions, accumulation of goods and/or assets, and more focused on the here and now as opposed to the future. We also haven't been through a depression and experienced the horror of not being able to buy what we needed. And there obviously still are people in this dire situation.
A few weeks ago I watched a news clip in which an anchor on one of the major broadcast stations interviewed a woman who complained of harassment by the police. She was dressed "to the nines", beautiful jewelry, hair style which seemed to be professionally done, expensive looking clothing...very attractive and professional appearing.
But she felt she was being discriminated against b/ she had had no vehicle insurance (couldn't afford it), and had other similar vehicle charges against her. I don't recall whether or not she even had a driver's license. I could feel no compassion for her b/c she made a choice and spent her money foolishly, not even considering that drivers have obligations to themselves and others to at least carry liability insurance.
My point is that expenditures are often a choice, not a mandate. Similar circumstances can exist at the government level. Beyond voting, or being active ourselves, what control can we exert to ensure that "wise" decisions are made? And that applies all the way up the government ladder, as well as to small governments in smaller areas.
A close example: the local government decided to create a "downtown" attraction for residents. It created the "attraction', closed off local streets, and traffic rerouted itself down 2 adjacent streets, that already were heavily traveled b/c the "government" did nothing about controlling traffic, especially speeding.
The noise level increased drastically, affecting not only air quality but safety. Accidents occurred on what was previously a quiet street. Potholes and cracks in the pavement developed. Garbage thrown out of cars appeared more often.
Booting out the politicians isn't possible b/c no one runs against them any more.
I wouldn't want any of these characters making decisions on my end of life treatment. And that's one of the drawbacks of government involvement, i.e., the caliber and intelligence of some of those involved in decision making.
OTOH, are all families in a position to create care opportunities for their own families?
You raise a complex scenario. I know that I certainly wouldn't rely on the federal government for my care. I don't even bother with the community senior center b/c I've seen what it has to offer: not much.
On the issue of "poor planning", I would suggest that the federal government hasn't necessarily demonstrated good planning; it's driven by political interests, by self interests and client interests. There are some dedicated politicians and ones who understand the need for real legislative action that addresses those in need. But they face off against self interest.