Evolving Home Care, part 1

Today, 80% of all long-term care is provided by family members and friends. This care is provided at home, and does not include hospitals, nursing homes and other institutions. Caregiving might include grocery shopping and housecleaning for a disabled parent during the week. Or, helping a loved one who is recuperating from surgery to bathe and dress several days each week. It also may include full immersion in providing 24-hour attention to an elderly parent or spouse struggling with Alzheimer’s.

The problem with this evolving model of care is that there are (or soon will be) fewer children to provide care. Today’s average couple has only two children, whereas earlier generations of their elders had four or more children in the family. Secondly, family members may not live nearby due to increased mobility, economic necessity, and relocation. Kids move out of state for jobs and schools, and may settle in another area. Third, there is an escalating number of singles without spouses due to rising divorce rates. (Approximately 50% of marriages end in divorce.) And finally, more middle-aged men and women continue to work for economic and/or professional reasons.

Meanwhile, on a daily basis, many baby boomers are coming to the realization that Medicare was never designed to cover long term costs. Even though the overwhelming majority of elders would prefer to be cared for at home, Medicare will only provide reimbursement for hospital and physician expenses. Medicare only offers limited support for nursing home and home health care. Another interesting fact — more than 90% of Americans have never discussed long term options, roles and responsibilities of family members. There is no plan for paying long term care needs.

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