Guess what: if you pay someone to help take care of grandmom, it costs more than if you just drive over and help her, but the largest expense if grandmom is so fragile you need to take care of her in your home.

In other words, if you pay a caretaker to take care of granny, you spend more than if you go over and give her a bath, do her bills, and clean her house yourself.

Thanks to the NYTimes article we are informed of that obvious fact.

Two problems:

one, if you pay someone to do it at a distance, you are not a “caretaker”. Many people in the US must move to make a living (one of the problems of capitalism) so this is sadly necessary, but don’t equate this as “caretaking”.
Two: lots of those caring for the elderly in their homes have done so because they prefer taking responsibility rather than to place granny in a nursing home: because she is too sick for merely having outside caretakers.

Many of these caretakers use paid caretakers to help in chores (bathing, nurse visits instead of doctor’s visits, and housecleaners) so that they can continue doing so.

And the majority of the elderly are able to stay in their own homes or in assisted living facilities because these caretaking services are available, and because a relative or sometimes a friend, is willing to take time to check up on them regularly.

Caretakers include nurses to check medicine (often weekly visits), nurses aids to help in bathing and personal care (often one hour two or thee times a week), meals on wheels (one meal a day) and housekeeping (once or twice a week). Few people have full time caretakers, and few people can pay for them. Assisted living arrangements help independent elderly in shopping etc. but most people have friends or relatives who spend time, sometimes daily, in visiting and doing chores or various jobs.

The article, in my opinion, underestimates the financial burdens.
The dirty little secret is that if you want a “free” nursing home, just spend all of granny’s money and Medicare will pay for one if she’s broke.

But few elderly want to spend time in a nursing home because the care is impersonal and even in the best homes, it is seen as a place to wait to die rather than a place to live.

That is why our patients often sacrifice much to care for their elderly and chronically ill relatives. Often they spend time running over and checking on their health and well being, and services such as home health visitors and meals on wheels enable many to stay at home or in minimal assisted living facilities rather than go to nursing homes.

Some people take in relatives, but most elderly prefer to live nearby on their own, especially since modern homes may lack enough bedrooms to care for loved ones.

The ordinary heroism of ordinary people who sacrifice for families is something rarely covered, and I am happy to see that Congress will be holding a hearing investigating how these families can be helped to continue doing the job.
Yet I have more problems with the NYTimes article.
The article, you see, is not about the financial problems of caretakers, but about getting tax cuts so that families can spend more on outside caretakers.

I agree. As a Democrat, social spending is high on my agenda.

But it is not made clear until paragraph five.

The article was not an investigation, but a paper published by a group whose aim is to (what else?) have the government give tax breaks to caretakers. And the paper was co sponsored by a Health care group that “coordinates” care for the elderly….

Translation: If families receive tax breaks to pay for caretakers rather than do it themselves, this group could potentially make lots of money if the tax breaks allowed people to afford more putside caretaking.

So the article is not really about the sacrifices by family members, but about politics, and another program for big government spending.

Translation: it will help Hillary’s campaign.

Yet there will be little help to those who sacrifice income to care for their elderly relative, either in their home or helping those who live nearby.

… 37 percent of survey respondents (compared with 16 percent in the 2004 research) who had to quit a job or reduce their hours due to caregiving responsibilities…

So the biggest winner will not be the ones who sacrifice income and time and money to care for an aging loved one, but Health care businesses and those who run and administer the work.
On the other hand, there are a lot of nice Philippino nurses who can’t pass the test for a US RN license who would love to have a green card to come over and care for your grandmom, so I guess I shouldn’t complain.


Nancy Reyes is a retired physician living in the rural Philippines. Her website is Finest Kind Clinic and Fishmarket. 

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