Sunday, April 13, 2008

Eldercare: adult children face the "pay your dues" rule

In the Sunday (April 13, 2008) Business Section, p F1, The Washington Post today runs a hard-hitting column by Michelle Singletary (in “The Color of Money” series) “Pay Your Dues When Your Parents Age,” link here. The column continues on p 3 with the secondary heading “Looking Out for Mom and Dad.” The author appears on National Public Radio on Tuesdays at here.

The heart of her essay appears near the beginning, “… my pastor recently suggested that adult children should set aside money in their budgets to take care of their elderly parents.”

She tries to make light of it, telling us about a fast-food place conversation with her own three kids, and concludes with “I may joke with my kids about taking care of my husband and me in our old age, but we are very serious about making sure they can if they have to.”

First, I love her “pay your dues” phrase. I have an essay on my main site “pay your bills and pay your dues” that seems to tie into this, here. That dates back to 2004 and I nuance what I say there differently today. “Pay your dues” is one of the most popular search arguments appearing on the Urchin reports on my site. I know people are more worried about this than the politicians will admit.

The columnist goes into the challenges posed by the financial world today. Adult children may well have their hands full with their own needs, with unemployment, upside-down mortgages, gasoline prices, their own health issues, and all the familiar economic problems. Most of all, they may be overwhelmed with the financial and personal responsibility of raising their own kids (hence the new term "sandwich generation"). The “individualistic” culture of today does not make this too easy, and often views these difficulties as the results of the parents’ “choices.”

But that’s part of the rub. Some people (me included) didn’t have any children. Some people were only kids (no siblings – me again). Of course, it doesn’t take much to see how this argument applies to many LGBT people.

There has been some talk recently in right wing circles of “demographic winter” (a book review here goes into that). Although that line of thinking is concerned with international political consequences of demographics that may affect Europe even more than the United States, there is still a big demographic shift going on here. As a whole, middle class (and above) people have fewer kids (and the increased social acceptability of LGBT lives is a factor), while people live longer. (It should be born in mind that the average life span is also rising because of lower infant mortality; there have always been some people who live a full century or more.) That would be great if all the elderly were like those select centenarians on Barbara Walters 's recent special “Live to Be 150,” but in fact many people, especially women, are living for years in frail and disabled condition in old age when they would have passed away soon earlier. Part of the problem is that medicine can keep people alive longer, and physicians feel pressured to prolong life for its own sake. At the same time, lifestyle changes (diet – “underfeeding – that fast food trip again!” -- and exercise) have not protected the current elderly as much as they may for future generations of elderly. The result is that adults who have never had their own children can be faced with long periods of eldercare, not so much (or not only) the financial issues but also the issues of emotional connectivity with elders who do not understand today’s individualistic culture. Think about the 50s movie “Marty”. In earlier eras, the unmarried (especially women) were expected to hang close to home to care for aging blood relatives (not always parents) but typically they did not live as long because medicine could not prolong their lives then. I cover some television programs on aging (including Barbara Walters as well as PBS’s “Caring for your Parents”) on my TV blog, April 2008, between April 1 and April 9, here.

The eldercare issue also challenges our ages old equivalence between sexuality and responsibility for others. It’s no longer true that responsibility to provide for someone else besides oneself occurs because of an act of (heterosexual) sexual intercourse conceiving a child. One can exist without the other, “in either direction.” In fact, it never really was true, That confounds the way we think about “public morality.”

The workplace also figures into this. In the United States, we do have a mandatory provision for unpaid family leave, which would cover eldercare (parents) as well as child care and maternity / paternity. In many European countries there is mandatory paid leave, and we’ve never figured out how they make it work. (And the Euro is doing a lot better than the dollar now, as even the Fed notices.) But, at a psychological level, going to bat for parents in the workplace is testy for someone who did not have his own children.

One legal fact that most columnists miss is that around 28 states have “filial responsibility laws” or “poor laws” which can compel adult children to provide for indigent parents (who would otherwise use Medicaid, even when there is no pre-inheritance look back). On this blog, my coverage of that issue appears with the label below.

Long term care insurance is, of course, relates to this discussion. But one problem is that long term care insurance does not always kick in when it needs to. If people are expected to save for possibly mandatory eldercare responsibilities, maybe there should exist pre-tax accounts for this purpose built into our tax policy. Another problem is that Medicare far from covers all elder medical expenses (the famous "doughnut hole" in Part D).

All three major presidential candidates are missing the boat on this issue.

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