Tuesday, June 16, 2009

Paula Span offers new hard-hitting perspective on caregiving, driven by sudden demographic changes


The Washington Post, in the Health Section, featured today (Tuesday June 16) an article by Paula Span on caregiving. The long title is “Their Parents’ Keepers: As the elderly live longer, with more ailments, children step up to the difficult task of care and often find it unexpectedly rewarding”, with link here. The link is here. The title for the continuation page is “Middle-aged Americans adjust to caring for their parents.” The article is a “special” to the Washington Post, adapted by the writer from her new book “When the Time Comes: Families with Aging Parents Share Their Struggles and Solutions” from Springboard Press, with website here. The title of the article sounds inspired by the controversial New Line Cinema film “Her Sister’s Keeper”, but this, of course, is about caring for our parents. The visitor should read Paula Span’s article thoroughly, as it speaks for itself. I will order the book from Amazon and review it soon on my books blog. Paula Span had also offered a major (and eye-opening) article on caregiving in the May 10 Washington Post Magazine, already discussed here. (Ms. Span is a Washington Post writer.)

Span points out that the amount of demand for caregiving by adult children, along with the growth of caregiving businesses and facilities, has been a rather sudden demographic development. Medicine has delayed deaths from heart attack and stroke, and to some extent has delayed disability. But because of the way medical practice works out many senior adults will face longer periods of disability than they would have experienced in past generations.

Will the caregiving industry and long term care insurance business be able to keep up with demand? It sounds like a big order to expect, and this is somewhat of a demographic shock, especially to single adults (especially men) who have not undergone the emotional preparation by marrying and having their own children. It’s interesting to me that the ideology (as it has developed since the Reagan 1980s) of hyperindividualism and “personal responsibility”, that views family responsibility as starting with the voluntary “choice” to have children, seems to break down over this demographic challenge, already noted by Phillip Longman and others who argue for a new “social contract.”

Span writes, for instance, “The out-of-pocket costs of caring for older adults averaged more than $5,500 a year, a recent national survey found, causing a third of caregivers to dip into their savings, cut back on home maintenance, or reduce saving for their own futures.” I can wonder what Suze Orman would say about this.

I’m writing about this with an impersonal tone because I want to point out that this is becoming a huge public policy – and public health – problem. I see articles like this, then (like Smallville’s character Jimmy) put “two and two together” with other issues, and wonder where we are heading. We have created a situation that is likely unsustainable, as caregivers may neglect their own health and create an unending chain of dependency, breaking down all of the libertarian aspirations of just ten years ago. I’m surprised that we don’t fold this in to the health insurance debate, which the president spoke about to the AMA yesterday. One other likely development is that many of the 28 states with “poor” laws or “filial responsibility laws” (check the label for this blog on the left side of the page) will try to start enforcing them, given their recession strapped budgets.

Other cultures have dealt with this issue without the diversion from “family centeredness” to cognition-based ("selfish" or perhaps "objectivistic") hyperindividualism that has developed in the West. China, for example, has a long tradition of filial piety, and its one-child-per-family policy may come into a collision course with that tradition. Other cultures, especially in the Islamic world, expect emigrants to support relatives (that means parents and siblings, not just their old children) back in home countries. So this is potentially a problem with international repercussions.

1 comment:

Bill Boushka said...

Paula Span emailed to me information about a book signing, as follows:

"If you're around on Monday June 22, I'm talking and signing at the Barnes

& Noble in Tyson's Corner at 7. Come by and say hi, and I'll sign a book for you."

That's Tyson's Corner, VA at Rt 7, Rt 123 and I-495.