admin March 20th, 2007
Is institutionalizing our parents and grandparents in nursing homes a loving, just, or economically sustainable thing to do?
It must be, because that’s what has become the norm in our society.
Fortunately all older people haven’t been institutionalized this way yet. Some older people are lucky enough, or healthy enough, to be able to ‘age in place’, being supported by family and friends if and when needed. But many are not so lucky. A growing number of elders unfortunately walk, or are pushed, down the common pathway to the nursing home.
My day-job is working for a health care research organization that studies issues in long term care among other things. It is clear from that research that we are already in big economic trouble caring for elders with the boomers hitting 60. And that problem is going to get much worse in the near future.
I’ve also had a fair amount of personal experience with assisted living and nursing facilities. I’ve found that once you get past the ‘chandelier effect’ (the big brass chandelier and French provincial furniture that usually grace the entryways and public rooms) the level of care can be devastatingly poor except in the more expensive programs.
Certainly some people proactively choose to go to nursing facilities, but there are many others, however, who are forced into this because there aren’t any other real options. In our society, living with your children or grandchildren is now usually considered to be an unfair burden and therefore not a real option.
Full-time nursing care or a nursing home is sometimes a practical solution, but there are better, higher quality, less expensive options, which often aren’t offered or aren’t considered.
Soon many of our parents, grandparents, and us for that matter, will not be able to afford to live in such a facility of any quality – and the range of quality in these facilities is breathtaking. The economics of long-term care are turning against us as the boomers age and health and custodial care costs go up. There are already far too few trained caregivers and facilities, and just too little money for many of us to afford the rapidly escalating costs of assisted living and nursing home care.
Folks getting close to retirement can forget about long-term care insurance because it is too expensive to justify the tiny benefit it will provide. For middle-aged folks the prospects are a little better, but not much. Long-term care is so expensive that even relatively good LTC insurance policies won’t come close to providing what will be needed.
We are racing toward a financial wall at break-neck speed, apparently without a thought as to how we are going to deal with it
More difficult than financing is the issue we have so far avoided thinking about:
Institutionalizing our parents is not a loving response to the normal process of aging.
It isn’t loving because no institution of any quality can provide the love and concern that a normally healthy family and community can, and they can’t provide the familiarity and comfort that ‘home’ provides at any stage of our lives. Home is home no matter how old you are. And it certainly isn’t loving to push our families into a terrible financial quagmire just to survive.
We try to avoid this issue because none of us want to see ourselves as unloving or uncaring, but in those fleeting moments when we are honest with ourselves this feeling pops-up as a very unwelcome intruder. Let’s face it: we are merely rationalizing when we try to convince ourselves that “they’re better off this way because we could never provide that kind of care.” Thank God you can’t provide that kind of care!
How did we get ourselves into this crisis?
Americans, in the Twentieth Century, took the notion of the self-reliant frontiersman and the rugged individualist to a new extreme. We decided that our children must be allowed to fulfill themselves as completely independent individuals, discovering their futures and making their fortunes no matter where that might lead them. This extreme individualism has become one of the key drivers for our culture.
This meant that kids routinely moved around the country in search of education, jobs, and spouses, usually never to return home to live. We then decided that individualism must also mean that the insular, nuclear family of two adults and two kids was a big improvement over the traditional extended family. This left us with families scattered across the country. Increasingly communities, particularly suburban communities, became case studies for the film “Bowling Alone” – large tracts of houses occupied by strangers who formed temporary alliances with a few people living close-by or at work.
‘Family’ has become a mere holiday entertainment involving costly and time-consuming travel, not to mention the newly traditional argument over whose family we will visit this year!
What does all this have to do with simple living? There seems to be nothing simple or sustainable about this new arrangement – especially not for the young and the old. The young are also farmed-out to day care or pre-pre-pre-school, which are simply mini-institutions but, we hope, not as bad as the nursing homes!
But it seems to me that a community of Christian people or congregations committed to living simply and caring for each other, could creatively work together at the congregational level to develop loving, effective, and enjoyable lives – not just for our elders, but also for every generation represented in our congregations. If we care, shouldn’t we be able to create our own ‘hand made’ solutions that are better than relying on ‘competitive free market forces’, the wisdom of government, or blind luck?
If we really began to live simple lives by cutting back on our demands for the ‘good life’ we might save time, money, and effort, which could then be re-invested in voluntarily caring for our youngsters who need day care and after-school care, and elders who could be cared for in their homes or congregationally run home and community care programs – rather than farming them out to commercial institutions. Young folks can help take care of elders along with adults, and elders can help take care of kids and provide other services as well. That way everyone stays useful, productive, and happy much longer. It builds community, and it builds family. Seems to me things used to be this way, but who am I to stand in the way of ‘progress’?
It’s not possible to turn back the clock, but I’m wondering if we haven’t thrown the baby out with the bath water in our race to be modern, self-fulfilled, well-off individuals – maybe otherwise known as a ‘race to the bottom’. Maybe we need to re-visit these issues and bring our lives and communities back into a truly human scale that have depth and meaning again.
Tags: Commentary