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For ten years I worked at a posh retirement community in a
tony suburb outside Chicago. My job as a
clinical social worker involved helping older adults and their families cope
with the process of aging. The busy
times of the year for me were the winter holidays and Mother's and Father's Day—times when adult children visited their parents after sometimes months of
I always steeled myself for these times, knowing they would
involve a series of painful telephone calls and family conferences, working
hard to explain that, yes, Mom was, in fact, different from just a few months
ago. Aging is a process of erosion for
many people. Our bodies can lose their
efficiency in many ways—physically, cognitively, even emotionally.
I saw this happen with both of my parents in the last year
of their lives. My mom lived for 11 months after being diagnosed with an aggressive brain tumor. She lived with right-sided paralysis,
cognitive changes, loss of speech and total dependence in her last year. My dad experienced acute neurological changes
in his last five months of life, which resulted in months of hospitalizations and
ultimately moving to and dying in an assisted living community he hated. His condition was a mystery and easy to chalk
up to dementia because of his advanced age. It wasn't until days before his death that it was determined that the lung
cancer he had been treated for just a few months earlier was responsible for
his decline and all the changes that came with it.
My personal and professional experiences have amplified one
roaring fact about aging in America: growing old is incredibly expensive.
Research Center study published this spring reveals that the number of
adults aged 65 and older in the U.S. will almost double by the year 2050. And more so than some of our European
counterparts (specifically Germany and Italy, two countries whose populations are
at least one-fifth over the age of 65), the majority of Americans believe the cost of
aging parents should be covered by either the older adult themselves or their
families—not the government.
Don't wait until a crisis, as many choose to do through inaction.
Huh. I wonder if that
will change as more and more Americans start to realize just how expensive
aging can be.
It cost my father $10,000
to hire a private medical plane to transport my mom from Biloxi, Miss., where she experienced that hemorrhaging brain tumor no one knew she had to a Chicago
hospital. The cost of 24-hour care for
my father in the last three weeks of his life—care that was deemed necessary for
him to remain in his assisted living room rather than make yet another move in
what had been an extremely chaotic and disorienting time—was almost $25,000.
We are talking serious bucks.
My folks were working class, but those
pennies saved over a lifetime add up and alleviated me and my siblings from
having to scramble financially.
Another thing I have learned in both of my personal and professional
realms of aging experience is that no one wants to talk about it. No one. Not the folks with money to cover these
expenses, not the folks who will rely on the government to fund their later
years via the No. 1 welfare program in the U.S., Medicare.
You do know that the government does not cover the cost of
aging in America, right? Not even
close. For most older Americans with
Medicare, hospital expenses are covered, but rehab and home health and
custodial care—things that if you live long enough you will most certainly
need—are generally not. Or, if they are covered, it is for only very limited
We don't know what is ahead for any of us, ourselves or our parents included. We don't all age gracefully.
I encourage any of you lucky enough to have parents still
alive to initiate conversation about this topic sooner rather than later. Don't wait until a crisis, as many choose to
do through inaction. Talk about it
today, while passing the salt over the Christmas dinner table. Talk about it while driving Mom or Dad to the
doctor. Keep bringing it up, even if
they don't want you to. It's
important. And a series of conversations
over a number of years will guide you in more ways than you can ever anticipate
when the time comes that answers are required.
My own family's story can be a lesson for your own. After my mom's experiences, it was clear to
all that with my dad's independent nature that naturally bucked authority, he
would never function well in a structured setting like a nursing home or
assisted living community. We had had
more than a few conversations, he and I, about how our home would always be
open to him, when and if he needed us.
The sad truth is that he did need us, but his specific needs
made it impossible for us to care for him in our home. Neurological changes are no joke, and they
impacted my dad in such a harrowing way that accepting help of any kind was
challenging at best, impossible at worst. The moral of our story is that while our planning did pan out, it did
help nudge decisions in the direction that provided resolution.
We don't know what is ahead for any of us, ourselves or our
parents included. We don't all age
gracefully. Sometimes it is gentle, many
times it is not. Talk about all of it
with those folks who brought you into this world. Talk about the good, the bad and the poopy,
because, yes, there will be poop. Be the
adult your parents raised you to be. Go
there, with good intentions and no illusions.