When I was growing up I had friends whose households were bustling with extended family. It was not unusual at all to see a grandmother or grandfather living with children and grandchildren. I’m not certain that all was well with the situation, but for the most part everyone appeared to be getting along. From what I observed there was a kind of happiness in those homes that made me want to be there. 

My own maternal grandmother never lived alone. She had two sons who were unmarried and remained in her house with her. One died rather young but the other watched over Grandma until the day she died. At the end of her life the family placed a hospital bed in the living room and took turns caring for her. They created an intricate calendar that detailed who and when would be in charge. With a family effort nobody was overwhelmed with that task of making Grandma comfortable in her final days. 

After his wife died my paternal grandfather rented a room from a young widow who needed extra income. The two of them were eventually joined by another woman, making it kind of “Three’s Company” situation”. They lived quite happily together and the women often mentioned that my grandfather had become like a father to them. Because his health was rather remarkable well past his one hundredth birthday he did not require any special assistance until a few months before his death at the age of one hundred eight. Nonetheless, his extraordinarily long life had left him penniless by that time so my brothers and I, along with a cousin, had to pay for his funeral and burial. 

We are living longer these days and with that great gift comes the possibility of needing structured care as our bodies and minds become weak. Somehow here in the United States we have not done our best to prepare for such eventualities. Often the end of life is difficult not just for the person who is fading away but for the family members as well. The physical, emotional and financial cost of end of life care can be devastating because we have few areas of support for our older citizens. As more and more of our population ages we are facing a crisis that is rarely discussed. 

My brothers and I took turns watching over our mother in our homes. She was an exceedingly undemanding and flexible person. It almost felt as though she was not even in the house. She spent much of her time reading her Bible or listening to Astros baseball games on the radio. She enjoyed talking on the phone with her sisters every morning and tuning in to her favorite daytime shows in the afternoon. She took a nap each day and retired for bed early in the evening. Her death from lung cancer came far more quickly that we were prepared to accept. It was an easy honor to be able to care for her in the last years of her life. Between the three of us, nobody ever felt burdened by our responsibilities to her. 

Things become far more difficult when aging children are still caring for exceptionally old parents while the cost of providing care in nursing homes or memory care facilities is exploding. The price tag can easily reach six thousand dollars a month or more and few elderly persons have enough retirement income to pay for such bills. Many are forced to sell homes and belongings and literally spend themselves down into poverty to care for a parent or spouse who requires longterm care. An otherwise healthy senior with dementia can drain family finances for years, leaving survivors wondering where the funds will come from if and when they need them. 

The fact is that eldercare is in a state of crisis in the United States and few wish to speak of it or attempt to do anything about it. Ironically the hardest hit group is in the middle class. The wealthy can afford concierge prices. The poor get coverage from Medicare and Medicaid. Those in the middle have to use savings, continue working well past retirement age, sell off possessions or be the caretakers themselves. It is a frightening situation that is only going to grow worse with time as aging Baby Boomers threaten to overwhelm the already limited options for care in our nation.

Horror stories about the lack of help for our most vulnerable seniors are already becoming more and more common as hardworking families are watching their assets draining away in a system that seems to have ignored the looming dangers. The time is rapidly approaching when we as a country of caring people will need to consider helping the elderly and their families to navigate the most difficult final months and years of life without asking them to plunder a lifetime of hard work. It is in the best interest of all of us to have a national plan that insures that nobody has to live in a locked basement because the money for his/her dementia care simply is not there. 

Other nations have managed to prepare for end of life care for citizens. It’s seems only fitting that we do the same for our seniors here in the United States. Meeting the needs of even a vibrant and seemingly healthy person in the later years can be more difficult than imagined. The clock is ticking we can beat it if we begin to discuss this issue now and do something constructive to face it.