To the Editor:
Re “Caregivers Who Are Cared For,” by Michelle Cottle (“Can America Age Gracefully?” project, Sunday Opinion, Sept. 10):
Ms. Cottle’s excellent and poignant article on the dire state of the caregiving for aging Americans at home points to multiple areas where elderly and ailing citizens are left without appropriate and/or accessible home care.
Patients on Medicare who remain at home are not covered for any nonmedical caregiving; even home hospice is able to provide only a few hours of paid aides daily, and in many cases only from Monday to Friday. What are the elderly ill supposed to do the other hours of the day or on weekends if they need help with meals, bathing, medications, toileting, etc.?
Most families don’t have the means to pay for aides, especially over long periods of time, and many family members don’t have the luxury of taking time off from work or from their own family responsibilities.
Additionally, as Ms. Cottle points out, there is usually little or no training offered to family members in how to take care of the ill (i.e., feeding, hydrating, giving medications, diapering, dressing), and often there is no emotional support offered in light of the physical and mental toll that caregiving for a relative can take.
I find it egregious and very painful to witness this country’s willingness to abandon an entire generation as it ages and suffers inevitable illnesses.
Barbara R. Rauch
New York
To the Editor:
Michelle Cottle paints a depressing picture of our nation’s failure to care for aging Americans who often have physical and mental impairments.
As a former gerontologist who led research teams studying the needs of caregivers of relatives with Alzheimer’s, I learned that families often designate the family member with the least resources to be the primary caregiver. Typically that’s a woman who is divorced, unmarried, childless or unemployed.
Caregiving is a stressful and thankless job that often leads to the caregiver’s depression and social isolation. Other family members may provide money to caregivers, but they seldom convey their sympathy or contribute their own precious time.
Until Americans learn to value the courageous contributions of caregivers along with the quality of life for their aging relative, there will be two people’s lives enduring gradual decline, not just one.
Frank Richter
Clawson, Mich.
To the Editor:
Michelle Cottle writes about the financial and psychological burdens of caregiving for the elderly. But it strikes me how differently we look at caregiving here in Nepal.
I live in a three-generation household. My parents work hard to support their parents financially and otherwise. My mother takes my grandparents to their monthly checkups. My father handles most of their medical bills. But that isn’t where it ends: Together, they also meet their emotional and social needs, from cooking their favorite meals to accompanying them at all rituals and gatherings.
Caring for our elders is a privilege — a part of our culture. If it were seen as an onerous responsibility, then members of joint families like mine would also suffer from mental health problems. Instead, looking after their parents gives my parents happiness.
For Americans to age gracefully, parents who once cared for their children must be cared for back with the same comfort and love; costs should be secondary.
Yugottam Koirala
Kathmandu, Nepal
To the Editor:
Thank you for highlighting the challenges around caregiving. A powerful strategy to confront this challenge is to provide housing where seniors can “age in community” — a different way to “age in place.”
Well-planned communities with services make it possible for seniors to maintain independence while having security and support as needed. Professional caregiving can be delivered more cost effectively in group settings, and family members needn’t provide services for which they are ill equipped when a community is well staffed.
Perhaps most important, programming to enrich residents’ physical, intellectual and emotional well-being keeps them from being lonely. According to the Centers for Disease Control and Prevention, social isolation is “associated with about a 50 percent increased risk of dementia and other serious medical conditions.”
Unfortunately, enriching senior communities are available only for the wealthy and in some subsidized communities, with few options for the middle class. Adding more senior community housing is a crucial piece to solving the caregiving puzzle, to the benefit of seniors and their families alike.
Allison Daskal Hausman
Brighton, Mass.
The writer is director of communications for 2Life Communities, which develops and runs senior living communities.
To the Editor:
The forgotten caregivers are the wives, partners and children of elders in nursing homes, who bear the brunt of the enormous fees for nursing home care and the constant vigilance required to ensure their loved ones get the care they need.
These loved ones often are the very old with dementia and in a wheelchair, requiring 24-hour care. The savings and assets accumulated over a lifetime are rapidly decimated, often with the realization that you pay or else see your loved one forced out of the institution.
The aging spouse or partner is often left impoverished, forced to sell their home, or to try to put the nursing home resident on Medicaid. The financial, mental and health toll on these aging caregivers is too often ignored. These are the forgotten victims of our caregiving and health care system.
Sandra T.W. Davis
Monroe, N.J.
The writer is an 85-year-old caregiver for her 93-year-old husband in a nursing home.
To the Editor:
Michelle Cottle gets it right at every turn, as have many others writing for decades about the failure in the U.S. to institute respectful, safer, well-staffed and well-paid health care for elderly Americans.
I did my own share of reporting on this issue in the 1990s, and the barriers remain endless, as Ms. Cottle points out. However, knowing what’s wrong doesn’t make it better. The real question is: What will?
Madge Kaplan
Cambridge, Mass.
The writer was the director of communications for the Institute for Healthcare Improvement and a health care correspondent for public radio’s “Marketplace.”
