Friday, February 22, 2008

Elderly Parents and Care Giving

For the past 48 hours, I've been pondering the racial and historical contexts of Hillary Clinton's continuous accusations of plagiarism against Barack Obama. And I've been combing the financial disclosure reports for each candidates' campaign, noting that of the three front runners, Obama, Clinton, and McCain, Obama has been the only candidate who has not received any money from political committees.

But there are issues closer to home for most of us than who will be our next President, although there is the strong possibility that the next President will greatly impact on the issue that plagues me most this morning, and that is the quality of life of our parents as they age and our quality of life as we age, too.

Currently, two of my friends are caring for elderly parents. Shirley is an only child and her father is deceased. So the responsibility of caring for her aging mother, who has dementia, rests solely on her. Although my other friend, Ricci, has two half-sisters, Ricci feels that it is his responsibility to care for his elderly father.

I marvel at both friends' resilience. I worry about Ricci because he has his own health issues that are exacerbated with stress. I know that going to the rehabilitation center daily for the past two weeks is beginning to take a toll on his health. He has promised to take off on Sunday and rest because his father's health has improved enough for the doctor to project a release date.

For my other friend, Shirley, her mother is in the early stages of dementia and hasn't started wandering out the house and getting lost in the neighborhood. However, my girlfriend did mention that her mother remains awake all night, and this is when her mother's behavior dramatically changes and requires Shirley's attention. After sleepless nights Shirley rises to teach a class online, provides psychological evaluations for clients, manages her own business, and is writing the last two chapters of her dissertation. She is 32 years old. I wonder how many of us were, or will be, caring for an ailing parent at 32 years old because of fear of inadequate health care, or concerns about the poor quality of the health care that is available.

I asked Shirley if she had not interceded and moved her mother to northern Virginia after seeing the poor care that her mother was receiving in Tennessee, where would her mother be today? Shirley unequivocally said, "she'd be dead." I know that on some level, Ricci feels the same way about his father. Once when Ricci traveled to metro DC to visit his father during a previous hospitilization, Ricci was so alarmed by the poor quality of care that his father was receiving that he physically carried his father out of a rehabilitation center. Ricci removed his father against doctor's orders, and within hours he had his father admitted to a cleaner facility with a more competent staff. However,the stress involved in bucking the system in order to provide his father with decent health care eventually took its toll on Ricci.

As my father ages, as I age, I ponder what is in store for me as both potential care giver and recipient of care. I wonder what the future holds for my son as an only child of divorced, middle-aged parents. My father always tells me not to worry. My son also tells me not to worry. I should be grateful that both my son and father, like my friends Shirley and Ricci, have the emotional, financial, and spiritual resources not to be plagued by the ever pressing need to revamp our health care system so that the young, sick, disabled, and elderly are provided for.

I pause when I think of the resources that Shirley and Ricci are expending in order to care for their parents. I also pause when I think about the fact that both Shirley's and Ricci's parents also have the resources to be independent during their elderly years, thereby, minimizing the impact of their failing health on their children's resources. I further pause and think that because of my father's resources, intellect, perseverance, and managerial skills, he was able to navigate the quagmire that the health care system became when my mother was ill with lung cancer. With spread sheets and research in hand, my father was able not only to have in-depth and informed conversations with my mother's doctors, but he was also confident that he could command the best of care for her because of his resources. Further, he was not dependent on his children to provide my mother with the care and support she needed.

But what about the tens of thousands of Americans who do not have such resources: health insurance; access to quality health care; homes with equity; savings; loving children; or family and friends to assist them during their most trying years?

As the size of U.S. families shrink and people are having children older but living longer, the possibilities of having a good quality of life as our population ages is being jeopardized. While we do age better than perhaps our grandparents did, the rising costs of health care and lack of access to a high standard of health care will compromise the quality of elderly life for all except the wealthiest of Americans.

As I peruse the financial disclosure reports of our members of Congress, I am certain that few of them are genuinely concerned about their quality of life if, and when, they become ill, or as they age. They have good health insurance and access to the best of health care; most have assets that far exceed those assets of the average, upper-income American; and they have pensions that will never be jeopardized by an Enron scandal.

Let's hope that at the very least, our next President will strongly consider the quality of life of an aging population; and this quality of life requires not only comprehensive and affordable health care insurance, but also a health care system that is affordable and with competent people who are paid a competitive wage to ensure a high standard of care regardless of a patient's income or economic status.

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