National Nurses United

RAD:May 7/3/08 1:22 PM Page 9 Rose Ann DeMoro Executive Director, CNA/NNOC Not So Golden Years Caring for an aging parent is unimaginably hard, and fighting with health insurers makes it even tougher i have worked for CNA/ NNOC since 1986. I have been the executive director for 15 years. This position puts me in the center of issues relating to health, including the personal harm that comes from the lack of a social healthcare system. I hear daily from nurses and patients across the country and every story is a painful loss. But no amount of knowledge, connections, or resources available prepared me for the challenges of coping with an ill and aging parent. Nothing. I am not alone in my experiences. The Labor Project for Working Families estimates that by the end of the year, two in three Americans under the age of 60 are expected to become caregivers for elders. It's not just the elderly who need extra help; many caregivers assist children, siblings, or partners who have met with unexpected accidents or debilitating diseases. But with medical advances making possible longer lifespans, the prospect of caring for an elderly parent or relative is becoming increasingly common in our aging society. The National Alliance for Caregiving even suggests that those currently in their 40s and 50s could be the first generation to spend more time caring for parents than for children. Caregiving is no easy task. Reversing the roles in the parent-child relationship can drastically change family dynamics and cause emotional repercussions. Caregivers may find themselves administering medicines, assisting with hygiene, providing transportation, setting boundaries, and keeping schedules in the same way their parents once did for them. While this transition can be disorienting and frightening for the caregiver, it can demoralize the care recipient as well. Parents may feel embarrassed or vulnerable by their sudden dependence on others, and can show their frustration through various emotions: stubbornness, hostility, shame, stoicism, or denial, all of which can hamper the caretaker's best efforts. JUNE 2008 Caretaking also invariably takes a major toll on the caregiver's work life. The Labor Project for Working Families tells us that 60 percent of caregivers work full time, of which 57 percent report having to go to work late, leave early, or take time off during the day to fulfill caregiver responsibilities. Caretaking is often full-time, albeit unrecognized, work. The Metropolitan Life Insurance Company claims that the value of family caregiving in America is estimated at $306 billion per year. These billions are actually donations of labor by family caregivers. Insurance companies, by systematically shifting financial responsibilities onto the shoulders of family caregivers, reap billions more in profit by being saved the expense of hiring healthcare providers. Easily the most challenging aspect of caring for an adult parent, and a problem common in America, is navigating the healthcare system and insurance morass. The elderly and the disabled are two segments of society requiring regular medical care, but are most likely to suffer under the United States' market-based system since insurance corporations are happy to collect premiums, but loath to spend money on care. We all know how maddening and hard it can be to advocate for ourselves within the system. Having to intervene on behalf of a loved one, especially one who faces the medical challenges of old age, can be brutal. It adds yet another stress and burden to the caregiver's responsibilities. Caretakers must navigate an impersonal, bureaucratic, callous, and inhumane healthcare system on a daily basis to access necessary medical appointments, referrals, diagnostic tests, procedures, medication, and other critical care. It's a process that is debilitating, frustrating, demanding, and thankless. That's why Medicare, for many elder caretakers, can be a welcome relief. Of course, Medicare isn't perfect. In recent years, the Bush administration has eroded it with attacks and privatization efforts, such as turning over to private insurance compaW W W. C A L N U R S E S . O R G nies the administration of the Part D drug benefit and an increasing share of service provision through Medicare HMO plans. Advocating on behalf of an elderly patient requires extensive knowledge of how the Medicare system works. But in comparison to the rapacious private insurance system which is deliberately and consciously constructed to discourage you from obtaining care, Medicare seems like a healthcare paradise. It's one of several reasons the nurses are fighting for single-payer healthcare. Of all the challenges posed by aging, the confusion of policies, denials, loopholes, and deductibles should not be a factor. One of the greatest rewards caregivers can receive, and which professional nurses provide and nurture on a daily basis, is the trust that is built through a long-term relationship with a patient. Often with so many other factors beyond their control, it's a relief for both patients and their worried relatives to know that they are in caring, capable hands and can depend on someone. The ability to continue care with the same caregiver is another excellent argument for singlepayer healthcare: By providing a single standard of guaranteed healthcare to our population, we can eliminate the prospect of a healthcare provider no longer being a "preferred provider" or a member of a "care network." Despite the economic and emotional hardships caregiving can present, the act of caring for a parent or relative in their last years is a profound act of love. More than that, it is a way to honor our society's elders and repay them for the support they gave us throughout our lives. It is vital that our society and our government recognize and respect the importance family caretakers have in our community. Eliminating the insurance nightmare through establishing a high-quality, single-payer healthcare system is one sure way we can do just that. I Rose Ann DeMoro is executive director of CNA/NNOC. REGISTERED NURSE 9

• Cover