National Nurses United

Aging:Final 9/4/07 4:06 PM Page 14 "When you are elderly you need not just medical attention and medications. You need good nutrition and exercise and things that challenge your mind. Otherwise it is just warehousing. It shouldn't be that way and needn't be that way." —kay mcvay, rn 14 REGISTERED NURSE where people age. Studies show that elders do better if they stay in their homes rather than going to a care facility. Staying put also saves money. But most homes are not designed for elders. Satariano, author of The Epidemiology of Aging: An Ecological Population by Age and Sex Age group 1950, 1990, and 2030 >80 _ 75-79 70–74 65–69 60-64 55–59 50–54 45–49 40–44 35–39 30–34 25-29 20–24 15–19 10–14 5–9 0–4 1950 Male 400 300 Female 200 100 0 100 200 300 400 Age group Population (millions) >80 _ 75-79 70–74 65–69 60-64 55–59 50–54 45–49 40–44 35–39 30–34 25-29 20–24 15–19 10–14 5–9 0–4 1990 Male 400 300 Female 200 100 0 100 200 300 400 Population (millions) Age group percent of them hold full-time jobs. Yet "women of all races tend to have jobs that either do not provide healthcare, are lower-paying so they can't afford private insurance, or they work part time in order to care for their family and have no benefits," said Martin. "Therefore, by the time they become eligible for Medicare, their health may be significantly worse." Because women are paid less, and may end up missing work to act as caregivers, they also end up drawing less Social Security. The Academy of Social Insurance estimates that family caregivers give up about $659,000 in lifetime wages and pension benefits. It is this "informal" labor force, however, that keeps the crisis of elder care from going into free fall. More than 20 million U.S. employees have ailing parents, and only 1 percent of the companies they work for pay for subsidized elder care. Medicare will not pay for long-term care, and Medicaid will only do so once the elders' assets are exhausted. The result of the government's unwillingness to take any responsibility in this area means that 64 percent of long-term care is "informal," and another 28 percent is a combination of informal care and elder resources. The average informal caregiver puts in 18 hours a week. "The problem of long-term care is the elephant in the room when policymakers and planners gather to talk about healthcare systems," Mary Jane Koran, a member of the National Commission for Quality Long Term Care told the House Subcommittee on Labor, Health, and Human Services in February. The Bush administration's solution to the long-term care crisis is to push market-driven schemes, like reverse mortgages and private long-term insurance. More than eight million Americans have purchased long-term care insurance, only to find that companies throw up one roadblock after another when it comes time to cash in. According to the state of California, one in four claims was denied in 2005. In the meantime, the industry has pulled in more than $50 billion in premiums. As for reverse mortgages, they essentially wipe out one of the few assets working class people can pass on to their children. According to AARP, the advocacy group for retirees, this informal labor network is valued at anywhere from $275 to $350 billion a year, more than twice what Medicare costs. But future demographics are working against "informal" caregiving as a solution to the long-term care crisis because people are having fewer children. In 1955 the average family size was 3.7. In 2000 that figure was 2.1. According to a study by the Robert M. LaFollette School of Public Affairs, "the average working couple has more living parents than children." The diseases associated with living longer than ever have become more challenging to care for, too. According to the Alzheimer's Association, by age 85, nearly half of the population will be stricken with the disease. Relatives will care for over 85 percent of those patients. A final component of elder care's "total terrain" has to do with >80 _ 75-79 70–74 65–69 60-64 55–59 50–54 45–49 40–44 35–39 30–34 25-29 20–24 15–19 10–14 5–9 0–4 W W W. C A L N U R S E S . O R G Projections for 2030 Male 400 300 Female 200 100 0 100 200 300 400 Population (millions) SOURCE: United Nations, 1999, and U.S. Bureau of the Census, 2000. SEPTEMBER 2007

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