By Steve Moran
On November 14, 2023, KFF Health News and the New York Times jointly published an article titled “Facing Financial Ruin As Costs Soar for Elder Care,” and while many of the issues addressed were important, it was an article more designed to get clicks than to provide an accurate assessment of the current state of elder care or to provide solutions.
What They Missed / Got Wrong
1. They make this bold statement: “The financial and emotional toll of providing and paying for long-term care is wreaking havoc on the lives of millions of Americans.”
This is simply not true. Millions of Americans is a gross overstatement. Are there families that are struggling with long-term care? Absolutely.
Part of the problem is that growing old, whether it is you or a loved one, is messy and hard. I face it every day with my 90-year-old stepfather. He is losing capacity and is not handling it well. It is part of life, not a crisis that needs something done about it.
2. The article contains a number of stories about how families had to sell the assets of their elders to pay for their care, as if that were a bad thing.
Here is one quote from the article:
“People are exposed to the possibility of depleting almost all their wealth,” said Richard Johnson, director of the program on retirement policy at the Urban Institute.
Placing her husband in such a place would have gutted the $500,000 they had saved before she retired from 35 years teaching art and French at a parochial school.
I want to know why the government should be paying for elder care with my tax dollars so families can inherit money and assets. I have always believed — I continue to believe — that being a responsible adult includes saving money and acquiring assets that can be used to provide a good life in later years.
Why is this no longer the case?
3. The article complains that “the United States has no coherent system of long-term care, mostly a patchwork.”
While true, the same can be said of many other Western countries, and it is similarly true of the health care system in general.
They seem to be suggesting that a government run system would be better. Looking at the largest “system” of government run health care and retirement communities, the VA system, it would be hard to argue they are doing a better job or reducing costs.
4. They make this statement: “About 8 million people 65 and older reported that they had dementia or difficulty with basic daily tasks like bathing and feeding themselves — and nearly 3 million of them had no assistance at all.”
It is fundamentally wrong to lump dementia with other physical limitations. It only makes sense if you are looking for an inflated number.
That 8 million number appears to be an extrapolated number from a large study. To say 8 million people reported anything is untrue.
It is impossible to know what “difficulty with basic daily tasks” really means. Once I am older, it takes more time and is more difficult to do things. Is that a real problem or a made-up one? I am nearing 70 years old, and while still very active, there are some basic things that are more difficult. So what? It is better than being dead.
A year or so ago I was in Colorado on a day hike. Stepped on a rock with some loose dirt and took a tumble. I had some bleeding that needed more than a simple bandage. The town had no place to purchase basic first aid supplies, so I went to the fire department, got bandaged up, and was good to go. I realized I had become a statistic in the elderly fall database, even though what happened was not related to age at all.
5. More bad data.
The article says, “At any given time, skilled nursing homes house roughly 630,000 older residents whose average age is about 77, according to recent estimates.”
The real number is about double that — 1.2 million people, according to the Office of the Inspector General (updated October 3, 2023).
According to research done by A Place For Mom, the average age is 81.5, not 77.
This is important because it calls into question the credibility of the entire article.
6. There is an underlying assumption that senior living run by for-profit companies is a bad thing.
Costs to older people have “led them to assisted living centers run by for-profit companies and private equity funds enjoying robust profits in this growing market.”
There are so many things wrong with this. First, most for-profit senior living companies are doing a good job and delivering good value to the nation’s older population. Second, most of the low income nursing home care is being done by for-profit companies because the not-for-profit nursing home companies are not interested in serving that population.
7. There is a common complaint that our system “demands” that family members are responsible for the care burdens of their elders.
We have lived it, and in fact we are living it. This is life. It is the product of health care increasing our lifespan. I can’t imagine that it is somehow the government’s responsibility to care for my 90-year-old stepfather as he ages. It is at times frustrating and limiting, but it is also a great privilege to do so.
While the article contains some significant truths, it paints a misleading and incomplete picture. It ignores the hundreds of thousands of families who are successfully working through this process of having aging parents and grandparents. Family members who take great joy in caring for their elders.
In some sense this article is the ultimate form of ageism, suggesting that somehow once a person gets old, they should be handed over to the care of the government because they are not really worth families caring about them.