2015.05.21 Who takes care of the care takers?

In Game of Thrones, HBO's very successful fantasy series, people generally don't die peacefully in their sleep.

Most die violent deaths as the series is a steady stream of blood and gore. The parts that are not gory are a stream of scantily clad lasses and broad-muscled lads. In some, scantily clad lasses are combined with blood and gore.

But winter is coming after a long, long summer, and the grandparents are deciding if they should go for a long walk into the snow, never to return. With starvation on the horizon, perhaps feeding the older generation is a waste?

Different cultures have very different ways in how they treat the older generation. One difference is if age and experience is revered (Asia comes to mind) or if ageism - assumptions of obsolescence once you are 40+ - dominates.

Another difference is if families take care of their old, if all people have to finance their own personal care taking needs, or if eldercare is something society lifts together.

The norm in the countries we normally compare us with has, up to not that long ago, been that families take care of their old. That is still the norm in many countries.

Hence, unless there is some other good system for taking care of old people, families will generally make sure that they have enough children for some to survive long enough to do the care taking.

And bummer for those who don't have children. Staying single or waiting for "the one" carries a different price if it leaves you without eldercare.

China has succeeded at diminishing their family sizes by force, not by instituting alternative social systems. Now that the one-child policy has been in place for a couple of generations, the burden of one working couple with four grandparents to care for becomes evident.

The preference for sons that has left China with 80 million men "too many" will have ramifications in a generation. As they were only children, they don't even have nieces and nephews. Would you look after your father's ailing cousin, if you already had your parents and your in-laws to care for?

In USA, eldercare is partly a societal, partly a private matter. The societal part is Social Security benefits and Medicaid, the health insurance for everybody over the age of 65.

If you talk to financial planners, they generally talk about your need for having an income in retirement that is 70-80% of what you made before. For most, Social Security doesn't cover that much. All the same, it is the only retirement security most Americans have. Even if you have saved in retirement accounts to the advised level, if you have to hire full time caretakers, that is nowhere in the ballpark of the amount needed.

Finally, there are countries where caretakers come 3-4 times every day, paid over the taxes by everybody, if you are feeble enough to qualify.

For those of us who live on a different continent than our elderly parents, many concerns relate to:

  • how much burden you put on siblings,
  • if your parents are OK,
  • if they have enough financial resources,
  • if they have enough social resources,
  • if their care takers are nice/competent/honest,
  • how long they can live in their own home,
  • and what when they can't,
  • ...

In Western societies, we are relying more and more on under appreciated, underpaid, immigrant helpers to look after our parents.

The only consolation is that people who have lived without much contact with foreigners all their lives can learn that some of the most loving, caring people may not be their own children but total strangers from far away. How is that for creating a global village?

I know. My mother's caretakers are Brazilian, Somalian, and two are from Afghanistan. They are all paid decent wages by the city my mother lives in. And they are not total strangers any more. Because of their efforts I can sleep at night.

My sister is juggling all the rest along with her own job - because I am on another continent. Because of her efforts I can sleep at night.

One of my neighbors here in California recently crossed the threshold where she had to move from her own home to an assisted living facility. She had for several years had a nice live-in caretaker whom we regularly met walking with her in the street.

The neighbors were all looking through their connections of elderly people to see if anybody were in need of a good and trustworthy live-in caretaker. When your eldercare system is mainly based on private, live-in caretakers, "people moving to assisted living facilities" means that the caretaker loses both job and home.

So once the caretakers can't lift, wash, drive... any longer, who takes care of the caretakers? We don't expect them to walk out into the snow, do we?