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Very interesting thread. Thank you for posting it, TUBORG.
I see the future, in re: to healthcare, as being very different than it is today. The pendulum is necessarily swinging back to pre-Hill/Burton days . . .
I envision a new type of "warehousing" necessarily evolving.
Gone will be the private rooms in hospitals (except for the very wealthy). Hospitals will be designed to accommodate patients in a "ward" setting, with 10 beds or so in a room. Same for nursing homes. Oh yeah, it will be called something else . . . and it may be that there will be some accommodation for privacy - more like "cubbies" we are used to in office settings. But all the upscale accoutrements, private care, staffing requirements - those things will change. They are already changing.
Docs will no longer be able to demand high salaries.
Medical education (how it is conducted; how physicians are licensed) will have to change, along with the cost of medical education.
There simply is not going to be enough money to continue to underwrite nursing home care as we know it now.
Gen Xers already have so much resentment towards their parents' generation . . . they will have no problem passing legislation to warehouse folks in nursing home settings.
There will be much more strict guidelines for Medicare and the delivery of service. For example, if a person is over 75, he/she won't get that knee replacement underwritten. Get a cane. Or a walker. Or a wheelchair.
Things will change and the changes are already happening. By 2030, things will have begun evolving into something similar to what I have outlined. By 2040, if you are alive, you will think of the year 2000 as having been "the good ole days" in regard to the delivery of healthcare in this country.
We've started down the road to socialist medicine and while there may be some redeeming points in that, if it turns out to be a one-way street we are equally in trouble in not having it.
I have a youngish acquaintance (practicing med here in the U.S.) who was trained as a medical doctor in the Czech Republic. Not only was her entire education and medical training free for her, she was guaranteed a job....on a gov't salary. That may be the way we will go, eventually, with the gov't running it all. The warehousing is an inevitable step, as the costs are simply not sustainable, and as I alluded to above in the Alzheimer's commentary this (warehousing–wards) would make sense for the "planners." I continue to wonder what LTC insurance will do, how long (how many years) it will cover everything, and what the premiums will cost from here on in. If folks have not socked away a fabulous amount of money that continues to grow, they will be in the same boat (er, ward).
So . . . after writing about the dire situation with provision of healthcare for the elderly in the not so distant future . . . perhaps I should also mention that the wise will prepare for their senior years by planning with those changes in mind.
One thing folks can be doing NOW is to consider combining resources with their children and build or buy a home together that has living space and access appropriate for their parents as they age, especially if that senior has chronic health issues that will most likely mean limited mobility (or diminished brain function) in the future.
Non traditional American families are doing that in many areas. Million dollar homes multiple generations together and the older providing child care so both parents can work without that expense and that money goes to the mortgage and providing home health care if needed.
Gen Xers already have so much resentment towards their parents' generation . . . they will have no problem passing legislation to warehouse folks in nursing home settings.
Forgot to say I think you're right on with this one too. What they will be unwittingly doing is ensuring a continual downgrade of care for themselves in 20 or 30 years.
One thing folks can be doing NOW is to consider combining resources with their children and build or buy a home together that has living space and access appropriate for their parents as they age, especially if that senior has chronic health issues that will most likely mean limited mobility (or diminished brain function) in the future.
This is a nice thought and wise strategy for those whose grown children are already settled in homes of their own and are stable in one place. In reality, however, I wonder what % of those now in their 30s and early 40s are actually in that secure scenario. At any rate, their parents (we, the boomers) aren't quite old enough yet for them to be thinking about accommodating us in any way. By the time these guys are well situated and we're much older, say in about 10 years maybe, the landscape could have already vastly changed (considering where we're at simply with the Alzheimer's trend, let alone other dementia, etc. trends).
This is a nice thought and wise strategy for those whose grown children are already settled in homes of their own and are stable in one place. In reality, however, I wonder what % of those now in their 30s and early 40s are actually in that secure scenario. At any rate, their parents (we, the boomers) aren't quite old enough yet for them to be thinking about accommodating us in any way. By the time these guys are well situated and we're much older, say in about 10 years maybe, the landscape could have already vastly changed (considering where we're at simply with the Alzheimer's trend, let alone other dementia, etc. trends).
Go to places like Northern Virginia and million dollar home communities with mostly Asian and Indian etc Families.
thanks for all the posts, all. Especially about faith posts are okay. Faith has done wonders for me managing the recent deaths in my fam.
Man makes plans and God laughs is an old Yiddish proverb, BTW. It hit me over the head when my dad went unexpectedly.
I remember he would read the news and say how Costa Rica was looking better and better. We have the multigen house but may have to change plans depending on what the future holds. That's the common denominator for most of us, no?
A toast to our long and happy lives. Thank your deity of choice.
Go to places like Northern Virginia and million dollar home communities with mostly Asian and Indian etc Families.
Actually, even smaller towns in NC have seen such arrangements for decades with Asian, Malaysian, etc families.
I got my real estate license in 1982 and the first house I sold was to a Pakistani family - grandparents included. Multigenerational. Very nice home . . . and grandparents were helping to take care of small children while father (physician) and mother (nurtionist) worked.
On my own street in Charlotte, we have Korean family with grandparents living there, too. Again, large, beautiful home and grandparents have helped out with childcare, have a gorgeous suburban veggie garden in the back that they tend to.
But my favorite examples are of family members who have been doing this since moving here in the 1700s. Until this last generation, it was typical for parents to move in with one of their children (or to have an adult child and his/her family move into the parents home).
My widowed Aunt even took her brother-in-law into her home back in the 70s, after a debilitating stroke. He had no children, so there was no one to be caretaker. He was bedridden and couldn't speak. She had a large home (on a farm) and she was his caretaker til he died - about 5 years.
I have friends here in the mountains who are caretaking their elderly parent in their homes. No one considered any other arrangement. "Family takes care of Family."
There are so many factors that can impact our life over which we have little to no control that it is almost unfathomable to the common mind. Just a couple of categories that come to my mind:
1) Personal health. Let's say you've been squirreling away from retirement diligently for a few decades then end up with a lethal disease or, perhaps worse, a costly, lifelong, debilitating one. Your best laid retirement plans just go out the window. You can take care of yourself, but again, it's not a guarantee.
2) Accidents. Any of us could die in a car wreck today or fall down the stairs and need a rod inserted into our leg to stabilize it. Our quality of life then diminishes substantially. You can be careful, but something could happen through no fault of your own.
3) Crime. Here in Indianapolis, crime is terrible. One can be impacted by crime anywhere, at any time. Some areas are obviously safer than mothers.
4) Natural disasters. No one ever thinks they're going to die due to the weather, but they do.
5) Malicious people. What if the spouse just up and leaves or your children take you for a ride? You can't control the actions of others.
6) Political changes. If a new local government is elected and your property taxes go through the roof, can you really do anything about it?
7) Large scale disruption or death. As Americans, we feel oddly immune to these types of things. There could be another pandemic. A war could break out.
I try to live and enjoy each day. As time goes on, I muddle through.
As you all have said, caretaking of family elders is not new.
Society has changed so that:
1 -- the adult children move away more for school and work than they did decades ago
They were all already in the same city. The elders didn't have to MOVE, leave their friends and life, to get the 'care' from the sdult children. Many elders fight tooth and nail NOT to move.
2 -- the middle generation mother -- the adult daughter or daughter-in-law -- that the parent(s) lived with didn't work, so she was at home....to DO the caretaking
Now that mom/daughter works so she's not at home to DO the caretaking
3 -- grandparents perhaps didn't live as long, and even if they did points one and two above took care of some of that.
4 -- the elders didn't have dementia as much
On this last point, did they not get it...or was it not diagnosed?
To be honest, I don't remember hearing about as many senile old people as I hear about now. We all knew families that had older grandparents, or had church/synogogue members who were elderly. But I declare I don't recall so many losing their mental skills.
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