Thursday, January 11, 2007

Elder-Care Costs Deplete Savings of a Generation

The New York Times

Elder-Care Costs Deplete Savings of a Generation

Nicole Bengiveno/The New York Time
Elizabeth Rodriguez used her 401(k) to help care for her father, Samuel. “You don’t stop and calculate,” she said. “You just buy what you have to buy.”

Published: December 30, 2006

To care for her ailing 97-year-old father over the past three years, Elizabeth Rodriguez, a vice president at the Federal Reserve Bank in New York, has borrowed against her 401(k) retirement plan, sold her house on Staten Island and depleted nearly 20 years of savings.

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The money has gone to lawyers’ fees ($50,000) to win a contested guardianship. It has gone for home-care equipment like the mattress for his hospital bed (about $3,000 in all) and for a food service to deliver meals ($400 a month).

It has gone for a two-bedroom rental apartment big enough for herself, her dad and a home aide ($1,600 a month more than a one-bedroom apartment in the same building), and for a wheelchair-accessible van to get him to doctors’ appointments ($330 a trip).

Asked to tally the costs, Ms. Rodriguez, 58, said she had no idea how much she was spending. “A shower chair, body cream with no alcohol, new shoes,” she said. “You don’t stop and calculate.

You just buy what you have to buy.”

Ms. Rodriguez is among the legion of adult children — more than 15 million, according to various calculations — who take care of their aging parents, a responsibility that often includes paying for all or part of their housing, medical supplies and incidental expenses. Many costs are out of pocket and largely unnoticed: clothing, home repair, a cellular telephone.

Adult children with the largest out-of-pocket expenses are those supervising care long distance, those who hire in-home help and those whose parents have too much money to qualify for government-subsidized Medicaid but not enough to pay for what could be a decade of frailty and dependence.

The burden is compounded by ignorance, according to a study by AARP, released in mid-December, which found that most Americans have no idea how much long-term care costs and believe that Medicare pays for it, when it does not.

Families have always looked after their elderly loved ones. But never has old age lasted so long or been so costly, compromising the retirement of baby boomers who were expecting inheritances rather than the shock of depleted savings.

“There is a myth out there that families abandon their frail elders,” said Dr. Robert L. Kane, a geriatrician at the University of Minnesota School of Public Health. “Instead, across the income spectrum, children are sacrificing to care for their parents to the limit of their means and sometimes beyond.”

Researchers have documented the time spent by adult children, and others, caring for ailing relatives. But data is woefully inadequate on how much they actually spend, health economists say, because most people do not keep itemized entries as they write checks, use their credit cards or pocket money to meet the demands of the day.

“When you’re in the middle of the forest, with so many things coming at you, you can’t really see the trees,” Ms. Rodriguez said. “But each one of those trees has actual dollars connected to it.”
Costs are astronomical for long-term, low-tech care, the sort most often needed by those who linger with Alzheimer’s disease or are too frail to get around on their own. Medicare is of almost no help, since it covers only acute episodes like a heart attack, cancer or repair of a broken hip.

That means the elderly and their families are left to pay for assisted living (which averages $35,000 a year), nursing homes ($74,000) or home health aides. Only the very poor receive Medicaid, which pays nursing-home bills nationwide but home care in only a few states (New York among them), and nothing toward assisted-living rent.

Nor does Medicare cover equipment like grab bars for the shower and incontinence supplies, which alone can run $2,000 a year, or travel expenses for an adult child responding to medical emergencies.

Marilyn de Leo, for instance, has made two trips from New York City to Los Angeles since September, when her mother fell in the bathroom and broke her neck and both ankles. Ms. de Leo, 62, an associate director in the development office of Mount Sinai Medical Center, spent $800 on airfare for the first frantic trip , plus $50 a day on taxis, since she had left her eyeglasses behind in a mad dash to the airport and therefore could not rent a car. Ms. de Leo has no savings left, and is $5,000 in debt. When asked about her own future, she said, “I’ll have to work till I drop.”

Only one authoritative survey, in 2004, has even asked adult children how much they contribute to their parents’ support. Half said they did, and the average monthly expenditure was $200. Respondents who looked after their parents at least 40 hours a week said they spent an average of $324 a month.

But those figures were based on “quick, top-of-the-head estimates,” said Gail Hunt, president of the National Alliance for Caregiving, which conducted the survey.

Knowing the extent of these expenses might inform public policy, some experts say, calling attention to a gap in the government safety net for the elderly.

“Should this burden fall solely on the individual and the family?” asked Judy Feder, dean of the Public Policy Institute at Georgetown University. “And can we really expect this arrangement to keep doing the job as a larger and larger population comes to grips with it?”
Correction: January 4, 2007
A front-page article on Saturday about adult children who take care of their aging parents referred incorrectly to expenses for the care of a spouse that are tax deductible if they exceed 7.5 percent of adjusted gross income. They are medical expenses, not any expenses.

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Subject: Father died peacefully at home on Saturday Jan 13 at 3:52 PM.
Date: Mon, 15 Jan 2007 05:55:57 -0500
To: "Jordi Reyes-Montblanc"

My father died peacefully at home on Saturday Jan 13 at 3:52 PM. Service and
viewing will be held at St. Mary's church, 440 Grand St in Manhattan (lower east

Viewing starts at the church at 10:30 am followed by mass at 11:00 am.
The body will be taken for cremation following the service.

To reach St Mary's Church by train take "F" to Delancey St or "J" or "M" to
Essex st. Walk south 2 blocks to Grand St. then 3 blocks to 440 Grand - St.
Mary's Church.

Please do not send flowers. Any expression of condolence should be offered (in
dad's name) to an elder citizen directly or to an organization that represents
the needs of the poor and elderly.

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