Saturday, February 18, 2012

What I really worry about...  

I don't mean to harsh your mood this morning, but this after spending two weeks listening to enormously prosperous farmers gripe loudly about imaginary looming regulatory nightmares (which essentially amounted to cleaning up our manure and fertilizer messes), I ran across this article that captured something of what I think is a more legitimate concern for People of a Certain Age.
However ghoulish, it is a world we will all soon get to know well, argues Gross: owing to medical advancements, cancer deaths now peak at age 65 and kill off just 20 percent of older Americans, while deaths due to organ failure peak at about 75 and kill off just another 25 percent, so the norm for seniors is becoming a long, drawn-out death after 85, requiring ever-increasing assistance for such simple daily activities as eating, bathing, and moving.
This is currently the case for approximately 40 percent of Americans older than 85, the country’s fastest-growing demographic, which is projected to more than double by 2035, from about 5 million to 11.5 million. And at that point, here comes the next wave—77 million of the youngest Baby Boomers will be turning 70.
Quick back-of-the-envelope calculation, for Baby Boomers currently shepherding the Greatest Generation to their final reward? Hope your aged parents have at least half a million dollars apiece in the bank, because if they are anything like Mama Gross, their care until death will absorb every penny. To which an anxious (let’s say 49-year-old) daughter might respond: But what about long-term-care insurance? In fact, Gross’s own mother had purchased it, and while it paid for some things, the sum was a pittance compared with a final family outlay of several hundred thousand dollars. But how about what everyone says about “spending down” in order to qualify for Medicare, Medicaid, Medi-Cal, or, ahwhich exactly is it?
Unfortunately, those hoping for a kind of Eldercare for Dummies will get no easy answers from A Bittersweet Season. Chides Gross: “Medicaid is a confusing and potentially boring subject, depending on how you feel about numbers and abstruse government policy, but it’s essential for you to understand.” Duly noted—so I read the relevant section several times and … I still don’t understand. All I can tell you is that the Medicaid mess has to do with some leftover historical quirks of the Johnson administration, colliding with today’s much longer life expectancies, colliding with a host of federal and state regulations that intertwine with each other in such a calcified snarl that by contrast—in a notion I never thought I’d utter—public education looks hopeful. Think of the Hoyer lift that can be delivered but never repaired, or the feeder who will not push, or the pusher who will not feed.
But it gets worse. Like an unnaturally iridescent convalescent-home maraschino cherry atop this Sisyphean slag heap of woe, what actually appears to take the greatest toll on caregivers is the sheer emotional burden of this (formless, thankless, seemingly endless) project. For one thing, unresolved family dynamics will probably begin to play out: “Every study I have seen on the subject of adult children as caregivers finds the greatest source of stress, by far, to be not the ailing parent but sibling disagreements,” Gross writes. Further, experts concur, “the daughter track is, by a wide margin, harder than the mommy track, emotionally and practically, because it has no happy ending and such an erratic and unpredictable course.” Gross notes, I think quite rightly, that however put-upon working parents feel (and we do keeningly complain, don’t we—oh the baby-proofing! oh the breast-pumping! oh the day care!), we can at least plan employment breaks around such relative foreseeables as pregnancy, the school year, and holidays. By contrast, ailing seniors trigger crises at random—falls in the bathroom, trips to the emergency room, episodes of wandering and forgetting and getting lost. [More]
Jan and I are blessed with loving and dutiful sons and daughters-in-law, and the idea of not doing my best to avoid this scenario seems like a singular abdication of my abiding love for them. I have written about this before (pdf), as I watched my parents' and grandmother's end of life, and I have friends currently undergoing this trial.

Writer Roger Rosenblatt, an essayist for Time magazine whose work I greatly admired, once described his heart condition as similar to having someone living in your basement who would occasionally try to come upstairs and kill you. The image stuck in my mind, but more often these days, the basement-guy looks less like a villain, and more like an answer.

As we continue to skew our resources to Boomers and their old age - which is THE federal budget problem - these lingering, unnatural death runways will stretch further and further into younger people's futures. We're only beginning to grasp the true consequences of enormous accumulated wealth and medical technology and their mutual attraction.

In the end, I doubt the regulatory overreach that many imagine in agriculture will amount to even an economic footnote, especially since compared to many developed countries (notable Europe) our farmers are allowed to run relatively rampant ( and given how we have obviously squandered both Roundup and Bt traits, this can't be too far off the mark).

Indeed, as we speak, soil conservationists are deeply concerned ag organizations will throw them off - if not under - the budget bus to get a higher buy-up or some such subsidy for a crop-insurance based farm program.

Our narrow- and short-sightedness has us fixated in ag on issues we can surmount with modest effort: runoff, over-application, food safety. I doubt any of these issues will end many farming operations.

But wait until Dad and Mom hit 70 and watch the equity leak away. That is an increasingly likely scenario.

1 comment:

Anonymous said...

Dead on. Perhaps a poor choice of words but 100 percent agreement anyway on both the ag regulatory and long term care front. It just seems so obvious.