On a recent morning, I accompanied Marian Sunabe, who travels from her South Pasadena home to Gardena once a week or so to visit her 100-year-old mother, to discuss the debilitating expense of elder care.
Her mother is independent-minded, prefers the comforts of her own home, and has no desire to live with Sunabe or her brother, according to Sunabe, a retired school psychologist. Reiko Kobata has had a daily caregiver for the past four years. However, in recent years, a nighttime caregiver has been introduced after a fall and subsequent pneumonia.
For a 13-hour shift, the daytime tab is $320. The cost of the 11-hour night shift is somewhat less than $300, making the daily total $620.
That comes to an astounding $18,600 every month. The fee is almost half that when the caregiver for the night shift is not required.
The majority of people couldn’t afford this. However, Sunabe had stated in an email that the only other choice is to admit them to a board and care facility, which can cost several thousand dollars each month. I’ve known persons who had to resign from their jobs in order to take care of their elderly parents. It’s a bad method that can quickly deplete all of your assets and money.
It’s actually a national catastrophe, and at a time when the world’s population is aging quickly, the United States lags behind many wealthy nations.
Paul Irving, a senior advisor at the Milken Institute, claims in the new PBS documentary Caregiving that Americans are unprepared for the difficulties of providing care. According to him, families eventually discover that health insurance does not cover necessary care, which is why, astonishingly, an increasing number of middle-class Americans must drop below the poverty line in order to be eligible for Medicaid. For both them and our federal government, that is an absurd arrangement.
Additionally, with the Trump administration’s and Congress’s sabotage of Medicare, it may not be an option for much longer.
I told Sunabe about my buddy Morrie Markoff, who lived to be 110, as we traveled south. He was lucky enough to have saved about $14,000 a month for in-home care. He and Sunabe’s mother, however, are not typical. I also wrote about Paul Hult, a 102-year-old World War II veteran who needed in-home care after suffering a fall and rapidly depleting his life savings.
On a piece of lined paper, Sunabe had carefully sketched columns of numbers for me that detailed the calculations involved in her mother’s care. To pay the $18,600 monthly fee, Kobata was combining her retirement funds, pensions, long-term care insurance, Social Security, and the proceeds from a rental property she and her late husband owned.
Kobata reimburses an organization that supplies the carer and pays them. Under such agreements, agencies may receive up to 50% of the total. In a sector where there is a severe scarcity of workers, it can be difficult to find more caregivers because their pay may be close to minimum wage.
Because of this, a large number of caregivers operate illegally and without proper documentation. Because there isn’t a split with an agency, clients save money. While on duty, many caregivers receive free housing and board, but they forgo their personal privacy and family time.
Filipino women, some with and some without legal status, comprise a significant share of California’s labor. Some of them live in barracks-style housing, as I have written, and many are currently living in fear of deportation as a result of the Trump administration’s immigration sweeps.
Therefore, what we are seeing is a massive failure of public policy, and it is not as though the age tsunami that has been cresting for decades was unexpected. According to the Public Policy Institute of California, the proportion of Californians 65 and older will increase from 14% in 2020 to 9 million in 2040, or 22% of the state’s total population.
Due to necessity, a technique that is quite typical in immigrant cultures will be used by an increasing number of families. They will take care of themselves, live together, juggle a lot, and hope that medical expenses won’t bankrupt them when the time comes.
Sunabe drove through the Gardena streets where she used to walk to school after getting off the 110 Freeway. As we got closer to the family home, she informed me that although her mother doesn’t keep track of the overall cost of her own care, she still prefers to write checks to pay her expenses.
She will occasionally inquire, “What is all this money going for?” “Sunabe said.”
Sunabe parked at her childhood home’s driveway. About sixty-five years ago, when Harold Kobata was a chemical engineer and his wife was a teacher’s assistant and school office assistant, her parents paid $13,000 for it.
Despite using a walker to get into the living room, Kobata seemed to be in very good health and much better spirits. Her grandson was on his way to work as a sushi chef at a local restaurant, staying with his grandmother.
Kobata took a seat on a cozy couch that was backed by a wall of family pictures. She told me she likes to stretch out the L.A. Times every day and read the entire paper from front to back, and she likes to take a morning stroll around the neighborhood. She watches the Dodgers, plays solitaire on her computer, takes care of her yard, and has a soft spot for Shohei Ohtani.
Kobata didn’t look 100, I told her.
How are you feeling? I inquired.
“I’m not sure,” she said. What are you meant to feel?
After giving it some thought, she stated that she felt roughly 90.
We had a great two-hour visit, but I didn’t want to interrupt Kobata’s nap. Sunabe stated during the drive back to South Pasadena that her mother’s circumstances are temporary, but she questions the larger social issue.
“You probably have a fortune in equity if you’ve lived in a house for a long time, so long that you don’t want to move out because it’s so comfortable and familiar,” she added. The solitude and care issues would be resolved by cashing out that equity if you downsized or relocated to a more community area.
Along with unpaid assistance from friends or family and a governmental program that offers limited care to elderly and low-income individuals, that is a possibility for some people.
But there are no cheap or simple answers, according to Irving and UCLA professor emeritus Fernando Torres-Gil, who also makes an appearance in Caregiving. He adds that his two-word reaction when asked for guidance on elder care is, “You’re screwed.”
In the middle of the last century, Torres-Gil said, the U.S. invested heavily in institutional care, enabling a huge for-profit industry to take hold. Other nations, such as Singapore, Japan, Taiwan, and South Korea, instead made investments in public funding for home-centered and community-based care.
According to Irving, we are lagging behind. Being the only developed nation without a universal health care system, we have high rates of chronic illness, shorter life expectancies, and a system that, if you can call it that, fails our seniors. Most Americans cannot afford nursing homes and assisted living facilities.
Ironically, the aging wave itself might be the only hope. As the population continues to decline, officials may learn the price of disregarding their pleas for assistance.
Steve Lopez at La Times
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