Who Gives a Care?: Plans To Help the Sandwich Generation and the Growing Care Crisis

Don’t you get nervous talking to attorneys? I do, and it’s been a nervous time for me lately.

I’ve been calling lawyers to ask about opening a trust — no, I don’t really know what that is either, except I keep reading advice that I should look into one, like, right now. You see, with advanced and progressing MS, and with my wife and I both being seniors, we have a good-enough chance of needing care down the line. While full-time home care can cost nearly $69,000 a year (CNN) and a nursing facility at least $104,000 yearly (KFF), our home and life’s savings won’t last long. To get any assistance, we’d have to qualify for Medicaid, which requires selling off the home from under my wife. My nervousness talking to attorneys is a small price to pay.

 francescoridolfi.com | Credit: Rido - stock.adobe.com

We’re not alone. Seventy percent of us who live to be seniors will need care, according to the Urban Institute. More than 105 million in the “sandwich generation” are caregivers of some sort, a number that has more than doubled in the last decade (Rand Corporation). More than 14 million are caring for service members or veterans. Two-thirds of them have to balance this with a job, and often they take a hit in income by having to go to part-time work or taking time off (AARP).

Seventy percent of seniors. One hundred four million people. Hm, think there’s a constituency there? Seniors just happen to be the most reliable voters, too.

Citing her own experiences caring for her late mother battling cancer, Vice Pres. Kamala Harris has proposed a Medicare at Home program, which would expand Medicare to help with home care costs for seniors and people with disabilities who might earn too much to qualify for Medicaid but cannot afford long-term care. She also wants to cap child care costs at 7% of income, pass paid family and medical leave, and raise wages for care workers. (The last one’s critical, because there is already a severe shortage of care workers due to the poor pay.) She proposes paying for this with savings from negotiating more prescription drug prices down with pharmaceutical makers, which has already been successful with a handful of drugs under 2022’s Inflation Reduction Act.

This follows Pres. Biden’s ambitious 2021 proposal to invest $400 billion in care services for children, seniors and people with disabilities. That part of the Build Back Better bill got shot down in haggling with Congress, but it was a bold target to set. Now the idea out there.

The need is great: I have spoken to an at-home care coordinator in Pennsylvania who says people in her area are stuck in nursing homes not because they need intensive care, but because there are no home workers available so that they can live a place of their own in the community. Also I’ve talked to the head of a statewide network of care workers in Austin, Texas, who recited a list of care workers she knows who, out of love, continue to work beyond what their aging bodies can handle, because there are no younger workers to take their place in caring for their clients. According to Nicole Jorwic, who has long watched the issue as head of advocacy at nonprofit Caring Across Generations in Washington, D.C., "It doesn't matter if you're in Portland or if you're in central Illinois, … it is a nationwide problem.” Plus, she noted, the population is aging and the need for care will only increase.

This weekend Donald Trump proposed a tax credit be given to family caregivers. Advocates like Jorwic are skeptical without details or ideas to build up the needed care “infrastructure,” i.e., creating more care workers and supports. But the point is that the care issue is on everyone’s radar now, and that’s good for us.

But for now, I pick up the phone, and prepare to get nervous again. Go vote and let them know we’re out here, people.

Put Your Heart Into It: Support Those Who Support Us

These are polarizing times, my friends, but there are some basic things we'll always have in common. Most of us love chocolate. The laughter of babies. And Scooby Doo. But even more basic, since you're reading this now, is that your heart is beating. No matter who you are, where you are, what you've done today, or what you're going to do, I predict that your heart is beating. Mine is, just talking to you right now. You have that effect on me.

It beats dozen of times every minute, thousands every hour. Bump-bump-bump, it keeps on pumping. Bump-bump-bump, delivering nutrients and oxygen to power the whole machine that is your body. It's the thing that never stops, no matter whether you're running a marathon, binge-watching a whole weekend of TV, or jumping a row of school buses with your motorcycle in front of Caesar's Palace, it's always going in the background, bump-bump-bump. Beneath the hundreds of conscious things that we do day after day, we take it for granted that, bump-bump-bump, it is still beating. Bump-bump-bump. Without any accolades, or even a social media account, it goes bump-bump-bump.

There are people who function like this, too. People doing the kinds of things we rely on without us ever thinking about it. We learned this in a big way during the lockdown. Suddenly everything shut down, suddenly things that we needed on the daily were no longer there. But we still needed to grocery-shop, fill up with gas, and use electricity for our computers to run Zoom, right? Those store employees, service station attendants and utility workers got new respect and a new name: essential workers. Like our hearts, they were working in the background. The whole time, quietly, diligently, day and night. Suddenly they were everyone's new best friend. Everyone hearted them.

Like our hearts, the essential workers continue producing even though we might treat them like crap. Some essential workers got pay bumps when everyone realized just how essential they are. Many had the extra pay snatched back away when things were deemed safe again. And now, some employers are having a hard time attracting these ex-essential workers. Similarly, one out of 5 healthcare workers have left their jobs. I wonder why. Like the hearts in our chests, if we treat them badly for long enough, they stop hearting as much.

One special class of essential workers have been putting their very lives on the line taking care of Covid patients in the hospitals for almost two years. Healthcare workers have labored under extraordinary stress, overwork, privation (remember how long it took to catch up on PPE?) and even disrespect and physical attacks. They continue putting themselves at risk, treating others who have refused to take the simplest free measures to protect themselves. This goes on because healthcare workers are a tiny minority who work in enclosed spaces out of sight from the rest of us. But whenever we've got an owie, they #$^& well better be on duty and waiting for us with hot coffee, right?

This is similar to the deal that military people get. A tiny minority serves and fights, often returning to war time and time and time again. It goes on because they are out of sight from the rest of us. I'm writing this on Veterans Day, when we like to thank them for their service. But on the next day, are we caring enough for the 40,000 vets who are homeless? For the 17 vets who commit suicide every day? For their families who go hungry? Or are they, and their sacrifices, out of sight out of mind too?

Caregivers are treated the same way. November is National Family Caregivers Month. Those who ensure the well-being of our ever-growing population of elderly, children and people with disabilities, are in crisis. For instance, base pay in our second-largest state, Texas, is $8.11 per hour, when one can go down the street to deliver pizzas for much more. One in five people are being cared for by unpaid family members. About the same percentage must provide unpaid care to family members. Mostly, this affects women, whose ability to work has already been jeopardized by the measures taken by schools to control the pandemic. We do not even have paid emergency and family leave provided by all other rich countries, even though it's overwhelming popularity with voters of all political parties. Again, here are people who work and sacrifice away the public eye.

Like our hearts beating, the caregivers, healthcare workers, military, first responders and essential workers keep things working and keep saving lives. They will continue doing so even though they are taken for granted, bump-bump-bump. But in the richest country in the world, is that the way we really want to do it? Wouldn't it be much better to take good care of them, which in turn takes good care of us?

As for our caregivers, there is a definite way to help, right now. We can call our senators at the U.S. Capitol Switchboard, (202) 224-3121, and demand support for home-based caregiver services and for family leave. There's a historic bill before them to support these now. I say this without regard for party: about 70 percent of us will end up needing long-term services and supports, and age and disability will come for all of us in a truly bipartisan fashion. Tell them to support these essential caregivers. Tell them to have a heart.