February 2009 - Honoring Our Black Seniors: Providing Care During Their Golden Years

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For many of us, our parents paved the way for our success through their discipline, hard work, and sacrifice. In return, it is an honor and a privilege to show our appreciation by providing for their care when they are sick, old, or unable to care for themselves. It is a natural part of the life cycle in which many baby-boomers find themselves today-caring for their elderly parents.

A colleague and I were talking recently about the old days when just about every elder was cared for at home. A network of adult children, grandchildren, extended family and friends did their best to comply with the elder's medical needs. And what they may have lacked in formal nursing ability, they made up for in around-the-clock loving attention-no matter how strenuous or time consuming. They offered comfort, home cooked food and the warmth and familiarity of family. However, in our generation, things have changed dramatically. Modern medicine has extended life spans into our eighth and ninth decades and beyond. The "family home" is virtually gone. Adult children often as not are separated from their aging parents by hundreds of miles and raising children of their own while meeting the demands of professional careers. Long-distance management of elder care can become a nightmare. The network of support has collapsed. What do families do?

The choices are generally two: care of elders in their own homes with support from home health providers or institutionalization in a nursing facility. Neither option is perfect since to work well, both require close family monitoring to ensure quality care. Both options are also expensive, and without excellent supplemental insurance, can quickly run through a family's savings. (In fact, the requirement for Medicaid eligibility is that the applicant have virtually no financial assets.)

Look at these projected annual nursing home expense estimates from The American Association of Retired Persons (AARP): 2007: $74,806; 2010: $86,597; 2015: $110,522; 2020: $141,057; 2025: $180, 029. It's clear from these numbers that yearly nursing home care costs have and will continue to outstrip the annual incomes most Americans made during their peak earning years and are well beyond the means of most African-American families.

Home health care is generally a more desirable option than a nursing home. But it too, is prohibitively expensive and without oversight, care can be sketchy, uneven and sometimes downright unprofessional. In Georgia for example, AARP estimates that current home care provided by Medicare-certified and licensed practitioners can cost about $123,300 annually. Less skilled care can run about $50,000 annually. These staggering numbers should offer each of us a sobering glimpse into the future. Those who are without financial resources and left to the mercy of public programs do not face happy or healthy golden years. Let's hope that national health care reform will provide broader, better and more affordable options for all our aging citizens.

In the meantime, what steps are you taking to ensure that your future care will not be burdensome to your children and affordable for you? If you don't have supplemental long-term disability insurance, now might be a good time to explore available options. As with most types of insurance, the earlier you sign up, the lower the premiums. If you are still working, the group health insurance plan offered through your job may offer a supplemental long-term disability plan. If you are retired, consider the plans available through your life insurance carrier or the AARP. Any option is better than no option at all.

It's hard to project what our lives may be like 20, 30 or 40 years from now. But it's useful to consider your current preferences and resources. For example, if you are a homeowner with significant equity in your home, a reverse mortgage might be a wise choice that will significantly reduce your monthly expenses and allow you to put your money to other good uses. A living will that specifies your wishes about the extent and duration of your medical care should you become incapacitated is a necessity, as is a general will that spells out in exact detail your last wishes about the disposal of your property and affairs.

No one likes to think about a future in which we will not be the vital, healthy people we are today. But the reality is that most of us will outlive our good health and perhaps our good minds. For our own sake and that of those we love, it's wise to plan now.

With you on your Journey To Wellness!
Dr. Mary S. Harris

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