It’s hard to put into words how lacking and dysfunctional our nation’s approach to caring for the elderly has become.
Let’s face it, nobody in her or his right mind would devise the hodgepodge, silo-centric, anti-intuitive and sometimes toxic senior living and care system that’s currently in place. Actually, to even call it a system is a stretch.
A big part of the challenge here is that We the People can’t seem to agree on whether or to what degree the old and rickety among us deserve a helping hand. That’s no coincidence, by the way.
For to offer a fully integrated, comprehensive arrangement of care and services, far more public funding will be required. Anybody up for higher taxes? Didn’t think so.
So surprise, surprise, what we are stuck with is a two-tiered system bifurcated by the ability to pay.
If money is no object — or at least is not a complete deal-killer — some decent senior living options exist. Mom needs help at home? Aides can be hired. Mom’s memory is going? There’s no shortage of assisted living and memory care communities that can help for $5,000 to $10,000 a month. Mom needs nursing care? Plenty of skilled care beds are out there for $100,000 to $200,000 per annum. Of course, the top-shelf stuff will cost a bit more, but you get the general idea.
Now if Mom is broke and the kids are unwilling/unable to chip in, well, there’s basically the welfare route. That certainly eliminates private aides at home, in addition to most assisted living/memory care choices. As for skilled care? Well, let’s just say if Medicaid is picking up the tab, most entry-level options are not very pretty.
Of course, none of these fiscal realities will come as a surprise to anyone who’s been paying even casual attention.
As for how to make things better and fairer? Policy wise, the easy answer is for Congress to fully fund what’s needed. Of course, the odds of that happening are roughly about the same as the odds of Kevin James winning an Ironman triathlon. So for now, it appears we’ll have to settle for the better-luck-next-time prize: a congressional commission.
Legislation introduced last week by Sens. John Boozman (R-AR) and Jacky Rosen (D-NV) would set another one up. Under the Supporting Our Seniors Act they propose, a commission would provide regular reports to Congress on service delivery, financing, workforce adequacy and other issues to increase older adults’ access to affordable long-term care services.
Hey, it’s a start. But if board members simply create another wish list? Well, we’ve been to that rodeo before.
What the commission is not going to do is fix the funding problem anytime soon. As for who will, I’d bet on developers and operators willing to take on the largely underserved middle market. To be sure, that adjustment may mean trading lower per-unit revenue for higher volume. Not always a slam dunk.
But the alternative is to do nothing and hope. Is there any doubt about which option is more likely to make things better?
John O’Connor is editorial director for McKnight’s Senior Living and its sister media brands, McKnight’s Long-Term Care News, which focuses on skilled nursing, and McKnight’s Home Care. Read more of his columns here.