Understanding the Need to Prepare for Long Distance Care Giving--For Both Elders and Their Loved Ones.

Part 1, by Ronald J. Iverson, copyright 2007

Author's Note:  Before a problem can be solved, it must be identified and defined.  Likewise, once it is identified and defined, it must be understood--by both the elderly person and their children.  This is not an insignificant matter.  These factors--Identification, Definition and Education--serve as the basic platform for any understanding of the long distance care giving needs of Americans, as we navigate through the 21st century. 

The Background of the Problem

Two generations of people in America have a problem today, but, even if they do know it, they are not quite sure how to identify it.  To understand current care problems, both local and long distance, we would do well to go back in time, study the past, and find solutions for the present and the future. So...let's start at the beginning.

For centuries, parents have raised their children.  And, those children, in turn, raised more children, thereby making their own parents, "grand-parents."  Further generations created "great-grand-parents," and so on.  Family lineage is a normal human function.

In most cultures, families normally stayed close to one another, or lived together, perhaps even in the same family home.  Geography was not a problem, because, if they did move, family members seldom traveled far from their traditional roots.

But things change.  World exploration, the Industrial Revolution, the rise of nations and nationalities, and a movement from agrarian living to the rise of cities, all contributed to this change.  In America, such factors as "Manifest Destiny," "Westward Expansion" and "Urban Living," preceded contemporary definitions of "The Sun Belt," "The 'Burbs," "The Golden Years," "The Greatest Generation," and "Baby Boomers."

So, after a whirlwind, three paragraph history lesson, where do we find ourselves today...in America?

Well...we find ourselves all over the map.  Long after the phrase "Ellis Island" ceased to be a common household phrase, several generations of Americans find themselves living apart--sometimes a long way apart--from their families.  The necessary call to "go where the jobs are," has precipitated most of this geographical separation.

As our society became more mobile, seldom did the aging parent, or grand-parent, live in the same house, let alone the same city, same county, or even the same state as "the kids."  At the same time, every decade of our existence has seen a lengthening of the "average" age of people. Not only has this demographic factor become a case of longevity, but, in reality, a case of "extended" longevity.

And, with that extended longevity, a "care issue" surfaces. 

We would like to think that "old age" indeed leads to "The Golden Years", and in many ways it has.  But the fact is, that for many people, it has only extended the lifetime of the day that an older person needs help--help with normal activities of daily living-- with what were once common, routine everyday tasks.  Thus, the need for help, or care, or care giving, becomes another step in a lifetime of the normal elderly person.

In fact, many Americans find themselves with more parents than children.  It is not unusual in America today, that both Mom and Dad are retired or elderly, but in addition, Grandma and Grandpa, as well as two possible sets of  Great-Grandrents, who may be living, and not always in the best of health.  When one considers the magnification of this circustance with each spouse in a marriage, the possible combinations can escalate. 

In Canada, this situation was identified in 2007, with 36% of "middle age" individuals having more parents than children.  Can America be far behind, if not yet there already? 

As America gets older, the issue of children taking care of their parents or grandparents, and how they accomplish that from a thousand miles away, or even next door, has become a common "household" problem for millions of Americans. An issue which takes us to the present day.

In most cases, no matter how far "the kids" live from their elderly parents, older children have a love and compassion for the welfare and well being of their parents.  Phone calls may be made weekly, or twice weekly, or even daily.  E-mailing has become popular.  Vacation time may well be spent "going to see Grandma and Grandpa," and an occasional flight is in order for the older folk to "come visit the Grandchildren."

Then, someplace along the line, things begin to change.  Somebody notices that the older parent is "acting differently," or experiencing physical problems.  Falling down is a common harbinger of things to come.  Forgetfulness may set in.  Communication with the parents' neighbors may become routine.  "Just checking in," is a common phrase.  To be sure, concern and compassion are still in vogue for most intergenerational families. 

Others are geographically closer.  For instance, the term "sandwich generation" is set aside for those who, for a variety of reasons (including simple family love, caring and compassion, or finances) have accepted familial responsibilities, and find themselves caring for older parents and rearing their own children--in the same home.  Everyone should be so lucky.

The services of Medicare, Medicaid, and Social Security normally provide government financial support for the parent or grand-parent.  Long Term Care Insurance, Short Term Care Insurance, and Medicare Supplements all contribute to the financial and "peace-of-mind" status of the older person.

But one thing is missing in the mix.  Certainly, Medicare and Medicare Supplements or Medicare Advantage plans, provide for payment of the physical or medicinal needs of the elderly.  Long Term Care and Short Term Care Insurance can help with the financial burden of "care" needs of the older patient.  But something is still missing.  What could it be?

The answer is found In a phrase, "Preparation for the implementation of care needs," or more to the point, "Preparation for the implementation and coordination of care and medical needs for the elderly, as experienced by their loved ones."

It's just that simple.  While the physical medicine needs are covered by Medicare and a Medicare Supplemental or Medicare Advantage policies, standing by to be used when needed, there is a missing factor--that of being prepared for the moment when those needs surface.  And Long Term Care policies are available for utilization of care needs.  But, how does the younger adult respond to implementation of those plans, or for scary medical situations which may arise, when they are a thousand miles away?

Part Two of this series will identify the problems, challenges and solutions to this background of coordinating care needs for elders and their loved ones.