THE WOMEN'S ISSUE OF LONG TERM CARE--THE NUMBER ONE WOMEN'S ISSUE !!! 

SALARIES, FINANCES, AND SOCIAL SECURITY

With the background of the previous three articles, we now know who really provides about 75% of the informal home caregiving for older loved ones.  So, let's see what we can expect for the women who work--in addition to providing care to an older family member--and see what kind of an impact caregiving has on employees in this country.

Let's start with wages.

The following findings are shameful, and reflect the greater outrage; that all forms of retirement and its problems are disproportionately out-of-balance towards the needs of women.  As we have shown, women have a greater and longer need for health care, a greater and longer need for long term care, a greater and longer need for Social Security, and a longer need for day-to-day living than men.

But, it appears that women cannot even earn the necessary wages of a full time job, which can help enable them to prepare for retirement.  Whoa, what's wrong with this picture?  As a country about to explode with every need I have discussed, we must work on a major overhaul of each issue and correct these problems, before we double the expected number of recipients in the next generation. 

Long Term Care insurance, purchased at a young age, and a satisfactory Medicare Supplement purchased at age 65 can solve two of the problems, but the problems of Social Security, retirement, and livable wages must get addressed soon.

Let me make something crystal clear at this point.  Should men be concerned with these issues--the ones discussed previously, and this issue of women's wages-at  this juncture?  The answer is an unarguable and loud yes!  It doesn't take a nuclear scientist to understand that since the female gender is at greater risk for the medical and long term care needs we have discussed; that dollars for payment of these situations becomes something close to critical mass. 

I'm not saying that men keep women from receiving equal pay for equal work, even though that may be the case, but "the system" seems to have developed just such a scenario.  In case any man looks at this chapter and determines that they are immune from the consequences of what appear to be women's problems--think again.  A complete brain will easily identify that if women can't receive adequate incomes to deal with disproportionate longevity, caregiving responsibilities, and health concerns, and still pay their bills, who would that responsibility fall back onto?  Oh, yeah, the government.  Sure. And who pays the government?  The taxpayer.  And who pays the majority of the taxes, if women's incomes don't compete?  Guess! 

This is not all that difficult to figure out.  And it's not all that difficult to arrive at a solution.  Get women's wages up.  Redistribute the caregiving workload.  Make the total employment picture more sensitive to women's logical and sensible needs, when not do so, results in "radar-screen warnings" that say, "Change the system so the ladies can pay their own way, or we're going to be doing it anyway."  And, buy Long Term Care Insurance during the working years.  Yes, there I go again, and as one of my college professors used to say, "Good ol' Iverson, He never forgets the objective."    Now that I've vented, let's get back to the facts.

Lest you think I have the cart before the horse here; in discussing wages before discussing working caregiver problems, let me set the table, and point out why disproportionate salaries for women and Social Security need to be addressed first.  Simply, Social Security beneficiaries receive benefits in proportion to what they have paid in.  That's right, it's just that simple.  If you make less money, you pay less in, and subsequently take less out per year.  Now, further exacerbate that problem with extended longevity, and it's pretty easy to see why most elderly women live in poverty.  In fact, according to the U.S. Department of Labor, of the elderly poor, nearly 75 percent are women.

There are a few other employment factors, which should be included in the male/female disparity.  According to the National Council of Women's Organizations, women are less likely to work full time, thereby reducing Social Security contributions; and women are more likely to spend time out of the paid labor force, again, lowering their income and Social Security contributions.  In addition to those problems, only 38 percent of women receive employer-provided pension benefits compared to 57 percent of men, according to the National Council of Women's Organizations.  So, with this background, let's get to the problems of America's caregivers, who we now know are three-quarters women.            

An AARP study conducted in 1997 found that "80 percent of working caregivers reported emotional strain, 50 percent reported financial strain, and 40 percent missed work on a regular basis due to the health needs of an elderly loved one."  Is it any wonder that financial strain and missed work (which results in even lower wages) is a serious burden to the day-to-day needs of a worker, and also creates a lower payment into the system which many workers rely on to solve most retirement needs?

Dozens of corporations have conducted studies regarding the influence and effect on both the employer and the employee who must provide family caregiving.  The conclusions are pretty similar, and, obviously, affect both parties.  The common threads were: 1) that employees work fewer hours than desired; 2) that employees must take time off from work without pay; 3) that some employees have to turn down advancements; 4) that the caregiving employees' ability to stay in the work force is overtaxed; 5) that employee vacation time, sick leave, and personal leave time is used up quickly; 6) that the employee's own needs (emotional, physical, financial) go unmet; and 7) that some employees simply have to quit their jobs.

A study by the National Alliance for Care Giving puts some numbers on the faces of the facts listed above.  1) The aggregate cost for care giving to U.S. business...exceeds $29 billion per year.  2) 69 percent of caregivers arrive late or leave work early.  3) 67 percent take time off during the day.  4) 64 percent use up their sick days and vacation time.  5) 29 percent resign.  6) 22 percent take a leave of absence. 

Then, a report by the National Center for Women and Aging puts some astonishing dollar amounts to the facts.  Suppose we rely on them for hard numbers which, relate to employee caregiving in general, and female employee caregiving (since 75% 0f caregiving is performed by women) in particular.  "Employees who are forced to care for an aging parent pay a toll in lost income and added stress with the following:  1) $566,500 in lost lifetime wages.  2) $67,000 lost lifetime retirement contributions.  3) 29 percent pass on promotions or new assignment.  4) 25 percent pass on transfers or relocations."

So there you have it.  The problems of caregivers in the workforce, with dollar amounts attached.  But, sadly, there's more than the dollar amounts and the physical and mental health concerns we have discussed.  There is also a matter of the ultimate sacrifice as reported in the Journal of the American Medical Association on December 15, 1999.  The Journal cites that, "elderly people caring for their spouse were 63 percent more likely to die than non-caregivers." 

We don't have a female/male ratio breakdown, but the facts are clear--caregiving takes its toll on all involved, and what were once carefree, loving relationships can become strained, tested, and complicated, if the caregiving must be provided by family members, whether for financial or voluntary reasons.  A large part of the chapter on "The Emotional Issues" in my book, "Guarding Your Gold II," is dedicated to the "sandwich generation," those caught in the middle of raising their own children, sometimes being expected to hold a job or two, and caring for their elders.  I wish these conditions were easier to write about, but they are not.     

In summary, so many writers say it all so well, that I cannot help but quote a few of them.  A brilliant piece, which appears in the Older Women's League (OWL) web page, ties things together quite well.  In an article titled, "State of Older Women in America," the writer encapsulates our chapter by writing, "Today in America, the average woman age 65 and over, lives six years longer than the average man.  As a result, she is typically widowed and living alone.  She struggles to make ends meet on an annual income of $15,615 (compared with over $29,171 for men).  During her lifetime she probably spent 17 years caring for children and 18 years caring for elderly parents.  Her retirement income is also smaller because she probably did not receive a pension, and was paid less than the average man.  As a result, she receives lower Social Security benefits.  She spends a higher proportion of her income on housing costs--leaving less for vital necessities such as utilities, medical costs, food, and transportation.  The average older woman spends 20 percent of her income each year on out-of-pocket health care costs."  That pretty well sums it up, doesn't it?  The facts are there, now all we need to do is pay attention to them, and do what we can do today to overcome the obstacles of tomorrow--prepare for them. 

Dr. Gary Applebaum, Senior Vice President and Medical Director of Renaissance Gardens, (who deserves credit for the title of this chapter) wrote in a December 12, 2001 issue of Long Term Care Provider, "Who would have ever thought that the baby boomer generation would be the biggest caregiver generation in history?  With the aging of the older generation comes a barrage of challenges.  Families and caregivers must learn to understand and care for adult relatives, especially those who are ill or frail.  Businesses must become much more aware of the needs of older adult employees, as well as of the morale and productivity issues of employees caring for older relatives."

"The perplexing thing about elder caregiving is that most employees suffer in silence, or so they think.  For a variety of reasons, stemming from a need for privacy to denial, they usually do not want to discuss their situations with supervisors or coworkers.  However, in most cases, their actions speak much louder than words.  These are people who are stressed, conflicted, and frightened.  People who have maxed out their sick, personal and vacation days, get frequent personal phone calls daily, arrive late and leave early, have way too many "family emergencies," and are dependent on the kindness of coworkers..."

"When you consider that by the year 2030 over 25 percent of all Americans will be 60 years or older, and by 2080, there will be one million U.S. centenarians, you can't afford not to take this silent crisis seriously."

Well said, Dr. Applebaum, well said.  "The silent crisis."  How true. And how few of us are willing to expose the silent crisis and start shouting about it?  What this silent crisis can do to our citizens, if we don't prepare for these painfully obvious problems now, or even better, yesterday, deserves bold front-page headlines.

As if all of the previous information were not enough somber news, listen to what Peter R. Fisher, Under Secretary of the Treasury, had to say in a press release from the Office of Public Affairs, November 14, 2002.  The remarks were made relative to all the Social Security and Medicare and Medicaid promises made by the U. S. Government over the last decade. 

"Think of the federal government as a gigantic insurance company (with a sideline business in national defense and homeland security) which only does its accounting on a cash basis-only counting premiums and payouts as they go in and out the door.  An insurance company with cash accounting is not really an insurance company at all.  It is an accident waiting to happen."

"This particular insurance company, it turns out, has made promises to its policyholders that have a current value $20 trillion or so (give or take a few trillion) in excess of the current value of the revenues that it expects to receive.  A real insurance company could try to grow its way out by raising premiums and its earnings on investments faster than its liabilities.  The federal government, however, would have to raise taxes or borrow faster than it increases outlays."

As for my own conclusion, I hate to be the messenger of bad news, but I know that at least two of the problems can be solved.  Today.  Sooner, than later.  I make no apology for offering the solutions of Long Term Care Insurance and Medicare Supplements, or Medicare Advantage plans.  If I didn't think there was help available, I wouldn't have written a book about it.  I have thirty-seven-plus years in the insurance field and I know the value of paper.  I have experiences, which I wish I didn't have.  Too many times I have seen personal situations where people denied the facts and delayed purchasing LTC coverage when premium was absolutely no problem.  Denial was the problem.  "It won't happen to me," was the attitude. 

To explain, let me offer a few personal stories.  Several years ago I became familiar with a family situation where "Mom" just wouldn't buy LTCI coverage, because, as she said, "The five children will take care of me."  Less than six months later, she became a person in continual need of care, and she was right-the youngest daughter quit her job and came home to take care of Mom.  For one month.  Then this.  "I've got to back to where I was living and try to get my old job back, because it's far easier than this," was her lament. 

Then the oldest daughter came to me and asked if we could still write the policy, which I had tried to convince her mother to buy.  Sadly, I had to explain that it was too late.  (You can't insure the car when it's sitting at the bottom of the lake, and you can't insure the house when the garage is on fire.)  But, I couldn't resist telling the daughter why.  "I couldn't get your mother to purchase an LTCI policy because she said that you would take care of her."  Brutal, but factual.  Delay and denial.  Mom went to the nursing home and paid for it herself.  The "kids" seemed to have gone low profile.

More recently, I found out about a personal friend, who had requested a first copy of my book, which I gave to him, and we and his wife spent some time talking about Long Term Care, and their need for a policy.  I didn't get the job done.  Within six months my friend developed a serious heart problem, and his wife, who was "sharp as a tack," at the time we discussed LTC, was diagnosed with Alzheimer's.  We now know that this insidious disease can last a long time, but her case seems to have advanced rather rapidly.  So, again, the oldest daughter quit her job in another city, and came to take care of Mom and Dad.  That worked for awhile--or at least until the daughter could no longer care for her mother.

One of my best policyholders, a man in his fifties, looked at things differently, and calmly stated it all so well.  After I had delivered the policy, which covered both he and his wife, he stated, "Ron, I just couldn't see my wife having to spend down our assets and eventually lose everything that we have spent years building up, if something were to happen to me.  That's why I did this with you." 

A lady agent friend of mine, who is very knowledgeable about LTC insurance matters, says that one of her biggest barriers in a "couples" presentation, is convincing the husband that in the long run, with an LTC policy, he will save the money he intended for his wife and family, so that "Mom" will not have to finish her last years in poverty.  Funny how "Mom" somehow already knew about that.  

Yes, the problems and conditions for women in America are serious, as presented by the evidence I have offered for your consideration.  But as severe as all of this is, I am proud that I represent the Long Term Care insurance industry, which finally can solve some of these problems for those who think ahead and prepare.  Comprehensive Long Term Care insurance coverage, even at home, can provide some peace-of-mind for the whole family, for at least part of the problem.  But the unfairness of all the issues discussed, seems to settle on the backs of the women of this country.

(Editor's note:  The above content is adapted from the book, "Guarding Your Gold II," by Ronald J. Iverson, Copyright, 2004.  Even though some of the statistical content is dated-- 1996 to 2001-- the basic premise of the chapter, that of women's issues regarding Long Term Care, remains the same.)