For years Cynthia Wilson has covered the business side of healthcare, while at the same time has been at the barrel end of a growing healthcare trend, caring for an elderly disabled parent in her home.
Wilson has collected what she’s learned into a book, Who Will Take Care of Mom: A Guide for Family-Managed Senior Care. Wilson’s book was written for the general public, but there are lessons for the entire healthcare industry.
Wilson took in her mother in 1999. At that time, Wilson was single, but now her mother lives with her, her husband and pre-teen son. Wilson is one of a growing trend, she believes. The baby boomer generation is retiring, and half have saved nothing for retirement. “How will they pay for [elder care] if public funds for Medicare and Medicaid programs for the elderly are dwindling?” Wilson asks in her book. “If the current trend continues, and I see no reason to believe that it won’t, it will be you or someone else in your family who picks up the tab.”
The law can get a little fuzzy when it comes to that line where a parent’s debts leave off and their children’s responsibility for that debt begins. Twenty-nine states, according to Wilson, have filial responsibility laws that require children to pay the debts of indigent parents.
Although Wilson does not live in one of those states, she got a glimpse into that world when her mother fell while visiting a relative. “I had to pay my mother’s bills when she had that accident,” she says in an interview. “Somebody had to do it.” She had some insurance, but “her copay was larger than her income,” Wilson says.
Wilson notes that the medical bills were especially high because her mother kept getting readmitted. “When it comes to elderly care, [insurance companies] want you out of the hospital as soon as possible,” says Wilson. If the patient is not well enough to leave, they return to the hospital, which racks up more co-pays.
Under the Patient Protection and Affordable Care Act (healthcare reform), hospitals will now be penalized for excessive readmissions, and Wilson knows firsthand that will benefit the consumer. It took her 18 months to pay her mother’s hospital bill.
Caring for an elderly parent “will put a crimp in your career and your earnings,” says Wilson. However she cannot bring herself to put her mother in an assisted living facility or nursing home. She described a recent experience where she visited a friend’s mother in a facility, and witnessed an incident where staff failed to provide the elderly woman dinner. Wilson recognizes that quality of care at nursing homes can vary widely, but as the number of elderly begins to explode with the aging baby boom demand will outstrip supply and quality will suffer. Therefore more individuals will pursue the path she chose and have the elderly parent or parents live with them.