Managing the Decline

We live in an increasingly gender-neutral society as customary roles continue to change, in some ways slowly and in some ways, not.  We’re now more than two decades into the stay-at-home-dad scenario and it’s gone from a notable phenomenon to a far more widespread and mundane situation.  If you aren’t certain about that, pay attention to that faithful barometer of social change, the television commercial.  We’ve moved from the standard means-well-but-clueless-in-the-household-Dad across a broad range of products to considerably more commercials where Dad is actively engaged in managing the household and interacting with the kids.  The former still exists but it’s not as prevalent as it once was.  But as this continues to progress, men had better get used to the fact that there’s liable to be a point in their middle-aged lives when they’ll not only be responsible for managing the rise of their children but also the decline of their parents.

There are most certainly cultural influences.  China’s society is one in which the son is responsible for the ultimate care of the parents and that – coupled with their long-standing one child policy – has led to a profound imbalance in the male/female ratio as newborn girls were given up for adoption so that the parents could have another shot at having a son.  But American culture has historically been predicated upon the daughter having principal responsibility for the care of her aging parents.  The model with which we’ve been familiar through our lives has been, until relatively recently, one in which the man worked and the woman was responsible for the household responsibilities and that extended to caring for their aging parents.  It’s been stretched considerably with the rise in mobility and the nuclear family, and even further by the movement of the woman into the workplace.  This has been offset by the growth of local and state government programs to provide increased assistance for the elderly and the great majority, if not all, of American counties have some semblance of an Office of Aging to act as a portal to the panoply of programs designed for the aging American.  But we’re now at a new point in American history in which the promises made to all of the various layers and segments of our society are far outstripped by the resources available to meet them; the former Comptroller General under Presidents Bush and Clinton, David Walker, recently noted that the actual federal debt is triple what is reported due to the unfunded liabilities taken on by the government.  These unfunded liabilities would include especially the promises made to the elder generation – Social Security – and Medicare.  It is simply unsustainable.

While there are going to be increasing concerns and issues about the funding, the costs of providing care to an aging population continue to mount.  These costs are not at an outrageously disproportionate rate like college tuition, but they are increasing slowly and steadily and having an impact upon the family.  According to a report published by Genworth Financial, the median hourly rate for a homemaker service worker – who assists with non-medical and “hands-off” activities for the elderly and can help to maintain their independence – is $20 and the five year compounded rate of 1.61%.  Note that this is for the most basic assistance available to an elderly person and has the lowest rate of cost growth.  When you reach the higher levels of care, such as a semi-private nursing home room, the cost has risen over the past five years by a compounded rate of 3.57%.  And that cost is not being borne solely by the elder and the governmental programs.  A survey of more than 1400 households involved in caregiving for an elder found that fully 46% of those households were spending more than $5000 annually in their funds to assist their elders.  So once again, costs are increasing and the sandwiched generation is being pulled from yet another direction.  Paul Krugman can wax eloquently about existential American despair in the op-ed pages of the Times, but this type of issue goes to the heart of the matter.  The American middle class is beset not only by decreasing incomes on one side, but increasing costs and responsiblities on the other as more costs are offloaded back to them.  This middle class generation was raised in a particular environment – employers with a set of benefits, a belief in the value of education, and an activist government – and they’re watching it vanish as costs are shifted back to them and most importantly, their children.  Healthcare benefits?  Higher tuition?  Jobs that enable their children to take their own place as productive adults?  Nope to all of that.  And when you consider that the writing is on the wall for future government spending, then there’s really nothing existential about it.

So what does this mean going forward?  An understanding that the old model of following the job and then monitoring the elders from a distance and managing via a cobbled-together network won’t be as operative as it once was.  State and local programs will be constrained and there’s a greater likelihood that the facilities available to help care for invalided parents will be less than optimal and perhaps, households will shift to more of an integrated and intergenerational model with the elders close by to assist with the children and in turn be assisted by their children and growing grandchildren as they become increasingly infirm.  My own perspective is also framed by an understanding that even if we don’t realize it, our children are watching us and taking their lessons from our actions and inactions alike.  That means that I try to model a more hands-on and involved approach with my own parent, even if the roles are increasingly reversed and frustrating in their own way.  If we can’t – and honestly shouldn’t – look to government and the private sector to handle everything, then we have to be prepared to step in and manage ourselves as best as we are able.  And if the parents are ultimately living longer, then the simple truth is that the men are going to have to move beyond their comfort zone and take on the additional burdens because their own mates are going to be similarly pressed; but if men can take on the kids – and we are most certainly able – then we can likewise take on the elders.

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