I've had quite a bit more experience in issues of elder care and support since you wrote the last post on rewarding caregivers a year ago, and I wish I had better things to say. Instead, I'm left with the impression that it's almost futile to start thinking about better ways of materially supporting older people before we can figure out how to, as a culture, make needing help something that doesn't spawn shame and avoidance, even to the point of intense harm.
Last year I was living in a house that had been converted into two apartments. My downstairs neighbor was an older man with no children. One day I found some notes on my door asking for help buying cigarettes and groceries because he was unable to walk. He also wanted me to post a letter for him, which I opened by mistake (thinking it was another note to me) and found evidence that he'd been victim to a financial scam. I called Adult Protective Services and they opened some kind of file on him. A few days later, his requests to me had intensified and became more and more nonsensical--he wanted me to drive him to a bank in the middle of an intense snowstorm and couldn't understand when I said no, he asked for blankets in the same snowstorm because he was too cold, while his windows were wide open. After hearing him fall and rushing down the stairs thinking he was dead, I called APS again and told them to send someone in the next hour or I would call 911. They found that the situation was much worse than even I had realized--he probably would have died of dehydration in the next few days had I not called--and he was eventually taken to a nursing home after a psychiatric hold. The last time I spoke to him he said "I know I'm being difficult, but I can't go die in a nursing home." As tragic as that was, it also made me really angry. He had clearly never thought about the fact that he would eventually decline and die. What did he want, for me to fulfil his list of demands and then one day find his dead body??????
I had the same experience after my grandmother's death a few months later, where my grandad just would not accept that he was unable to live independently without her help. We didn't have power of attorney over him, so all we could do is hire someone to come help him for an hour a day. We were finally able to get him into an assisted living facility recently, and all I can feel is relief that I'm no longer waiting for a call saying that he died because he stopped taking his medications, or fell and there was no one around.
The silver lining of this whole experience has been that my dad and I have had some more frank conversations about my parents' plan on aging, and he's planning to turn over power of attorney to me before any inevitable mental decline. We've also discussed the fact that retiring in some idyllic location is probably not going to be an option--they will have to retire close to me or one of my siblings.
But, I guess all of this is to say, it's hard for me to even think about material support for aging right now when the more salient concern seems to be--how can we encourage people to be comfortable even just talking about, and planning for, their eventual decline and death?
No way! This past week, while keeping up with our household finances and bills and such, I fell down a rabbit hole and was literally reading the Social Security Administration's retirement benefits website, for the first time suddenly curious about how such rules might apply to me in particular. (I had a very modest salary for ten years, and have not earned income for the past six; my spouse's federal salary and pension support our family and have become the basis of how we plan to meet current and future needs.) I admit I was taken aback to realize precisely how that gap in income-earning time factors into the formula for benefits received. So I come to this post energized and a bit indignant!
Three other notes from this week which seem pertinent:
1) After cruising the SSA site, I felt compelled to tally up the economic value of the administrative skill and leadership I've been donating to a nonprofit organization in recent years, after choosing as a parent of (then newly two and now busily three) young children to say farewell to that full-time paycheck. To my surprise, I average out to a consistent 0.25 FTE over more than six years. Had I been paid at the same rate as other part-time and quarter-time folks on staff, it would be an equivalent of >$10K/year or $2,500/quarter. That's a modest amount and nothing to stake a retirement decade or two or three on, but it's certainly enough to qualify for Social Security benefits. So even taken separately from my caregiving role of parenting going on at the same time, that's 24 quarters of opportunity cost in the SS tally, in order to offer those skills freely for free as a volunteer gift in kind. Huh. It seems to speak to both sides of your "just vs achievable" conundrum, because I have worked consistently, unpaid, for the common good, in an institution where others DO earn income/SS credit when officially on the payroll; and I have also been investing my time and energy as a parent of young children. None of that is on the radar for federal retirement benefits. (And all of it I embrace with warmth and energy; but it's human capital that disappears entirely from the "market".)
2) As it's the 15th of the month, today the IRS direct-deposited the latest installment of the advance child tax credit into our checking account. (I joke with my spouse that this amazing $800 is the *children's* paycheck, their "UBI from Uncle Joe".) What I like about the advance CTC is that there is nothing extra involved-- just being a child in the United States is enough to qualify (being a child of parents with an income below a certain range anyway). The implication is that children have unique needs which are inherently worth meeting. In a discussion about vulnerability and caregiving and interdependence, it is notable that this now provides a mechanism (temporarily anyway) for getting resources to a population whose needs are deemed both unique and urgent compared to working-age adults, without the need for them to have ever been the one working. If children are one such population, are elders another? How might dipping our toe into this experiment of supporting children open up other avenues for more equitably serving elders, decoupled from their (our) employment history?
3) Today I received yet another jury duty summons in the mail. It occurs to me that my county courthouse might be the only government entity which has record of (or which has made a meaningful distinction between) my having children and *caring* for them personally, and having children and *providing* for them economically-- because the county court is who I had to talk to in years past when I was summoned as a nursing mother of newborns. The county court granted that my babies changed my essential functions in the moment, but they did not change my essential civic value. Yet, the potential retirement/elder benefits that I hold in common with other citizens seem to center only on my economic input/output value.
I’m writing from a weird position: stay at home mother, with live-in-granny. It’s taking me a little while to respond, because I have been busy with caring for grandma. (This is my 85 year old grandmother, not my mother.) I have also had multiple conversations with my 72 year old MIL.
What has been interesting to me is witnessing how these people navigate the medical system. My MIL has been having trouble navigating after double knee replacement surgery; it’s honestly been hard for me to follow what she thinks the problem is after at least an hour+ of talking to her. I don’t know what a doctor would be able to figure out in his 20 min slot. My grandmother still similarly struggles with following along with how much a doctor has to cover in such a narrow time slot. I don’t think it’s efficient for the doctor to bill for more time. But they have gotten to the point where they can’t functionally navigate the medical system alone to obtain the results they need.
This is what I wonder about when I talk to other people about retirement. Have you considered what type of care you will need before you’re so bad that you require diaper changes? When you are in that interim stage with the executive functioning of a 10 year old and you require some assistance but not so much that it’s obvious you are struggling to function alone? And there is a certain disgust that has been expressed when ever I mention considering children as part of your retirement plan. Yet it’s a heck of a lot cheaper to have your children take over part of your care (perhaps with the help of a grandchild as in our situation) than it is to pay for out of pocket care. If you aren’t paying your child, you are going to be paying for someone else’s child - and they probably won’t speak English as well as you’d like.
This all makes me realize we need to incentivize having children and caregiving way more than we do. Elizabeth Warren wants universal childcare; go read her story. When she was young, she had her Aunt Bea come live with them to provide childcare. She believes universal childcare is essential to ensuring women can enter the workforce. What hypocrisy! For her own children she wanted in-home care overseeing 2 kids, but what she wants for other women is a daycare? The only better answer I can devise is some type of care credit - to compensate women for the choice to stay out of the workforce or to care for their own parents. But it’s not even obvious to me that this is worth it.
My MIL lives in a house 3x bigger than what she needs to survive that she can’t afford to maintain but she can hold onto because property taxes are low in CA. The answer is that she needs to sell her house and downsize. But this is anathema to suggest in America. And even though she lives only 20-40 min away depending on traffic, joining her for doctor’s appointments requires me to have a car and to invest an extra hour to manage. We hire a teenaged babysitter to help watch the kids so I can do this.
I asked grandma today how she thinks raising children is different today vs when she was born and raising kids. She said she thinks her grandkids are spoiled; they aren’t told no very often and are given a lot of things. I probed deeper and learned that she lived in one room with her mother and brother within her grandparents’ house (her father abandoned them) until she was in her 20s. After her grandfather passed away, her grandmother rented their spare room to strangers. Today grandma lives in our master suite with two walk-in closets and has all her meals cared for. …I am beginning to suspect that it is her generation who may be more spoiled in comparison! Our great grandparents would not have felt that living alone in a large house in their 70s-80s was their birthright! And that birthright has been maintained through federal policies which promoted mortgages on single family houses. I don’t even know that we need SS to incentivize caregiving; could we focus on not incentivizing single family housing first?
Sorry this turned into a rant, but yeah… lots of feelings on this today.
So you might reasonably ask: then Cathy, what positive change would you like to see? I'd like to see a basic guaranteed income. I still like the basic capitalist/socialist idea advanced in the old classic, "Communitas" -- enough basic guaranteed income for a bare modest life (plenty for anyone interested in a vow of poverty, for example, or dedicated to simple living). And anyone could work in the overall larger capitalist system to earn as much as they pleased.
This two-tier money economy would preserve privacy and enhance freedom A guaranteed national income also enhances the gift economy -- and living in what Zander calls "the vision world." The "measurement world" can be aggressive in overruning its uses and making our own moments thin and shallow and fleeting -- becoming a master in the name of security.
All well intentioned changes to laws and rules entail unexpected harmful drawbacks. One I foresee in expanding SS credits to parenting, caregiving and other voluunteer work is that it could create a system much like the Chinese "social credits." In the United States we woudn't intentionally punish not having enough social credits. (The Chinese government intends to do exactly that.) However, it would leave those in poverty after official retirement age vulnerable to even more shame than now. What was wrong with them that they didn't contribute more to society? Ah...probably alcoholics or drug addicts or just lazy.
Now...if social security isn't enough to cover the most basic cost of food and shelter, SSI kicks in. But someone on SSI isn't automatically assumed to have wasted their lives on drink, drugs, or laziness. Poverty is already undignified enough (and hard work, try waiting in long lines and filling in endless forms.) Let's be extremely careful not to take away even a shred of the privacy and dignity that remains.
Personally, I just accepted that caring for my life partner was going to require taking early SS instead of waiting till 70 as I'd planned -- and using the inheritance I'd expected to use for a new art studio, to cover the debt entailed with my own loss of income and the expenses of hiring a caregiver so I could work even part time. No tax credits available since we couldn't be legally married. Just...all less important than creating a high quality of life for both of us. In my personal experience, life events often seem unfair, with much loss -- and every great loss can lead to amazing unexpected gifts. This isn't a reason to hold myself back from working for justice for all -- nor from offering help to others in the situation in which I found myself.
I've had quite a bit more experience in issues of elder care and support since you wrote the last post on rewarding caregivers a year ago, and I wish I had better things to say. Instead, I'm left with the impression that it's almost futile to start thinking about better ways of materially supporting older people before we can figure out how to, as a culture, make needing help something that doesn't spawn shame and avoidance, even to the point of intense harm.
Last year I was living in a house that had been converted into two apartments. My downstairs neighbor was an older man with no children. One day I found some notes on my door asking for help buying cigarettes and groceries because he was unable to walk. He also wanted me to post a letter for him, which I opened by mistake (thinking it was another note to me) and found evidence that he'd been victim to a financial scam. I called Adult Protective Services and they opened some kind of file on him. A few days later, his requests to me had intensified and became more and more nonsensical--he wanted me to drive him to a bank in the middle of an intense snowstorm and couldn't understand when I said no, he asked for blankets in the same snowstorm because he was too cold, while his windows were wide open. After hearing him fall and rushing down the stairs thinking he was dead, I called APS again and told them to send someone in the next hour or I would call 911. They found that the situation was much worse than even I had realized--he probably would have died of dehydration in the next few days had I not called--and he was eventually taken to a nursing home after a psychiatric hold. The last time I spoke to him he said "I know I'm being difficult, but I can't go die in a nursing home." As tragic as that was, it also made me really angry. He had clearly never thought about the fact that he would eventually decline and die. What did he want, for me to fulfil his list of demands and then one day find his dead body??????
I had the same experience after my grandmother's death a few months later, where my grandad just would not accept that he was unable to live independently without her help. We didn't have power of attorney over him, so all we could do is hire someone to come help him for an hour a day. We were finally able to get him into an assisted living facility recently, and all I can feel is relief that I'm no longer waiting for a call saying that he died because he stopped taking his medications, or fell and there was no one around.
The silver lining of this whole experience has been that my dad and I have had some more frank conversations about my parents' plan on aging, and he's planning to turn over power of attorney to me before any inevitable mental decline. We've also discussed the fact that retiring in some idyllic location is probably not going to be an option--they will have to retire close to me or one of my siblings.
But, I guess all of this is to say, it's hard for me to even think about material support for aging right now when the more salient concern seems to be--how can we encourage people to be comfortable even just talking about, and planning for, their eventual decline and death?
No way! This past week, while keeping up with our household finances and bills and such, I fell down a rabbit hole and was literally reading the Social Security Administration's retirement benefits website, for the first time suddenly curious about how such rules might apply to me in particular. (I had a very modest salary for ten years, and have not earned income for the past six; my spouse's federal salary and pension support our family and have become the basis of how we plan to meet current and future needs.) I admit I was taken aback to realize precisely how that gap in income-earning time factors into the formula for benefits received. So I come to this post energized and a bit indignant!
Three other notes from this week which seem pertinent:
1) After cruising the SSA site, I felt compelled to tally up the economic value of the administrative skill and leadership I've been donating to a nonprofit organization in recent years, after choosing as a parent of (then newly two and now busily three) young children to say farewell to that full-time paycheck. To my surprise, I average out to a consistent 0.25 FTE over more than six years. Had I been paid at the same rate as other part-time and quarter-time folks on staff, it would be an equivalent of >$10K/year or $2,500/quarter. That's a modest amount and nothing to stake a retirement decade or two or three on, but it's certainly enough to qualify for Social Security benefits. So even taken separately from my caregiving role of parenting going on at the same time, that's 24 quarters of opportunity cost in the SS tally, in order to offer those skills freely for free as a volunteer gift in kind. Huh. It seems to speak to both sides of your "just vs achievable" conundrum, because I have worked consistently, unpaid, for the common good, in an institution where others DO earn income/SS credit when officially on the payroll; and I have also been investing my time and energy as a parent of young children. None of that is on the radar for federal retirement benefits. (And all of it I embrace with warmth and energy; but it's human capital that disappears entirely from the "market".)
2) As it's the 15th of the month, today the IRS direct-deposited the latest installment of the advance child tax credit into our checking account. (I joke with my spouse that this amazing $800 is the *children's* paycheck, their "UBI from Uncle Joe".) What I like about the advance CTC is that there is nothing extra involved-- just being a child in the United States is enough to qualify (being a child of parents with an income below a certain range anyway). The implication is that children have unique needs which are inherently worth meeting. In a discussion about vulnerability and caregiving and interdependence, it is notable that this now provides a mechanism (temporarily anyway) for getting resources to a population whose needs are deemed both unique and urgent compared to working-age adults, without the need for them to have ever been the one working. If children are one such population, are elders another? How might dipping our toe into this experiment of supporting children open up other avenues for more equitably serving elders, decoupled from their (our) employment history?
3) Today I received yet another jury duty summons in the mail. It occurs to me that my county courthouse might be the only government entity which has record of (or which has made a meaningful distinction between) my having children and *caring* for them personally, and having children and *providing* for them economically-- because the county court is who I had to talk to in years past when I was summoned as a nursing mother of newborns. The county court granted that my babies changed my essential functions in the moment, but they did not change my essential civic value. Yet, the potential retirement/elder benefits that I hold in common with other citizens seem to center only on my economic input/output value.
I’m writing from a weird position: stay at home mother, with live-in-granny. It’s taking me a little while to respond, because I have been busy with caring for grandma. (This is my 85 year old grandmother, not my mother.) I have also had multiple conversations with my 72 year old MIL.
What has been interesting to me is witnessing how these people navigate the medical system. My MIL has been having trouble navigating after double knee replacement surgery; it’s honestly been hard for me to follow what she thinks the problem is after at least an hour+ of talking to her. I don’t know what a doctor would be able to figure out in his 20 min slot. My grandmother still similarly struggles with following along with how much a doctor has to cover in such a narrow time slot. I don’t think it’s efficient for the doctor to bill for more time. But they have gotten to the point where they can’t functionally navigate the medical system alone to obtain the results they need.
This is what I wonder about when I talk to other people about retirement. Have you considered what type of care you will need before you’re so bad that you require diaper changes? When you are in that interim stage with the executive functioning of a 10 year old and you require some assistance but not so much that it’s obvious you are struggling to function alone? And there is a certain disgust that has been expressed when ever I mention considering children as part of your retirement plan. Yet it’s a heck of a lot cheaper to have your children take over part of your care (perhaps with the help of a grandchild as in our situation) than it is to pay for out of pocket care. If you aren’t paying your child, you are going to be paying for someone else’s child - and they probably won’t speak English as well as you’d like.
This all makes me realize we need to incentivize having children and caregiving way more than we do. Elizabeth Warren wants universal childcare; go read her story. When she was young, she had her Aunt Bea come live with them to provide childcare. She believes universal childcare is essential to ensuring women can enter the workforce. What hypocrisy! For her own children she wanted in-home care overseeing 2 kids, but what she wants for other women is a daycare? The only better answer I can devise is some type of care credit - to compensate women for the choice to stay out of the workforce or to care for their own parents. But it’s not even obvious to me that this is worth it.
My MIL lives in a house 3x bigger than what she needs to survive that she can’t afford to maintain but she can hold onto because property taxes are low in CA. The answer is that she needs to sell her house and downsize. But this is anathema to suggest in America. And even though she lives only 20-40 min away depending on traffic, joining her for doctor’s appointments requires me to have a car and to invest an extra hour to manage. We hire a teenaged babysitter to help watch the kids so I can do this.
I asked grandma today how she thinks raising children is different today vs when she was born and raising kids. She said she thinks her grandkids are spoiled; they aren’t told no very often and are given a lot of things. I probed deeper and learned that she lived in one room with her mother and brother within her grandparents’ house (her father abandoned them) until she was in her 20s. After her grandfather passed away, her grandmother rented their spare room to strangers. Today grandma lives in our master suite with two walk-in closets and has all her meals cared for. …I am beginning to suspect that it is her generation who may be more spoiled in comparison! Our great grandparents would not have felt that living alone in a large house in their 70s-80s was their birthright! And that birthright has been maintained through federal policies which promoted mortgages on single family houses. I don’t even know that we need SS to incentivize caregiving; could we focus on not incentivizing single family housing first?
Sorry this turned into a rant, but yeah… lots of feelings on this today.
So you might reasonably ask: then Cathy, what positive change would you like to see? I'd like to see a basic guaranteed income. I still like the basic capitalist/socialist idea advanced in the old classic, "Communitas" -- enough basic guaranteed income for a bare modest life (plenty for anyone interested in a vow of poverty, for example, or dedicated to simple living). And anyone could work in the overall larger capitalist system to earn as much as they pleased.
This two-tier money economy would preserve privacy and enhance freedom A guaranteed national income also enhances the gift economy -- and living in what Zander calls "the vision world." The "measurement world" can be aggressive in overruning its uses and making our own moments thin and shallow and fleeting -- becoming a master in the name of security.
How has the structure of our retirement benefits shaped your own approach to caregiving?
Maximizing contributions to company sponsored retirement plans when I was working and right before I discontinued working.
Minimizing expenses and saving as much as I can now that I'm not working outside the home.
What kinds of non-conventional work would you like to see covered under a Social Security credit program?
Caregiving for children and elderly relatives, of course, but also caregiving for other relatives and even friends.
All well intentioned changes to laws and rules entail unexpected harmful drawbacks. One I foresee in expanding SS credits to parenting, caregiving and other voluunteer work is that it could create a system much like the Chinese "social credits." In the United States we woudn't intentionally punish not having enough social credits. (The Chinese government intends to do exactly that.) However, it would leave those in poverty after official retirement age vulnerable to even more shame than now. What was wrong with them that they didn't contribute more to society? Ah...probably alcoholics or drug addicts or just lazy.
Now...if social security isn't enough to cover the most basic cost of food and shelter, SSI kicks in. But someone on SSI isn't automatically assumed to have wasted their lives on drink, drugs, or laziness. Poverty is already undignified enough (and hard work, try waiting in long lines and filling in endless forms.) Let's be extremely careful not to take away even a shred of the privacy and dignity that remains.
Personally, I just accepted that caring for my life partner was going to require taking early SS instead of waiting till 70 as I'd planned -- and using the inheritance I'd expected to use for a new art studio, to cover the debt entailed with my own loss of income and the expenses of hiring a caregiver so I could work even part time. No tax credits available since we couldn't be legally married. Just...all less important than creating a high quality of life for both of us. In my personal experience, life events often seem unfair, with much loss -- and every great loss can lead to amazing unexpected gifts. This isn't a reason to hold myself back from working for justice for all -- nor from offering help to others in the situation in which I found myself.