The Many Costs of Long-Term Care

  • A fascinating caregiving article on the New York Times Web site has grabbed a lot of attention in the past few days. Titled “Elder-Care Costs Deplete Savings of a Generation,” and written by Jane Gross, the article ran December 30, 2006.

    The elder-care article begins with the following:

    “To care for her ailing 97-year-old father over the past three years, Elizabeth Rodriguez, a vice president at the Federal Reserve Bank in New York, has borrowed against her 401(k) retirement plan, sold her house on Staten Island and depleted nearly 20 years of savings.”

    Elizabeth Rodriguez’ story is more dramatic than mine. But, when I pass what my family and I jokingly call the “Bradley Wing” of a local North Dakota nursing home – a very good facility, I must add – I do feel her pain.
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    My Dad, after a brain operation failed to correct complications from a WWII brain injury worsened with aging, spent over ten years in a nursing facility. Because of a health trust in his name, the cost of his stay was, blessedly, covered. It was totally private pay. The trust, however, only covered my dad’s health.

    My uncle had spent five years in the same facility. He was able to pay his way, and, since he had no children, and my aunt - my mother’s sister - was dead, he left the bulk of what was left of his estate to my mother.

    It wasn’t long after my uncle’s death that my mother joined my dad in the same facility, though they each had private rooms. Her arthritis and dementia required more care than the family could give her.

    She spent seven-and-a-half years there, most of it in her private room. If I would have known more about Medicaid law, I would have gone to Social Services for advice earlier, but I was afraid she’d lose her private room, so I just kept paying, without checking out options. In the end, it made little difference. My siblings and I were concerned first and foremost, about her quality of life, and that meant the private room for as long as possible.

    We used everything my parents had accumulated, for their care. We used my mother’s inheritance, of course, and we had to cash out Dad's insurance policies. It was all worth it. They received good care, they were near by so I could visit daily, and they had friends who could stop by. My sister drove in from out of town nearly every week.

    The hard part was that Mom had always been the money person in the family and insisted that I bring her checkbook and statement every month, for her to examine. The problem was her memory was impaired.

    I tried to avoid bringing the records up, because she would get so distraught over the amount of the nursing home payment. She hated watching her nest-egg disappear. But she insisted I show her, and each time I would have to tell her that the huge check at the beginning of the month was for her to stay in the home. She could not keep that in her memory. It was more than she could grasp – despite the fact that she had written similar checks to the same facility, when my uncle was there.

  • She’d then go on a guilt trip. I’d tell her that the money was there to take care of her. That it was okay. It’s just how things worked out. But it pained her so. She was frustrated that she wouldn’t have anything to leave her kids and grandkids. That monthly check loomed large in her mind.
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    Sometimes we could go a couple of months without this painful scenario, because she’d lose track of time. But then something would trigger her money memory, and I’d have to drag out all the files and show her, again, what was happening to her money.

    The last months of her life, as her money ran out, she and Dad moved into a double room, together. Shortly after, he died. Mom died soon after that, and was only on Medicaid a short while, during which time I was buying her clothes, and footing the bill for the gifts she loved to give – which I could ill afford. However, it was the only way to give her peace. I had to help her think she had money until the end.

    We are all facing unimaginable costs as we live longer and often live that way in poor health. Laws will continue to change. We need to educate ourselves about the complicated and unpleasant aspects of aging in poor health. It could happen to any one of us, at any time.

    The whole money thing still colors the memories I have of my mother’s last years. It’s painful. But, we did our best. I believe strongly in paying my own way. So did my parents. But the cost of care, as we all live longer, is mind boggling. While I’d love to leave my kids something when I’m gone, I know that is unlikely. I just wonder how I’ll pay my own way while I’m alive.

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Published On: January 02, 2007