Wednesday, February 17, 2016

The United States Abuses Its Elderly Population

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She didn't look at us when she barked her orders. Eventually, when we questioned her tone, questioned the extra steps she was asking us to take, she looked at our faces, our younger faces, but she didn't look at her. She didn't look at Mami. The barking woman, who was supposed to be helping us at the Bergen County Department of Motor Vehicles didn't look at my elderly mother, who we had to drag out on a cold day because on the previous day we were told that the person who had Power of Attorney over my father, who has Alzheimer's, had to be there. Like a good daughter, I had tried to do all of this for my parents, so that they would not have to worry about red tape anymore in their old age. I went to the DMV with the doctor's form and I tried to get a handicapped placard so that my dad, Papi, would not have to walk too much, in his delirium, when we took him to appointments or restaurants. Our kind doctor said it would be a breeze, "Just give them this form. It's only a placard, not the actual plate or anything."

But this was not the case, because not only did the folks at the DMV make me drag my mother there, they also mistreated us when we questioned the now additional requirements they hadn't mentioned the day before, they yelled at us, they told us to calm down when we spoke in a normal tone, and they even threatened to remove us from the station. All this, just so that I could get a small plastic square that acknowledges that my dad is old and needs help. Didn't the doctor confirm that? My little viejita mother was pointing her finger at the folks at the DMV, caliente, upset, and they still didn't listen to her, she who has lived more than them and has more wisdom in her little toe than they. I told her, "Vamonos, they don't care about what they are making a viejita do here." The woman behind the counter, finally seeing my mother and maybe even thinking about her mistake said, "Yes, we do." I said, "No, you don't," and we left.

This is how we treat our elderly in the United States. This past weekend, my husband and I decided to see the new Michael Moore film, "Where to Invade Next," and I was struck by what a woman, a CEO in a northern European country, said directly to us, citizens of the U.S. She said, and I paraphrase, "I would not want to live there in a million years because of how you treat each other. I could not live with myself knowing that even though there is plenty, there are people who go hungry, there are elderly people who aren't cared for. I couldn't live with it." Michael Moore said to her that he felt bad about it and she said, "Well, that's good. You should."

I do, too. I cannot bear it. On the drive home, being solution-oriented as I am, I decided that the best way to solve this problem is to give the doctors the power to distribute the placards. If the person drives, then yes, of course, have the person go to the DMV, but if it is just an issue of giving a placard to someone who is a caregiver, the doctor can do that. But that is only a Band Aid. The larger issue is how we treat our elderly. It is atrocious how we treat them. Each person should carry a reverence for someone who managed to stay alive longer than us. However, that takes proper training.

First of all, we have to see them. If they aren't in our lives regularly, how in the world are we going to learn from them and treat them properly? We must interact! I thank my parents for ensuring that I grew up with elderly people throughout my life, dancing with them, laughing with them, and learning from them constantly. The U.S. and England are notorious for locking their elderly away in facilities and abandoning them. But that is only the beginning of the possible abuse we inflict on those who gave us all the knowledge in our brains. Let me outline care for the elderly, how we treat them, and then maybe suggest what we could be doing differently.

Roughly 20% of the U.S. population is over the age of 60; that's about 63 million people. That is a lot of people, in case you're bad at math. Furthermore, the elderly population is growing at a faster rate than ever before because we're living longer, so expect to be part of that ever-growing population. We're clearly not prepared for this change, as has been widely stated by countless fumbling politicians who don't know what to do with the population they are soon to be a part of. We've made healthcare part of our political rhetoric, but we haven't successfully addressed the growing need for elder care in the United States. Nearly 30% of the adult population in the United States is giving care to an elderly person, some of whom are also disabled and/or have dementia or Alzheimer's disease. These unpaid caregivers provide work that is valued at about half a trillion dollars.

The U.S. government is taking advantage of the fact that the mainly female caregivers are providing their work for free. Future Alzheimer's care alone is expected to exceed $1 trillion annually. The government wants no part in paying for that. If the women give the work for free, why bother? In other words, this is not only an elder rights issue, but it is also a women's rights issue. Women are not being given the support they need, often going into debt to support their aging parents. Not surprising, some elderly folks end up homeless because they either don't have family to care for them or because their family cannot take on the financial/emotional burden. In fact, there is a projected increase in homelessness among the elderly because our population over 60 is growing, so the number of elderly who are homeless will, in turn, increase. Right now, we have 45,000 homeless seniors; that is expected to double by 2050. I think that number should always be zero. I don't see any reason why there should ever be an elderly person on the street. It is the worst offense possible.

But even elderly folks who do have the financial/mental stability to have a home and healthcare have a difficult job ahead of them in the United States. Elderly folks in the U.S. are sicker than in other countries. 68% of our elderly have two or more chronic health conditions; compare that with 37% in New Zealand. I choose New Zealand because it is the only other nation with an obesity rate close to ours. Somehow, even though they are 30% obese, they still manage to stay healthier than us into old age. That, despite the fact that we spend much more than most other developed nations on healthcare, especially in terms of out-of-pocket costs. Over 10% of the U.S. population reported difficulty with paying medical costs, and while seniors definitely benefit from Social Security and Medicare, nearly 20% of U.S. citizens over the age of 65 report not going to the doctor or taking a prescription because of issues with the cost. Again, that is an unlawful burden that we are placing on the elderly. They, who gave us everything that allows us to exist, should not be expected to worry about the costs of their care, especially medical care. Would we expect a child to pay for his/her medicine? I am not infantilizing our elderly with that comparison; I am reminding everyone that just as we were taken care of when we were vulnerable, we must take care of those who gave us so much when they, too, return to a vulnerable state.

The inevitable result of disregarding the elderly in such a widespread fashion is outright abuse. We have set a precedent in this country, one of total abandonment of age, wisdom, and responsibility, and that has led to the widespread abuse of our elders. We often hear of children being abused, but did you know that we abuse our elderly at nearly the same rate? About 6 million children a year are abused in the United States; it is estimated that about 5 million elderly people are abused a year, but most abuse isn't reported because the elderly are incapable of sharing the information and they are incredibly isolated, more than a school-going child would be. Similar to child abuse, it is often family members who are abusing the elderly. This would occur less if folks had the support to care for the elderly properly. We have extensive systems in place to try to minimize how many children are abused but we have nothing in place to ensure that the elderly are not neglected, abused, or taken advantage of. To return to the notion that this is a female rights issue, 33% of women with disabilities  in elder care report being abused. That is one-third! What is also important to note is that the elderly are especially vulnerable in terms of their finances. The abuse is not just physical and mental, it is also financial. Simply put, we steal from our elderly, and that deserves prosecution. Most people haven't heard of elder abuse, while all of us have heard of child abuse, but that shouldn't be so. We should all know about how we neglect and abuse our elders in this country. There is even a World Elder Abuse Prevention Day; it is on June 15th.

Ever watchful, the treatment of the elderly intrigued Jared Diamond, author of Guns, Germs, and Steel, and UCLA professor. He decided to study it and figure out why different cultures treat the elderly in different ways. He said this in an interview: " 'The repositories of knowledge are the memories of old people,' Diamond said. 'If you don’t have old people to remember what happened 50 years ago, you’ve lost a lot of experience for that society,' from communal history to advice on how to survive a cyclone or other natural disaster." In Korean cultures, there are special celebrations at the 60th and 70th birthdays, and in Chinese cultures, one is ostracized for putting a parent in a nursing home, according to this article. We would never ostracize someone for placing their parent in a home in the U.S. because we all have very long workdays that rarely allow us to care for our own children, let alone our parents, properly. It would be great to adopt the customs of other countries, or be able to support our own customs - Latinos/as traditionally care for the elderly in the home - here in the U.S., but without social support, it is incredibly difficult. Interestingly, a Latina wrote this article on the same subject, how we treat the elderly around the world. Karina Martinez-Carter starts the essay with the Elderly Rights Law, passed in China, which requires children to treat their elderly parents in a humane way, visiting them at least once a week. China, too, has long work hours and young people who have moved to urban centers to work, but unlike the U.S., they have made it a requirement to care for the elderly. They are experiencing their own challenges, especially because their one-child policy created a lack of children to actually care for parents, but the government does reimburse citizens for in-home care, which would be considered shocking in the U.S.

However, that is exactly what I am recommending. Just as parents are given tax credits for having children, adult children should be given some sort of reimbursement or credit for caring for their parents, beyond what the tax law allows for dependents. This site has some suggestions on how to get reimbursed for elder care, but they aren't very good. The first one is to get paid by the elderly you are helping! However, there are also some state programs that, apparently, reimburse caregivers (a little, anyway).

The Hearth Organization, which seeks to end homelessness among the elderly in the U.S. recommends a variety of low-income housing services for the elderly, at both the federal and state levels, and interagency programs with Medicaid and Medicare that connect the elderly to services they would not have known about. I agree with its suggestions. I also believe there should be an initiative to make sure there is never an elderly person on the street. Just as we try not to have homeless children, we should not have homeless elderly folks.

I also suggest that the media be more vocal about this issue, so that we may face it fearlessly as a community and find new ideas. No one is thinking about our elderly, but everyone is thinking about Beyonce's latest video. There's something wrong with that. Julianne Moore could have used the word "Alzheimer's" in her acceptance speech when she won for her role in "Still Alice." She could have advocated for more help in elder care, let alone Alzheimer's research, but she chose not to. That was irresponsible of her.

When I was an undergraduate, a wonderful professor brought in a disabled speaker, a young man who lost use of his legs in a car accident. The most important thing he said, to me, that day, was that we always think of the disabled as "other," as "that" population, even though at any moment we could be part of that population. It is unlike being Latino/a, or White, or Black, because those things don't change. Your ability can change. Anyone can become disabled.

The same is true of being elderly, except for the words "can become." Instead, the words are "will become." Everyone will become elderly. And that shouldn't be perceived as death itself. We have the right to live, and enjoy life, as elderly citizens. We have the right to live and enjoy life until our breath decides to leave and not before.

WE have the right to live with dignity as elderly citizens.
WE have the right to healthcare as elderly citizens.
WE have the right to a safe environment and home as elderly citizens.
WE have the right to be cared for as elderly citizens.
WE have the right to clear and easy access to needed services as elderly citizens.
WE have the right to enjoy our families as elderly citizens.
WE have the right to be respected as the creators of the existing world as elderly citizens.
WE have the right to be honored as the keepers of wisdom as elderly citizens.
WE have the right to happiness as elderly citizens.
WE have the right to live.
WE have the right to live.
WE have the right to live.


4 comments:

Carolina Hinojosa-Cisneros said...

"In other words, this is not only an elder rights issue, but it is also a women's rights issue." I couldn't agree more with this. My grandma and her 2 sisters took turns caring for Ma Mary (my great-grandma). With 7 brothers, you would think that the amount of time my grandma (also not young) and her sisters spent away from home would be far less, but it wasn't. They knew two weeks out of the month, they would be with her and away from home. Ma Mary didn't want to leave her house (another story altogether). We will ALL get old. That's not a speculation, it is the truth. I believe how we handle our elderly says a lot about us as people. We always want what is best (and comfortable) for us never thinking that we will one day be exactly where they are. Some of us a lot worse than others. I pray this situation begins to be corrected. I also pray that people wake up and take care of their responsibilities and not pawn them off into homes where strangers rule. We would NEVER do that to our children, we say. But, we do the same (on a smaller scale with them). When they are unsupportable, we ship them off to the military or homes for corrective action. There is a huge issue with how easy it is to sever ourselves from our limbs if they are not working for us anymore. I could also go on. I take this article to heart. Keep raising awareness, Dr. Acosta. Dios la bendiga.

Grisel said...

Thanks for your thoughtful words, Carolina!

Mara Lazda said...

Grisel, I happened upon your blog through the announcement of your upcoming talk at BCC. Congrats on the talk and the blog! Thank you for this post. My maternal grandmother lived with us for many years until she died and I think about how "we" treat the elderly all the time. Living with her changed how I see the world, and the inequities and attitudes we much need to fix. If we don't, we lose as a society.

Grisel said...

Hi Mara!

I didn't see your post until now. I'm so happy you appreciate this blog entry - and thank you so much for sharing about your grandmother. Yes, living with our wiser elders does change our perspective, and that is so valuable.