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Martha Stewart

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The Other Health Care Crisis -- America's Elderly

Posted: 01/20/10 01:38 PM ET

As the health care bill winds its way through Congress, sparking passions, heated debate and countless news stories, I have been struck by the dearth of discussion about a looming health care crisis: In 2011, the first of 78 million baby boomers will start turning 65. We, as a nation, are utterly unprepared for this rapidly approaching "silver tsunami." We do not have enough doctors skilled in the care of the very demographic group with the greatest overall health care needs. And we do not provide proper support for the more than 48 million men and women who, according to a recent report from the National Alliance for Caregiving, are caring for older family members and friends.

Our population is growing older and living longer. Life expectancy in the United States is at an all-time high of nearly 78 years. The oldest old, those who are age 85 and over, are the fastest growing segment of the population. Yet very few doctors are trained in the care of the elderly. Do you know that there is currently one geriatrician to every 10,000 baby boomers? There are about three times as many cosmetic surgeons, a fact that speaks volumes about how we view aging in this country.

With the increase in the elderly population comes a concomitant increase in informal caregivers. Because around-the-clock home care runs as high as $150,000 per year (not including rent or food) and, depending on where you live, residence in an assisted living facility can easily cost $4,000 per month (none of which is covered by Medicare), more than 75 percent of Americans receiving long-term care rely solely on family and friends to provide assistance. The vast majority of these caregivers are women, most of whom devote an average of 19 hours a week to their caregiving role, often while also holding down a paying job. Many are caring for young children and their aging parents at the same time. And many more, surveys show, have used all of their savings or cut back on their own health care spending in order to cover the cost of caregiving for their relative.

I come to these issues as the daughter of a woman who lived to the age of 93. My mother remained actively engaged in life and healthy nearly to the end. Still, we came to know first-hand some of the issues that need to be managed and the constant worry that shadows every day. What if she falls? What if she takes her medicine twice or, as was more likely with my mother, what if she decides not to take them at all?

My family's experience opened my eyes to the challenges facing countless Americans and their families, and inspired me to found the Martha Stewart Center for Living at the Mt. Sinai Medical Center in New York City. At the Center, which is dedicated to my mother, our mission is to help people live longer, healthier, productive lives even as they grow older. We also aim to develop new models of care for people over the age of 65 that will help our country and the world better meet the healthcare demands of an aging population.

There is an urgent need for innovative ideas and new paradigms -- and no quick fixes. But there are steps we can and should take. First, we must recognize that older adults are an idiosyncratic population with a broad spectrum of needs from the frail and fading Alzheimer's patient to the physically and mentally active senior like, for example, Clint Eastwood who at age 79 is arguably at the height of his creative powers. And we must educate doctors--whether or not they are geriatricians--so they can better understand and serve this demographic. At Mt. Sinai, every medical student is required to do at least some of their training at the Center for Living. No matter what specialty of medicine these doctors ultimately choose, they will be better prepared to work with our rapidly aging population.

Passage of the C.L.A.S.S. Act, a national long-term care insurance program that is currently part of both the House and Senate health care bills, could also make a difference. Introduced by the late Senator Edward M. Kennedy, the C.L.A.S.S. Act (short for Community Living Assistance Services and Support) would allow people to purchase long-term care insurance through payroll deductions and to receive cash to pay for home care, adult day programs, assisted living or nursing homes. The program's fiscal soundness has come under fire from certain quarters. There's no question that new legislation must be well-designed and viable over the long term, but, at the same time, we must not lose sight of a pressing need for solutions that will offer older adults and their families some financial protection.

We're all in this together. Whether or not you care about older people, you will, if you're lucky, be one of them. It's not just a demographic. It's personal -- it's you, your parents, your aunts, uncles, friends and children. We need to do a better job caring for this population -- and supporting those who care for them.

Martha Stewart is the founder of the Martha Stewart Center for Living at Mt. Sinai and Martha Stewart Living Omnimedia, Inc.

 
 
 
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12:40 PM on 01/27/2010
As the daughter of two parents both from the baby boomer generation I am constantly educating myself on how to best care for them as they age. This article sheds light on many truths about the "silver tsunami" that many would like to ignore; however, it's coming and we need to prepare for it. Thank you Martha for taking a stand on these issues!
My parents and grandparents live out of state from me and I constantly deal with guilt for being far from them. I recently found a helpful solution that looks perfect for always staying connected and giving my family peace of mind. Maybe it could work for some of you too! http://pomguard.com/
08:49 PM on 01/25/2010
Martha:
As you note, elders and their families make significant sacrifices to stay home, often to avoid a nursing home. Are all these sacrifices necessary? Imagine walking into a small house where the first thing you see is an elder folding laundry in front of a fire, where a book club is just breaking up, and where rich smells draw you to the warm kitchen where an elder is teaching her new friend a favorite family recipe. What if this could be a nursing home for people with the highest needs?
Well, it is. It is called a Green House home. More than 70 are open nationwide with the support of The Green House Project (www.thegreenhouseproject.org), a program of The Robert Wood Johnson Foundation and NCB Capital Impact.
At its core, The Green House model transforms nursing homes into small homes controlled by elders where meaningful days are supported by highly trained caregivers. The model’s organizational and physical redesign fosters far better outcomes without needing to increase overall staffing or costs. And research backs this up, not a surprise since it is a key lesson you have helped us learn - that we can greatly improve our daily experience by refocusing on simple things and using what we have more creatively.
As you look for innovative models that work within existing constraints, I hope you will take a look at the Green House model as one way to ease the unnecessary sacrifices of elders and their caregivers.
Robert Jenkens
07:01 PM on 01/24/2010
What was that? Have families take care of their elderly? Surely you jest.

When I was too old to work ,my daughter kicked me out of her home, and I spent 3 months in a homeless shelter because I couldn't find a job. I was too old. The head of the shelter said she gets a lot of us there. She calls us "disposable parents".

Texas had to make a law forcing children to care for their parents who couldn't care for themselves because they were leaving them on the curbs in front of hospitals and driving away--and that was before the recession.

I was blessed. A local charity adopted me, and I now live in government housing and get some of my food from a food bank. When I need a nursing home, tho, it's a little scary. I don't know what to do. But I've willed my body to a teaching hospital in San Antonio, so my death is taken care of.

Don't kid yourselves. The boomers are way too self-absorbed to "take care" of their parents.
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MaryMay
May your tears come from laughing
05:38 PM on 01/25/2010
Oh my, aren't you angry because your own "selfish" daughter kicked you out?

I have been taking care of my parents for over 15 years now. Why?

They raised me with love and taught me responsibility. My mother took care of her mother and father for years before they passed.

I'm not going to say you didn't do you best by your own daughter, because there are many parents who do a great job of raising their children only for the children to turn out selfish in this regard.

But don't paint all boomers as "way too self-absorbed to take care of their parents." Maybe you leveled those kinds of accusational absolutes at your daughter over the years , eh? Nice.
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dsws
No owning ideas. Limit only commercial use.
04:36 PM on 01/24/2010
I don't think that what we need is more specialist physicians. We have lots of specialists. The emphasis should be shifted toward more and better general practitioners, and more and better support for the GPs, instead of having dozens of different doctors involved in each patient's care because there's a specialist for everything.
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Ryan McGavin
04:19 PM on 01/24/2010
Love you Martha Stewart, you fierce ruling diva.
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03:00 PM on 01/24/2010
The way to fix it:

Go back to a Hills-Burton standard of 10-to-1 ratio of hospital beds, clinics, doctors, nurses and the latest and greatest scientific technologies in equipment and facilities.

We don't need anymore financial engineers to structure worthless derivatives and credit-default swaps; so stop educating people for that nonsense.

Instead we should make education in nursing and being a medical physician a top priority by subsidizing all of the costs to educate our people to do so - everybody should learn how to be a doctor.

Again the only way to do that of course is to cancel the bail outs for Wall Street - let it go; let it die; we need our elderly not Wall Street.
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lendmeanear
02:52 PM on 01/24/2010
If we think we have a healthcare crisis now, just wait til the baby boomers hit. Tick tock. Tick tock.
02:31 PM on 01/24/2010
Great article. Thank you, Ms. Stewart.
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MidwestMomma
Just a Pilgrim on the Mayflower of Life!
01:47 PM on 01/24/2010
As a veteran healthcare giver, I can attest to the unpreparedness of our present system to meet the needs of our aging population. We often joke that our nations approach to the baby boomers aging is to keep the healthcare system so bad we just stay home and die. It is very reassuring to know there are people like you taking a proactive approach on the issue. This is a very "good thing" and thank you!
01:30 PM on 01/24/2010
It speaks volumes of our narcissistic society. There wouldn't be 3 times more plastic surgeons if there wasn't a demand.
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vginger
10:57 AM on 01/24/2010
Thank You, Ms. Stewart..now you are teaching...and the subject you have chosen is very pertinent to our times.....Everything you have written is truth...and very well spoken.
I applaud your choice to contribute in such a meaning ful way...the center,etc....and also via Huffpost.
The Health Care Bill...it must be structured by people such as yourself...dr.oz...dr.weil...dr. christaine northrup...persons who have also speak out about what is relevant to our times.
We must build Seniour Communities.....and train specialy care givers...a think tank of young people wishing to enter the health care system at all levels...from aides to nurses to docs...and everyone in between...we must start everything at the level of renewing our ways of growing healthy foods...and providing such from early years to old age to our citizens...schools must be restructured in what it is they teach...right down the line...we have the option to recreate our nation on every level.
Certainly our President cannot do all of this but he can search out the best of the best to create these think tanks...people who wish to honestly serve...not in it for the power or the money.
Yep, keep it up Lady...you have started the ball rolling on this particular issue, and as someones mom...gram...and great grandmother...I thank you.. V;
01:08 PM on 01/24/2010
I find myself a fan of some things Martha and not of others. I like her sentiments here however I'm sure I differ greatly on how we solve the problem.

We can't have a bill that gets rammed through as was just attempted. That was an injustice to everyone.

This has to be palatable. For that I like the idea of exploring a sales tax as opposed to income tax . Not on everything but limited to restaurants and take out along with alcohol and luxury items such as Auto's over 50,000 in the amount of 3%.
Think about how much money would be raised if every restaurant bill had a 3% addded tax. McDonnalds to the finest eatery. Some folks would cut back some but the wealthy would be paying a ton more tax and businesses even more. Few would cut back drasticly. Billions of dollars would be raised for a voucher fund and there would be choice. No one has to eat out alot. No one has to spend $50K on a car. Tax Alcohol for this of 10%. People paying money hand over fist in bars accross america aren't holding back when their beer costs $5 or more each so I doubt this will stop them or hurt them.

Everyone gets a voucher toward the policy of their choice. It won't pay for everything but its a painless way to get it started. Then show costs can be cut and managed by governement with policy.
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mi
07:18 AM on 01/24/2010
Thank you Martha, for giving this issue the attention it needs,and
actually doing something about it.
09:42 PM on 01/23/2010
Thank you for this, Martha. So often we hear about helping "the children," but rarely about aiding "the elderly." Recently a friend's father died died at 95. He had applied for VA. help after an accident but was turned down. Never mind that he fought in WW II and won a Purple Heart for bravery on the battlefield. Disgraceful.

And did you happen to read about the Motion Picture Home debacle? Kicking out ill, aged residents because board members (at least one of whom is a HuffPost blogger) wants to cut costs?
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MyTurn2020
mybigblackblog.com
05:12 PM on 01/23/2010
I really appreciate this from Martha...but you only have to look at our nation in the context of other leading nations to know we don't value mature adults, let alone the elderly. AARP is still a "youthful" organization with massive power but the political strength and will to protect Americas' seniors must come from those in power now...and certainly from the grassroots.

As a social worker, I know firsthand we need more service professionals with expertise in gerontology, more nursing homes with quality care, and above all a healthcare system that is interconnected and from medical to mental health to physical therapy to hospice. That's my soapbox, I'm off now.
04:13 AM on 01/24/2010
Excelllent comment. I would go a step further. We need a system to match people who are starting to become frail with lay caregivers who receive incentives to stay in long term family style care arrangements with the seniors. I am talking about seniors who do not have Father Knows Best families where loving children are at their beck and call. Patient advocacy is very important to help seniors deal with the harsh realities of long term care and all the issues of growing old. Young adults in caring professions such as physical therapy can be recruited to perform part time work as lay caregivers. Right now even the 25% of seniors who can afford such help have no vehicle for becoming matched with young care givers who might remain in touch over a 20 year period of time and step in in the place of absent or non existent family support. Participation by charitable organizations that think outside the box can expand this % well beyond the seniors who can afford to pay cash. In MHO "insuring" for patient advocacy is as important as traditional long term care insurance.
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JavaManiac
...with liberty and justice for all
01:08 PM on 01/23/2010
In Italy the life expectancy for men is 78 and women 84. There is nothing special for them medically - they usually live with or very near to one of their children. They attend every family function (they are the ladies in black lining one wall - and the old guys sitting out front solving the worlds problems.

What is different is they do not all live in Florida or Arizona. They live near or with their families. Maybe that is the answer for the baby boomers in the US.
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Catriona
Wha daur meddle wi me?
01:42 PM on 01/23/2010
In Italy the life expectancy for men is 78 and women 84. There is nothing special for them medically - they usually live with or very near to one of their children. They attend every family function (they are the ladies in black lining one wall - and the old guys sitting out front solving the worlds problems.

What is different is they do not all live in Florida or Arizona. They live near or with their families. Maybe that is the answer for the baby boomers in the US.

----------------------------------

What is different is Italy os in the EU and has universal healthcare.

I have looked after elderly relatives here in Europe, but I had a lot of help from carers. Americans get no help at all, and allow themselves to be dragged into the situation that Mrs Stewart describes.
11:15 AM on 01/24/2010
Spot on comment - Long Term Care Insurance is no solution to anything. It is a re-packaging of health insurance with an asset accumulation (reserve). It is made financially viable for insurance companies not by actuarial science but by claims underwriting - denying claims you thought were covered and having limitations that toss you on the street. Unlike health ins it rarely - perhaps never as I only say rarely as I am retire from actuarial work -has a claims loss ratio requirement.

I do not know Ted's bill - but as to concept - it is the wrong way to go. Expand Medicare to inc what ever you see as good in Ted's bill.

For now do a budget recon 51 vote passage of the Medicare expansion via buy in at age 50, Medicaid expansion to cover 15 million more, paid for by those "Medicare sav