As the caregiver of an 82 year old parent, I'm heartened that there are people hard at work at the Federal Interagency Forum on Aging Statistics (with the catchy url of agingstats.gov). Heartened because a recent update to their "2008 Older Americans: Key Indicators of Well-Being" sounded a warning bell loud enough for people on the Hill to hear.
On top of other challenges, the Forum tells us, our aging society is facing health illiteracy, a dangerous problem that has been flying under the radar. We have elders whose limited comprehension of the state of their health puts them at a great disadvantage. They don't understand their medical conditions, and that disconnect means they might not be getting the care they need and are entitled to. The report calculates that 39% of people 75 and over have below basic health literacy -- they can circle the date of a medical appointment, and not much else. The next tranche, 31%, has only basic HL, the ability to understand a one-pager on a health condition.
That tells me, and anyone who's listening, that beyond helping pay for our aging parents' health care if they can't fill the donut hold on their own, we as caregivers may have to provide them with health instruction at a most fundamental level. This makes our predicament even harder because we are not always there on the ground with them to do it. Our mobile society means many of the country's elders are far from family members during the years they need them the most. The result -- long-distance caregiving -- is the pickle on the plate of the sandwich generation.
In an unexpected way, another statistic is compounding the problem. Less than five percent of Americans over 65 live in a nursing home setting. The vast majority lives at home and wants to stay there indefinitely. With most media attention on the aging demo focused on their medical costs, a ray of hope, the "Aging in Place" initiative, isn't as widely reported on as it should be. With an agenda that includes showing communities how to adapt to a growing aging population and improve the quality of life for seniors, Aging in Place correlates to healthier, happier older Americans who stay vibrant longer and may need less medical care.
But until Aging In Place takes hold, and until those health illiteracy numbers improve, we have aging Americans who are becoming isolated in their own homes and who don't understand how to take care of themselves. And this is on top of a government system that created a drug plan so complicated seniors need help deciphering it. Health and Human Services needs to take a step back and ask: Who is going to protect our parents? Who is going to connect the dots between the health care system and the people who might be too frail to access it on their own?
I got lucky during my own mother's illness and recovery, and discovered exactly who that person is: the care manager, a health care expert who can actually be our eyes and ears for our parents, available not just when a crisis occurs, but beforehand to communicate between doctors, coordinate care and possibly prevent the crisis. It's ironic that in a time of unprecedented job loss, here's an emerging field that will need to expand for our 36 million over-65ers and we, as a nation, aren't doing enough to grow it. Right now, a care manager is an out-of-pocket luxury rarely covered by even long-term care policies, but needs to be if our elders are to gain access to the health innovations that are being discovered to keep them alive longer. Not a case worker assigned to a claim, but a care worker assisting a person, this new breed of health care professional needs to be part of the national dialogue on elder issues.
David Zoll is one of three founders of Parentgiving.com, an online resource for caregivers of aging parents. The site's mission is to provide all the resources and information needed to give better care to aging parents.