Families Spend More To Care For Their Aging Parents Than To Raise Their Kids

It costs families more to care for a frail older adult than to raise a child for the first 17 years of her life. Yet, while the government routinely provides a broad range of assistance and free services for children, it offers only limited benefits for those needing long-term supports and services—and mostly only for those who are impoverished and very ill.

The other day, the federal government released a headline grabbing report: The average out-of-pocket cost of raising a child from birth to age 17 is about $234,000. Among families where an older adult has severe long-term care needs and uses paid care, out-of-pocket costs average $140,000, according to research by my Urban Institute colleague Melissa Favreault. That enormous cost is generally spread over much less time, typically four years in contrast to 17.

But those estimates include only some of the total out-of-pocket expenses families face when a loved one has long-term care needs. They exclude costs of care during the time when a parent or spouse needs lower levels of paid assistance. They do not include costs incurred by their adult children. And, in contrast to the government's estimates of child rearing expenses, they exclude out-of-pocket spending for medical care.

However, health care expenses are a major strain on the budgets of older adults. The average total out-of-pocket cost for health care after age 65 is at least another $100,000. Those with chronic illnesses that lead to many long-term care needs pay far more than that.

What We Do For Kids

Yet, think about what the government does for families with kids. There is, of course, 12 years of free public school. And in many communities, there is access to charter schools or vouchers for private or religious schools.

For low- and middle-income households, there are tax credits such as the Earned Income Credit (EITC) and the Child Tax Credit (CTC). Families with one child can receive up to $3,400 annually from the EITC, and families with more kids can get up to nearly $6,300. They may receive another $1,000 per child from the CTC. Combined, these credits cost the government $26 billion annually.

There are additional credits for adoption, foster care, and child care.

When it comes to health care, there is Medicaid, which provides medical care for low-income families, including kids; and the $25 billion State Children’s Health Insurance Program (CHIP) that covers children from families whose incomes are a bit too high to qualify for Medicaid.  In addition, private insurance acquired through employers (including family insurance) is heavily subsidized through the tax code.  Last year, this subsidy was worth $145 billion.

What about long-term care for older adults and younger people with disabilities? Well, there is Medicaid, if you are poor enough and need a high enough level of care. Nearly all seniors are eligible for Medicare, of course. But despite a widespread misconception, Medicare covers only medical treatment, not personal supports and other long-term care.

Support for Aging Parents

You can deduct some long-term care costs from your federal income tax, but only if you’re total medical expenses exceed 10 percent of your income. And if you are poor (and if you are disabled you probably are), a tax deduction isn’t worth very much. For low- and middle-income families, it is much less generous than the tax credits available for families with kids.

There also are programs funded through the Older Americans Act, such as Meals on Wheels or information services, but spending for most of them has been frozen for years. Then there is…well, nothing.

If you require long-term care, you are pretty much on your own. Most families just take care of their loved ones on their own, without any paid assistance.  Of the $266,000 in average costs for those families who use paid care, $140,000, or 55 percent, is paid out of pocket.  Medicaid picks up about one-third on average, or about $90,000. But remember, only about 18 percent of Americans age 65 or older will ever qualify for Medicaid long-term care benefits.

I am in no way suggesting that the US reduce assistance for families--especially low-income families—who are raising kids. I am suggesting that we recognize that the financial burdens (to say nothing of the physical and emotional costs) are as high or higher for those who are caring for aging parents or younger relatives with disabilities.

A society has an obligation to be sure its kids are well cared-for. But it has the same responsibility for its frail elderly and disabled. The US is doing its share for its children. It is not doing so for its aging parents.

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Families Spend More To Care For Their Aging Parents Than To Raise Their Kids

Generations who fought before us deserve justice, protection

Commentary  by Karen C. Buck

Imagine a world without the elders of our country — those who fought racism and discrimination in the civil rights, voting rights, and women's rights movements; those who fought bravely on foreign shores, in WWII against Nazi brutality and on other harrowing grounds; and those who blazed trails for all of us. Strong women and men who through the last half-century have helped raise their voices for justice, for equality, and for their communities, who helped enrich our city and our world at large.

In July 1965 in Washington, D.C., President Lyndon B. Johnson envisioned a nation that "no longer will ... refuse the hand of justice to those who have given a lifetime of service and wisdom and labor to the progress of this progressive country." As a result of his eloquence and advocacy, the federal Older Americans Act was passed, perhaps the most important piece of aging legislation in our lifetimes.

President Obama signed its reauthorization in April, after years of no reauthorization by Congress. Essential life-saving services for older Americans, our parents and grandparents, our senior veterans, those who have been instrumental in the defining events of modern American history and law, were seemingly not a priority.

Seeking justice for older Americans, as our country faces what has been deemed an "aging tsunami," is today a dynamic area of law, often called "elder justice." Congress passed the Elder Justice Act with broad bipartisan support to recognize that elder abuse is a national crisis. The Pennsylvania Supreme Court has made access to justice for older Pennsylvanians a priority with the groundbreaking Office of Elder Justice in the Courts, and the Advisory Council on Elder Justice.

Judicial leaders in Philadelphia are strategizing on how to create an Elder Court and/or court-based Elder Justice Resource Center. Great progress and leadership. Yet the challenges continue for seniors in our country: poverty, homelessness, abuse, exploitation. And most seniors deal not with death and end of life, but with all of the complexities of modern life.

Currently, Pennsylvania is the fourth "oldest" state in the nation, with 2.8 million individuals aged 60 and older — 20 percent of the state population. By the year 2030, it is estimated that 3.6 million Pennsylvanians will be aged 60 and older. More than a quarter of grandparents over the age of 60 are primarily responsible for their grandchildren under the age of 18. Seniors serve and enrich their communities, families, and country at all ages and in all economic, racial, and linguistic sectors. They are cherished mentors, advocates, caregivers, volunteers, leaders.

We as public-interest attorneys and advocates provide free services to those in need in complex and daunting areas which affect real people's lives, their safety, security, and survival. SeniorLAW Center celebrates 38 years of pursuing elder justice, and proudly recognizes those who came before us.

At its annual gala earlier this month, SeniorLAW Center recognized remarkable older Americans and advocates for justice. We honored older women who broke glass ceilings in the law and the judiciary; who fought sexual harassment before it was recognized as an actionable and despicable act; who advocated for diversity in our profession and posthumously fought for admission of a grandfather into the Pennsylvania Bar decades after he was denied on grounds of being black; older artists who used their tools of film and photography to tell the stories of poverty and access to justice; those who created programs for the elderly and poor in our most struggling neighborhoods; and all who continue to fight for what is right and good and just.

Today, hundreds of thousands of seniors face their elder years in poverty or are targeted for exploitation, abuse, fraud, disenfranchisement and homelessness as they enter the "third age" and last chapters of their lives. At least 1 in 10 older Americans will be a victim of abuse over their lifetime.

According to research funded by the National Institute of Justice, almost 11 percent of people age 60 and older, or 5.7 million individuals, suffered from some form of abuse in 2009 alone. Elder abuse includes physical, emotional and sexual abuse, self-neglect, and shocking and sometimes highly sophisticated forms of financial exploitation.

Elder abuse is deadly: Victims of elder abuse, neglect, and financial exploitation have three times the risk of dying prematurely. Elder abuse is devastating: Financial exploitation costs older Americans at least $3 billion nationally, as estimated by the MetLife Mature Market Institute and the National Committee for the Prevention of Elder Abuse. Abuse of power of attorney or guardianship, fraudulent deed conveyances, home repair contractor fraud, credit card and bank account fraud, and unauthorized use, pressured sales of unsuitable products, lottery scams, and illegal and exploitative telemarketing and collection practices are just examples of the many forms of elder financial exploitation. And elder abuse is the only form of family violence for which the federal government has historically provided virtually no funding.

Philadelphia is home to one of the largest populations of senior citizens in the country — and one of the poorest. One in five of our seniors lives in poverty. Most are women. Last year, SeniorLAW Center assisted over 5,000 clients throughout Pennsylvania ranging in age from 60 to 101, and as diverse as our nation, of all colors, races, languages, and orientations. We are the only such organization in Pennsylvania and one of few in the nation focusing the power of the law to help elders live their best lives.

I recently returned from a two-month sabbatical in Iceland, Japan, New Zealand, and Australia, meeting with leaders in government, the law, and aging to share and glean best practices in elder justice. There is much we can learn from the world, and they from us. Aging is a universal truth: If we live, we will age. Our elders represent where we've come from, our ancestors, and where we are going, our future. Join us as we strive to ensure that elder justice becomes not just a new term of art, but a reality, for the elders of today and for generations to come.

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Generations who fought before us deserve justice, protection

Bill would give state elder abuse programs a federal funding boost

Legislation proposed in the Senate last week would authorize federal assistance to state programs that seek to prevent elder abuse, neglect and exploitation.

S. 2727, the Elder Protection and Abuse Protection Act, was introduced last Tuesday by Sen. Richard Blumenthal (D-CT), with Sens. Al Franken (D-MN), Sheldon Whitehouse (D-RI) and Bob Casey (D-PA) co-sponsoring.

The bill would amend portions of the Older American Act of 1965 to define elder abuse as “the knowing infliction of physical or psychological harm or the knowing deprivation of goods or services that are necessary to meet essential needs or to avoid physical or psychological harm.” 

Under the bill, federal funds also would be appropriated for states to establish elder abuse screening, reporting and support programs.

“By requiring tough national standards for screening and reporting, this bill would help hold bad actors accountable for their deplorable behavior and provide critical protections for senior citizens,” Blumenthal said in a statement on the bill.

Just 1 in 23.5 cases of elder abuse is ever reported due to a lack of screening, awareness and prevention resources, according to the bill. The mortality rate of seniors who fall victim to elder abuse is three times higher than those who don't experience elder abuse, and the annual financial loss of those victims is estimated to be at least $2.9 billion, Blumenthal said.

Blumenthal introduced similar bills in 2012 and 2013, but the Senate passed neither.

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Bill would give state elder abuse programs a federal funding boost

Older American's Month Starts Today!

NCOA Offers 5 Ways Congress Can Help Seniors in 2014

With close to one-quarter of voters this November expected to be over age 65, the National Council on Aging (NCOA) suggests five ways Congress can help seniors this year—especially those in greatest need.

1. Restore funding for and modernize aging services
The Older Americans Act (OAA) funds critical services that help seniors stay healthy, independent, and economically secure in their own homes. These include programs like senior nutrition, prevention, caregiver support, and transportation.

Senior services are facing a double whammy—funding has not kept up with inflation or the growing population of seniors and the federal budget sequester has caused even deeper cuts. -

2. Protect low-income Medicare beneficiaries
The Medicare Qualified Individual (QI) program pays Medicare Part B premiums for beneficiaries whose incomes are 120-135% of poverty—about $13,700-$15,300 per year. Without this assistance, these seniors would not be able to afford doctor visits.

3. Renew the Farm Bill to help fight senior hunger
The Farm Bill renewal is poised to boost funding for the nation’s food banks, transition the Commodity Supplemental Food Program to a seniors-only program, and test using the Supplemental Nutrition Assistance Program (SNAP) for nonprofit grocery delivery programs for seniors.

4. Introduce long-term care legislation
The number of Americans needing long-term services and supports will more than double as the boomers age. Medicare does not cover them, and private insurance is unaffordable for most people. The current system places enormous burdens on family caregivers and forces seniors to spend-down their life savings into poverty before getting help from Medicaid. A recent Long-Term Care Commission report included recommendations to improve the system.

5. Pass immigration reform
Comprehensive immigration reform would strengthen the direct care workforce, 20-23% of whom are foreign born. Direct care workers provide home care and other services that allow seniors to stay independent. Reform also would produce economic benefits to Medicare and Social Security by increasing the number of younger workers paying into these funds.

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NCOA Offers 5 Ways Congress Can Help Seniors in 2014

Senator Frankin Pushes Legislation to Protect Minnesota Seniors From Elder Abuse

U.S. Sen. Al Franken (D-Minn.) reintroduced a bill to guarantee Minnesota seniors basic rights and protections from abuse and neglect as they receive long-term services and support in their homes and communities.

Sen. Franken will push to get this bill included in the Older Americans Act when it comes up for reauthorization in this Congress, which is expected as early as this Thursday.

"Seniors from Moorhead to Winona have told me that remaining independent and at home is a top priority for them and their families," said Sen. Franken. "We work to keep our seniors in their homes, we also have to make sure they're safe.

This legislation would ensure that seniors who choose to receive long-term services and supports in their homes and communities have the same rights and protections from elder abuse that seniors living in nursing rooms already have." Residents of nursing homes are guaranteed certain rights and protections from elder abuse, but Sen. Franken has heard from Minnesota seniors and their advocates that seniors who receive services in their homes and communities are often left without a place to turn if they feel unsafe or have problems with their services.

Sen. Franken has reintroduced the Home Care Consumer Bill of Rights Act to address these concerns.

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Senator Franken Pushes Legislation to Protect Seniors From Elder Abuse