If you are a baby boomer lucky enough to have one or both of your parents alive and involved in your life, there is a good chance that you are deeply involved in their lives, too – particularly in dealing with the infirmities of old age.
You may not be quite as involved, however, as Socorrito Baez-Page and her husband, David Page. Ms. Baez-Page’s mother, Viola Baez, lives in her daughter’s backyard in a structure nicknamed a “granny pod.” The Washington Post recently profiled the family and their use of what is essentially a portable hospital room that can be assembled on the property of its occupant’s child or other primary caregiver.
The MedCottage is not cheap at $125,000, though assisted living facilities and in-home caretakers are not cheap either. Depending on the senior citizen’s particular needs, many of the pod’s amenities may be quite helpful. But my reaction, which mirrored that of several readers who posted comments on the story, is that this is an attempt to use hardware to solve a problem that is really mostly about labor.
In Baez’s case, both her daughter and her son-in-law are doctors, and her daughter can devote substantial time each day to looking after her mother. Most of us do not have the training or the resources to provide comprehensive care to aging family members. Who will assist the growing number of elderly Americans that need care?
Nursing homes offer a variety of skilled labor, but they are very expensive. Many residents end up relying on Medicaid after they exhaust their own financial resources. These costs are driving Medicaid expenses to unsustainable levels. As my colleagues and I have previously written, long-term care insurance is a deeply flawed response to this problem, because any such insurance that is realistically priced will be too expensive for most people who might need it. Insurance cannot magically make a large and likely expense get cheaper.
Elderly people who are placed in nursing homes may also find that their privacy is curtailed and that they have less opportunity to spend time with family. Many would prefer to remain in their own homes if they could get enough help to keep them safe and comfortable. Good home health aides, however, can be hard to find and even harder to keep. There are agencies that provider such personnel, but the agencies’ overhead and profit margin add significantly to cost, while turnover and the limited pool of qualified help can affect service quality. As with most services, there are good and bad providers.
Individual households can try to directly employ their own help. Many Americans are still looking for work, but not many have the patience and domestic skills to tend infirm and often highly demanding elderly patients at rates most families can afford. Plenty of workers outside the country are ready and willing to step into that gap, but immigration laws restrict this avenue, even when U.S. nationals are not readily available to take these jobs.
Households that directly employ caretakers also face a variety of confusing tax and regulatory requirements, which can trip up even those employers doing their best to comply. Besides withholding, remitting and reporting the correct taxes on wages, household employers must deal with disability, worker’s compensation, unemployment insurance, and wage and hour requirements that vary from place to place and frequently change. Failure to take the required steps can bring steep penalties.
Ultimately, hardware is not going to be more than a small part of the answer. We have to find an affordable pool of people to look after the growing numbers of elderly Americans. That help may not be entirely within the United States. I suspect we will see increasing numbers of older Americans moving abroad, not only in early retirement, but into their later years as well. Off-shore institutions, especially in relatively nearby Mexico and the Caribbean, will increasingly advertise to older Americans, pointing out that their retirement savings will often last longer overseas.
There is nothing wrong with spending one’s golden years in the warm, southern sun. But it would be a shame to force our parents and grandparents to spend their last years far removed from their families simply because of financial considerations. We love our senior citizens. We want to keep them close. A granny pod in the backyard is only a small part of the answer.