Lessons, Sinking In: Long-Term Healthcare in a Post-Pandemic World

Lessons, Sinking In: Long-Term Healthcare in a Post-Pandemic World

If you think the independent woman is a modern creation, sprung somehow from the pages of women’s magazines in the 1970s – overlooking the centuries of intellectual effort, hard organizing and never-soft jail terms for suffragettes and other pioneers – you clearly never met my Auntie Bee.

Great Aunt Bertha was born in Boston in 1898. She sat in Fenway Park in its inaugural season of 1914, and followed the Red Sox until she died at 90. The 25-cent bleachers were her preferred seats – they’d bumped up to $1 by 1967 – outrageous! – but Bee kept going until she took a spill in her 75th year and had trouble walking. We got her a black-and-white TV, though, so she got by.

In the hard 1930s – and then, in the brutal 1950s – she and my grandmother would come back from Fenway, and one or the other would say, “You’d think those Yankees would let our boys win just once.” My mother told me about it, and she could never fathom how two Irish ladies could stand those rough brutes in the stands. It probably helped, a left-handed blessing, that Auntie Bee had been deaf since she was 18.

It was a tough age for the handicapped, as they were called then. With little-to-no government aid, Auntie Bee learned to cope with help from agencies supported by her Catholic Church, the Boston Synagogues and other do-gooders – they did good, and how! Auntie Bee learned to type and supported herself, and was happy to live in her own apartment on Boylston Street, where she stayed for decades.

During WW2, she worked as a data-entry clerk on an electro-mechanical computer – yes, they had those things back then, and the infinitely complex war effort depended on them. The early computers were operated by women and their story is largely forgotten, but it’s a nice little bit of history, if you care to know it. Auntie Bee made no fuss about it or anything else she did – she just lived it. And those fresh-mouthed boys in the bleachers never gave her anything but the best seat going, and sometimes a Pepsi – her only, but eternal, tipple.

Vulnerability, though, comes to everyone with age. We have this thing in New England we call the Montreal Express: in January, the ice-toothed wind sweeps down from Canada and socks us good. In 1973, that wind blew down old Auntie, slid her viciously along the ice and landed her in the hospital, but only for a week. Then, she came to stay with our family.

A nurse visited once or twice and taught my mother to change Auntie Bee’s bandages and keep an eye on the broken bones. At the top of her lungs – there’s no such thing as aural discretion when you’re deaf – she’d say things like, “Your mother’s doing OK, but I just can’t stand being away from my own apaht-ment.” Poor old mom, on 24-hour duty, gritting her teeth in the kitchen, making her mother’s sister her favorite turkey soup. If you never ate my mother’s turkey soup… Well, you know the rest.

Auntie got her wish after a few months, and this time, the city and the feds stepped up, finding her a smaller place, still in the old neighborhood, and helping to foot the bill. Times change, sometimes a bit for the better. But there’s no substitute for family and good old do-it-yourself.

We habitually write about long-term healthcare, both the ballooning costs and things our clients should do to prepare. The task is daunting, but if the older folks teach us anything, it’s how to face adversity. Auntie Bee survived major illness in her youth, as well as the Spanish Flu, the Great Depression and much more. She never really got over Tony Conigliaro, but that’s a Boston thing.

COVID-19 is particularly cruel to the vulnerable elderly and also plays unfair with the healthcare workers who treat them. The unusually high infection and fatality rates in nursing facilities during the pandemic have reinforced a trend seen in recent years: when long-term care is needed, people want treatment at home, or with close relatives. The lessons of recent experience will not go unlearned. There is likely to be a long-lasting impact on LT care planning.

We have reasonable safety nets in place today: Medicaid pays around half of the country’s long-term care costs, and another 20% comes from other public funding sources. The government long favored paying for nursing-home care, but the trend has tipped toward supporting in-home treatment. Look for that shift to continue, to the benefit of suitably insured clients.

Still, an estimated 34 million Americans cared for relatives last year, without compensation. Some of the afflicted were suffering from short-term injury or illness; others ­– more persistent ailments; still others were stricken with dementia. The burden of care, even in those rare cases when funds are ample, is inevitably heavy.

Public funding of LT care costs is significant, but its reach is uneven and individuals still need to provide for long-term care, in whole or in part. The desire for home care is strong and rising. For a while now, insurers have connected with customers anxious for policies that pay homecare benefits equaling those for nursing facilities. In 2019, these products comprised over 96% of the LT care policies sold. Again, look for the trend to continue its course.

Auntie Bee, along with the other joyful, wrought-iron women in my family, taught me lessons about self-reliance and perseverance that rival anything Thoreau ever wrote. When Auntie passed away, she left me a little tin box of keepsakes that her brother brought back from WW1: old French coins, a few letters, his Victory Medal – the kinds of things she knew I’d love. They’re sitting on my table as I write.

If you ever must care for an aged relative – mother, father, great aunt – I hope this story provides insight that helps you bear the very real burdens. The experience can give you rich treasures to carry in your memory, things that go beyond a few simple keepsakes, however beloved.

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