Making promises we can’t keep

Published 1:46 pm Tuesday, September 8, 2020

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By Ron Kauffman

Senior Lifestyles


It seems that a lot more attention is now being drawn to the problems caused by Alzheimer’s disease, both early onset among younger boomers and seniors, and later onset for those 80 and older. We can estimate that in Polk County approximately 500-600 people have been impacted by some form of disease within the dementia family of illnesses.

Did you know that by age 85, there’s a 50/50 chance of developing some form of dementia? Dementia is but one of a number of medical challenges that often confronts and impacts families with requirements for full-time daily care. But what if there is no one to around or capable of caring for the aging parent or loved one in the home, and no government funding is available to help pay for it?

When that costly situation arises, a number of decisions have to be made, and often the biggest challenge has to do with finances. If families do not have either a long term care insurance policy or the financial means to afford in-home care or private placement in a facility, the choices available become very limited.

Don’t assume that Obamacare or Medicare will pay for long term, in-home custodial care or placement in a skilled nursing home – they won’t. Furthermore, it’s neither easy nor a quick process to apply for and be approved for Medicaid which doesn’t pay for non-facility based care for dementia patients, and not every nursing or memory care facility accepts Medicaid patients.

Many married couples vowed to love and care for their mate in sickness and in health, and often promised to never allow one or the other to be placed in a nursing home. Imagine the guilt trip that can be triggered by an aging parent who in tears says, “But you promised me you would never put me in a home.” Hearing those words while devastating typically doesn’t change the required decision to do what’s best. The reality is that promises to never place your spouse or parent in a nursing home should not be made, as it’s often a promise that can’t be kept.

Families often struggle when confronted with the issues of insufficient money, or disagreements among adult children because they can’t decide on what to do or how to pay for the care for an ill or aging parent. Those of us who work in the area of geriatric care have seen the challenges families can face, and unresolved those arguments can and have destroyed family relationships.

Today, the unfunded liabilities of Social Security, Medicare and Medicaid exceed $100 trillion, and our government has no current plan as to how they intend to pay for just those three programs. Add to that the inevitable demands that Americans will be making for affordable housing and care as they age, and you begin to see how unsustainable this current situation facing our country really has become.

What is clear is that the future of healthcare and aging is fraught with problems, and it’s not just a political party issue. This is a looming local and national disaster that could shatter not only the promises made between spouses, but the healthcare system of our county, state and nation.

Ron Kauffman is a Consultant & Expert Speaker on Issues of Aging. Contact them at 828-696-9799 or