Angelus News | March 22, 2024 | Vol. 9 No. 6

elative — even just to spend time with them — can be
considered a corporal work of mercy.
And an aging society will provide plenty of opportunities to
engage in that kind of charity. The federal Administration
on Aging estimates that 70% of adults 65 and over will need
some kind of long-term care assistance, services, or support in
their remaining years. This isn’t intensive medical treatment;
just a helping hand with daily activities like preparing food,
bathing, or using the bathroom. On average, seniors need this
type of care for about three years, though for some the need
can stretch out much longer.
For many, family is the first and primary caretaker. Many
seniors know they can rely on one or more of their children
to attend to some of their more basic needs. But those needs
often require more constant time and attention than adults
with their own children to care for can devote. A report from
the Pew Research Center found that more than half of adults
in their 40s are members of the so-called “Sandwich Generation”
— those who have an elderly parent while also raising
at least one child at home.
And for other seniors, family isn’t a viable option. Broken
relationships, alienated children, divorce; all can mean a
fracturing of the safety net that family is meant to provide.
And with more Americans opting out of parenthood altogether,
an increasing share of adults will enter their senior years
with thinner family trees, and fewer people to visit them in
retirement, an assisted-living facility, or hospice care.
Family members from different generations attend an encounter and Mass for the elderly led by Pope Francis in
St. Peter’s Square at the Vatican in this 2014 file photo. | CNS/PAUL HARING
These trends will put increasing pressure on a social system
that has not adjusted to the new realities of smaller families
and longer lives. Caring for the elderly is inherently labor-intensive
— it’s a one-to-one service that often requires some
level of trust, even intimacy. Like child care, it’s a job that
can’t become more “efficient” or “productive” without losing
quality. A recent research paper found that when private
equity firms took over a nursing facility, profits went up and
patient outcomes — including mortality — took a turn for
the worse.
In Japan, they are seeking to supplement their senior care
with robots trained to change bedpans, remotely monitor vital
signs, and — more speculatively — engage in conversation
to provide a simulacrum of social engagement. According to
the MIT Technology Review, the Japanese government has
spent more than $300 million on research and development
for these new devices, though they remain niche, rather than
mainstream, devices so far.
One does not need to be a smartphone-avoiding Luddite
to be skeptical of the idea of innovating our way out of the
increasing demand for elder care. Technology could be used
in some cases — like monitoring a senior’s apartment for
falls — but can never be expected, or desired, to replace the
human connection of a relationship with a caregiver. If anything,
these advances mean our seniors need more in-person
relationships and interactions, not fewer.
Medicaid, for example, won’t pay for personal care for
seniors. So for many Americans, the primary vehicle for most
Americans to access care in their senior years is through
long-term care insurance. Yet the market for such services has
real problems: The number of options available to individuals
fell from 125 two decades ago to under 15 more recently,
according to the American Action Forum. Washington state
recently rolled out a new state tax aimed at providing longterm
care to residents, but it has been plagued with difficulties
and it is unclear whether it will
collect enough revenue to solve the
looming problem.
The looming crisis of senior care will
likely require touching some political
third rails. Allowing Medicaid to pay
for long-term care, for example, will
dramatically increase its expenditures
and worsen our nation’s fiscal picture,
especially if we seek to raise wages
for home health aides. As the whole
economy has recently experienced, a
world with declining birthrates means
fewer workers and increased labor
shortages — especially in labor-intensive
jobs like child and elder care.
It may be the case that the need for
home health care aides and nursing
home staff spurs America to revisit its
immigration policy before too long.
And any step toward broader public
funding will almost certainly require
higher taxes.
Solving these problems may sound
like drudgery. Yet if we don’t tackle the financial side that
makes aging a difficult problem to solve with compassion,
less salutary “solutions” may present themselves. While
none of the activists who push for access to physician-assisted
suicide like to focus on the financial benefits, governments
facing entitlement spending challenges may see a certain
allure in being able to terminate an elderly citizen’s claims on
medical spending under the false flag of “compassion.”
March 22, 2024 • ANGELUS • 23