1000’s of readers reacted to the articles within the Dying Broke sequence concerning the monetary burden of long-term care in america. They supplied their assessments for the federal government and market failures which have drained the lifetime financial savings of so many American households. And a few supplied potential options.

In additional than 4,200 feedback, readers of all ages shared their struggles in caring for spouses, older dad and mom and grandparents. They expressed their very own anxieties about getting older and needing assist to remain at house or in establishments like nursing houses or assisted-living services.

Many steered modifications to U.S. coverage, like increasing the federal government’s funds for care and permitting extra immigrants to remain within the nation to assist meet the demand for staff. Some even mentioned they might somewhat finish their lives than change into a monetary burden to their youngsters.

Many readers blamed the predominantly for-profit nature of American medication and the long-term care business for depleting the monetary assets of older folks, leaving the federal-state Medicaid packages to maintain them as soon as they had been destitute.

“It’s incorrect to say the cash isn’t there to pay for elder care,” Jim Castrone, 72, a retired monetary controller from Placitas, N.M., commented. “It’s there, within the type of income that accrue to the house owners of those services.”

“It’s a system of wealth transference from the center class and the poor to the house owners of for-profit medical care, together with hospitals and the long-term care services outlined on this article, underwritten by the federal government,” he added.

However different readers pointed to insurance coverage insurance policies that, regardless of limitations, had helped them pay for companies. And a few relayed their considerations that People weren’t saving sufficient and had been unprepared to maintain themselves as they aged.

“It was an extended, lonely job, a tragic job, an uphill climb.”

Marsha Moyer

What different nations present

Different international locations’ remedy of their older residents was repeatedly talked about. Readers contrasted the care they noticed older folks receiving in overseas international locations with the remedy in america, which spends much less on long-term care as a portion of its gross home product than do most rich nations.

Marsha Moyer, 75, a retired instructing assistant from Memphis, mentioned she spent 12 years as a caregiver for her dad and mom in San Diego County and one other six for her husband. Whereas that they had benefits many don’t, Ms. Moyer mentioned, “it was an extended, lonely job, a tragic job, an uphill climb.”

In distinction, her sister-in-law’s mom lived to 103 in a “absolutely funded, beautiful elder care house” in Denmark throughout her final 5 years. “My sister-in-law didn’t have to decide on between her personal life, her profession and serving to her wholesome however very previous mom,” Ms. Moyer mentioned. “She may have each. I had to decide on.”

Birgit Rosenberg, 58, a software program developer from Southampton, Pa., mentioned her mom had end-stage dementia and had been in a nursing house in Germany for greater than two years. “The associated fee for her completely glorious care in a cheerful, clear facility is her pittance of Social Safety, about $180 a month,” she mentioned. “A pal lately needed to put her mom right into a nursing house right here within the U.S. Twice, when visiting, she has discovered her mom on the ground in her room, the place she had been for who is aware of how lengthy.”

Brad and Carol Burns moved from Fort Price, Texas, in 2019 to Chapala, Jalisco, in Mexico, dumping their $650 a month long-term care coverage as a result of care is a lot extra inexpensive south of the border. Mr. Burns, 63, a retired pharmaceutical researcher, mentioned his mom lived only a few miles away in a reminiscence care facility that prices $2,050 a month, which she will be able to afford together with her Social Safety funds and an annuity. She is receiving “wonderful” care, he mentioned.

“As a reminder, most individuals in Mexico can not afford the care we discover inexpensive and that makes me unhappy,” he mentioned. “However their take care of us is wonderful, all well being care, right here, really. At her house, my mother, they handle her as Mother or Barbarita, little Barbara.”

Insurance coverage insurance policies debated

Many, many readers mentioned they might relate to issues with long-term care insurance coverage insurance policies, and their hovering prices. Some who maintain such insurance policies mentioned they supplied consolation for a potential worst-case state of affairs whereas others castigated insurers for making it troublesome to entry advantages.

“They actually make you’re employed for the cash, and also you’d higher have somebody out there who can name them and work on the limitless and ever-changing paperwork,” mentioned Janet Blanding, 62, a technical author from Fancy Hole, Va.

Derek Sippel, 47, a registered nurse from Naples, Fla., cited the $11,000 month-to-month value of his mom’s nursing house take care of dementia as the rationale he purchased a coverage. He mentioned he pays about $195 a month with a lifetime advantage of $350,000. “I could by no means want to make use of the profit(s), however it makes me really feel higher understanding that I’ve it if I want it,” he wrote. He mentioned he couldn’t make that type of cash by investing on his personal.

“It’s the chance you’re taking with any type of insurance coverage,” he mentioned. “I don’t need to be a burden on anybody.”

Pleas for extra immigrant staff

One answer that readers proposed was to extend the variety of immigrants allowed into the nation to assist handle the persistent scarcity of long-term care staff. Larry Cretan, 73, a retired financial institution government from Woodside, Calif., mentioned that over time, his dad and mom had six caretakers who had been immigrants. “There isn’t any magic bullet,” he mentioned, “however one apparent step — howdy folks — we’d like extra immigrants! Who do you assume does most of this work?”

Victoria Raab, 67, a retired copy editor from New York, mentioned that many older People should use paid assist as a result of their grown youngsters reside far-off. Her dad and mom and a few of their friends depend on immigrants from the Philippines and Eritrea, she mentioned, “working loosely inside the margins of labor laws.”

“These exemplary populations ought to have the ability to fill caretaker roles transparently in change for citizenship as a result of they’re an apparent and invaluable asset to a troublesome occupation that lacks American staff of their talent and optimistic cultural attitudes towards the aged,” Ms. Raab mentioned.

“For too many, the reply is, ‘How can we cover belongings and make the federal government pay?’”

Mark Dennen

Federal fixes sought

Others known as for the federal authorities to create a complete nationwide long-term care system, as another international locations have. In america, federal and state packages that finance long-term care are primarily out there solely to the very poor. For middle-class households, sustained subsidies for house care, for instance, are pretty nonexistent.

“I’m a geriatric nurse practitioner in New York and have seen this story time and time once more,” Sarah Romanelli, 31, mentioned. “My sufferers are shocked once we evaluation the choices and its prices. Medicaid can’t be the one choice to pay for long-term care. Congress must act to determine a greater system for middle-class People to finance long-term care,” she mentioned.

John Reeder, 76, a retired federal economist from Arlington, Va., known as for a federal single-payer system “from delivery to senior care by which all of us pay and profit-making eliminated.”

Different readers, nevertheless, argued that individuals wanted to take extra accountability by getting ready for the expense of previous age.

Mark Dennen, 69, from West Harwich, Mass., mentioned folks ought to save extra somewhat than anticipate taxpayers to bail them out. “For too many, the reply is, ‘How can we cover belongings and make the federal government pay?’ That’s simply one other means of claiming, ‘How can I make any individual else pay my payments?’” he mentioned, including: “We don’t want the most recent cellphone/automotive/garments, however we are going to want long-term care. Decisions.”

Questioning life-prolonging procedures

A lot of readers condemned the nation’s medical tradition for pushing costly surgical procedures and different procedures that do little to enhance the standard of individuals’s few remaining years.

Dr. Thomas Thuene, 60, a guide in Roslindale, Mass., described how a pal’s mom who had coronary heart failure was repeatedly despatched from the elder care facility the place she lived to the hospital and again, by way of ambulance. “There was no arguing with the care facility,” he mentioned. “Nonetheless, the second all her cash was gone, the ability gently nudged my pal to consider end-of-life take care of his mom. It appears the monetary smash is baked into the system.”

Joan Chambers, 69, an architectural draftsperson from Southold, N.Y., mentioned that in a hospitalization on a cardiac unit she noticed many fellow sufferers “bedridden with empty eyes,” awaiting implants of stents and pacemakers.

“I don’t need to be a burden on anybody.”

Derek Sippel

“I spotted then and there that we’re not sufferers, we’re commodities,” she mentioned. “Most of us will die from coronary heart failure. It’ll take braveness for a member of the family to refuse a ‘easy’ process that may hold a cherished one’s coronary heart beating for just a few extra years however we have now to cease this cruelty.

“We have now to do not forget that although we’re grateful to our well being care professionals, they don’t seem to be our buddies, they’re our workers and we are able to say no.”

One doctor, Dr. James D. Sullivan, 64, from Cataumet, Mass., mentioned he deliberate to refuse hospitalization and different extraordinary measures if he suffered from dementia. “We spend billions of {dollars}, and numerous heartache, treating demented folks for pneumonia, urinary tract infections, cancers, issues which might be going to kill them in the end, for no significant profit,” Dr. Sullivan mentioned. “I’d not need my son to spend his good years, and cash, serving to to take care of me alive if I don’t even know what’s occurring,” he mentioned.

Ideas on assisted dying

Others went additional, declaring they might somewhat prepare for their very own deaths somewhat than endure in tremendously diminished capability. “My long-term care plan is straightforward,” mentioned Karen D. Clodfelter, 65, a library assistant from St. Louis. “When the cash runs out I’ll take myself out of the image.” Ms. Clodfelter mentioned she helped take care of her mom till her demise at 101. “I’ve seen excessive previous age,” she mentioned, “and I’m not keen on going there.”

Some steered that assisted dying ought to be a extra extensively out there possibility in a rustic that takes such poor care of its aged. Meridee Wendell, 76, from Sunnyvale, Calif., mentioned: “If we are able to’t handle to supply assisted dwelling to our fellow People, may we at the very least provide assisted dying? Not less than a few of us would see it as a fascinating answer.”