Die Rich...Die Poor

   Recently a couple who were long term family friends died.  More precisely, they died only a few days apart from non related lingering illnesses, he from heart disease and she from pneumonia.  They lives stable and responsible lives in an affluent neighborhood in a Midwestern city.  For twenty years they coped with their declining health and consequent support needs, in the manner touted for aging wealthy Americans.  They did not leave their long term million dollar suburban house, they continued to buy new cars, even as they were unable to drive, they supported their "not so financially fortunate" children, promoted charities, and generally sustained their adult lifestyle till the end.  

     Of course, carrying out this "end of life solution" required that they ongoingly hired various professionals to oversee their "activities of daily living" ADL's.  The lawyers, financial advisors, doctors, residence contractors, etc. were not new relationships and, it would seem, proved to be generally beneficial and stable.  Personal Care Services proved to be a different matter.  The list of agencies and provided staff that cared for their needs was long and captioned with failures, both great and small.  The only thing consistent in their twenty year saga of buying "24/7 in home services", was the cost.  It started out high and increased steadily.  As their needs ended, the charges were astounding.  One Caregiver was often not sufficient to complete ADL services for two frail elderly persons, both impaired yet cogent such that their food, clothing, communication, hygiene, aesthetics, resulted in heavy agendas.  Our friends made it through this treacherous stage in the life cycle.  They paid someone to contract for, on average, 250 hours per week of "in home care' at hourly costs that escalated from around $25 per hour in 2000 to about $45 per hour 20 years later. At the end of their lives the cost for their "Personal Care" was approaching $50,000 per month.

     I am not sure why I have memorialized this story.  I don't know whether it is a good story or a bad story. However, at 78, I have little patience for ambivalence.  I do know that this friend could have lived as well, and perhaps better in a Four Star Assisted Living for less than $10,000 per month.  As such, I feel a compulsion to judge and offer my take that a culture and the economy that enables this is solution is far from optimal.  Yes, I know some of the elitist  "trickle down" justifications for privilege. but.....

PS:  I would like to believe that if I had resources for "end of life" care similar to this friend, I would opt for the $10,000 Assisted Living Facility door and leave the $10,000,000 "opulence premium" to the Gates Foundation.