#60: questions about caring as we age
"encountering unusual events often means you didn’t think things through"
In this letter: Questions about caring as we age.
References Mentioned:
Working Daughter: A Guide to Caring for Your Aging Parents While Making a Living by Liz O’Donnell (Book)
2019 Profile of Older Americans by the Administration for Community Living (Department of Health & Human Services)
It’s tough to find eldercare for immigrants. These places could help. (19th News)
Dementia Caregiving East and West: Issues of Communication (Book)
The Care Crisis Isn’t What You Think (The American Prospect)
Care, ethics, and policy (Gawain)
Investing in Compassion from the Institute for New Economic Thinking (Podcast)
The Typical American Lives Only 18 Miles From Mom (The Upshot)
‘A crisis of care’: We are not ready for the skyrocketing need for caregivers, says sociologist (GBH Morning Edition)
Live With The 19th: Aging Well and Equitably (Event Recording)
The staggering, exhausting, invisible costs of caring for America’s elderly (Vox)
Good morning,
I’ve been going through old bookmarks to pull research together and thought I’d share a little cluster on aging and eldercare. I first became interested in this topic because when you hit your thirties and don’t have children yet, you enter into a strange period that I can only describe as “quiet” — the quiet between aging (your own and that of your parents’ generation) and births you have yet to give, which transform us all into parents and grandparents, and temporarily allow us to lose sight of the aging.
Here’s a little excerpt and diagram from an essay I wrote about it at the time I started feeling the quiet between aging and birth:
No one tells you about the quiet between aging and birth—a quiet that is tremendous and expansive and which you must travel through alone, between your own aging and the births you will give.
I first noticed that I was aging after my first year of marriage, which happened to coincide with the first year of my fourth decade alive, and a global pandemic. It felt different from growing, which (unlike the steady loss of vitality that aging tends to provide) culminates in your feeling more and more capable.
Aging happened in small ways which taught me that one’s vitality must be nourished to avoid it fading.
I found myself catching and reviving it each place it started to wither: in my kneecaps, which suddenly and spontaneously ached; in my hands, which clenched themselves to near death while watching the news; in my eyes, which felt a little less curious and a little more weary each day; and most of all in my chest, which started racing even when no visible danger was around, worried that my weathered tools of survival couldn’t protect me anymore.
***
The movies hardly ever show the period of time before a book is written. The news hardly ever mentions what a woman was doing before she becomes a mother. No one talks about the abyss people float in between retirement and grandparenthood. Birth is newsworthy only after it is given, and often, I noticed, when we go back and learn how it was made, people only talk about the ingredients: passion, hard work, madness, inspiration, magic, medical science. No one ever talks about the stillness and the silence. No one talks about aging.
Needless to say, I am still living with the questions surrounding aging and over the last few years I’ve been collecting resources on it, particularly around elderhood and how one can prepare or advocate for better resources around the inevitable chapters we or our loved ones will experience. Here are a few.
✨ Cluster: On Eldercare and Aging
My first foray into this field was Liz O’Donnell’s Working Daughter: A Guide to Caring for Your Aging Parents While Making a Living which, like many books on life transitions for women other than parenting (say, periods and perimenopause) ought to be required reading.
In it, she cited an AARP report (published in 2013) that gave me pause and I think about often:
AARP predicts that by 2030, the United States will need between 5.7 and 6.6 million caregivers to support the sick and aging. That’s an increase from the 1.9 million paid caregivers currently serving the elderly population in the United States.
By a more recent measure from the US Department of Health & Human Services, by 2040, 80.8 million baby boomers will be over 65, more than twice the number of people over 65 in 2000.
There are question of nuance and cultural awareness, which is lacking in many care services but especially for the elderly. The 19th has done great solutions journalism on this issue and this resource comparing communicative approaches to dementia care from both western and eastern researchers is fascinating.
There are infrastructure questions that are far from exclusive to eldercare but symptoms of our devaluing of disability in the first place, which Laura Mauldin outlines here:
In the lead-up to the BBB bill, there have been many conversations about our nation’s care crisis. If we look closely, our disdain for disability and the lengths we’ll go to to avoid talking about it begin right there. If talked about at all, disability is often safely disguised as an elder care disaster, encapsulated by the phrase “silver tsunami,” which refers to demographic changes in the U.S. By 2040, 80.8 million baby boomers will be over 65… Since the prevalence of disability rises with age, approximately 70 percent of this cohort is predicted to need long-term care.
While it’s true that rates of disability rise with age, and these numbers are indeed daunting, the “silver tsunami” framing suggests disability is somehow only for, or synonymous with, the elderly. But according to the Centers for Disease Control and Prevention, 26 percent of U.S. adults live with a disability; 6 in 10 have a chronic condition; and 4 in 10 have two or more.
And then there are the moral questions, on which Gawain wrote a really useful essay last year, especially this bit on why we need to figure out how to apply care ethics into public policy:
How can we sensitize policy to the ethical considerations that people are making in their lives around care? How should policy and public resources support care providers and care receivers and strengthen the relationships between them? Can we re-envision the need to provide care, not as a problem to solve, but as a central human endeavor that enriches the lives of care providers as well as care receivers. So many people want to provide care to their loved ones, to friends and neighbors, even to strangers, but find obstacles in their way and an economy that doesn’t “count” care, rendering it nearly invisible and undervalued.
Here are other bookmarked resources on the issue, also included in references section above:
Sarita Mohanty of the SCAN Foundation interviewed by Rob Johnson of the Institute for New Economics Thinking on compassionate investment into eldercare.
The Upshot’s 2015 analysis of a comprehensive survey of older Americans.
Mindy Fried of The Shape of Care podcast on the GBH’s Morning Edition last year, discussing the skyrocketing need for caregivers.
The 19th’s panel on Aging Well and Equitably with speakers from the Centers from Medicare and Medicaid Services and several research organizations.
Anne Helen Peterson’s primer for Vox on elder care issues.
I’ll leave you with a novel on the topic, because this is something that must be approached from so many perspectives:
“Most things in the world are not unexpected if one thinks carefully about them. Even something one would call unusual—if one thinks about it, it’s really just a thing that was supposed to happen. Encountering unusual events often means you didn’t think things through.”
— Kyung-Sook Shin in Please Look After Mom
Time Spent is an entirely free resource on media/culture and a public part of my writing practice. Spreading the word is immensely helpful as I test out some of this thinking. If you enjoy it, please consider sending to a friend :)
Happy Monday!
Jihii
This was wonderful, thank you for such a useful collection of resources.