Who Will Care for Margaret?
She loved teaching the little ones. Margaret taught reading and language arts to first through third grader for over three decades in West Virginia. She never married. Margaret devoted all of her energy and resources to the school children which she referred to as “my children.” In fact, she used her own money to purchase warm clothing, food, and school supplies to keep her kids on track to be successful readers before she launched them into higher grades. Her former students kept her in their hearts as they graduated and began families of their own. The parent teacher conferences were filled with her former students, returning as parents, confident that their children were in the best hands to become successful readers.
Margaret retired once her feet and back became too weary to endure the long school days. She also retired because, well, the community was changing around her. She felt less safe and commanding. The principal and other teachers of her early career had moved on and now it was her time to say goodbye.
Margaret is bookish. In the past, she devoted all of here energy to “her children.” Margaret’s social circle are the other teachers from her generation. Needless to say, these friends are experiencing the same realities. The pandemic cut them off even further. Loneliness, pets, and hobbies fill their days. Margaret owns her home, but the upkeep and renovation are beyond her financial resources. This is a Catch-22 because this dwelling is her largest asset. “It’s tough asking for help,” said Margaret, “I like being the one who gives not receives.”
Margaret is a fiercely independent person who manages to overcome life’s challenges on her own. However, Margaret’s health is deteriorating. She is struggling to take care of herself due to her chronic health conditions – heart disease, diabetes, hypertension, and asthma. Margaret’s Medicare plan has a limited provider network preventing her from going to the doctor as frequently as she needs. At most recent office visit, she reports that she has no energy. She often neglects her own personal care. However, her teacher’s pension and social security income are too high to qualify for needs-based government funded care services but too little to afford a private pay aide costing $25.00 per hour.
Do you know or serve a Margaret?
Half of all women over age sixty-five could be Margaret. Let that sink in. Women, on average, live five to eight years longer than men. Historically women earn less lifetime income than their male counterparts. Caregiving is likely part of her life story where she sacrificed her own retirement savings to pay for other’s needs.
Our reactive care system fails Margaret
The current system penalizes Margaret for having too much money to qualify for Medicaid and too little to afford the high cost of home care. Government programs will rank her needs against all the other Margarets and put her on waiting lists for services. It is unfortunate that our reactive care system waits till she suffers a traumatic medical event, like a stroke or falls and breaks a hip, which requires expensive hospital and specialty care. Often the care she does receive will be inadequate due to the healthcare workforce shortages, especially in communities like Margaret’s.
Downward Spiral of a Life Well Lived
If she ends up in the hospital, Margaret is a risk for an early discharge before she is capable of caring for herself. This means Margaret will return home sicker and less able to care for herself. Our broken care system fails to share the information about her hospital stay with her primary care provider. There is no coordinated follow-up care or adjustments to her medication despite the fact she now has three new pills each day.
Due to her increasing care needs, women like Margaret will one day qualify for home and community-based services. A home care aid is scheduled for two days per week to help with bathing, cooking, and cleaning. It may be too late for Margaret to recapture her independence. She is becoming increasingly anxious that she will die at home alone.
This is how we reward Margaret for a lifetime of service to our community and children? We’ve got to do better than this.