New Options (and Risks) in Home Care for Elderly
The New York Times, March 1st, 2007
Dr. Diane E. Meier, a geriatrician at Mount Sinai Medical Center in New York, is an expert on end-of-life care. So when her elderly parents needed long-term help at home with bathing,
dressing and cooking after her father’s stroke, she knew where to find
assistance.
It was not through agencies in Manhattan that provide home health aides who
are bonded, insured and certified. A year of custodial care from such an agency
would cost her family $150,000, and in short order exhaust its savings because
aides are not covered by government assistance unless patients are poor or fresh
from a hospital stay.
Instead Dr. Meier turned to “a little list” of aides from the so-called gray
market, an over-the-back-fence network of women. They are usually untrained,
unscreened and unsupervised, but more affordable without an agency’s fee, less
constrained by regulations and hired through personal recommendation.
With 4.2 million Americans currently over 85 — a number expected to grow to
5.9 million by 2014 and then accelerate with the baby boom generation — the
exploding need for long-term care is remaking the home-care industry, driving
more of it underground. Gray-market hiring, fraught with risks, is a solution
that middle-class families are turning to as they face the crushing burden of
indefinite home-care expenses. But it is hardly the only one, as businesses rush
to meet the needs of these families, the fastest-growing segment of the
marketplace, who are intent on keeping their loved ones out of nursing homes.
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