I love my job, but I hate "the talk" that often comes with it.
I'm a geriatrician, a doctor who specializes in caring for older adults and those coping with disabilities. I feel honored to be able to help my patients, and it's immensely satisfying to address their medical needs, which are often complex and demanding.
So what's the problem? "The talk." That's when I tell a family that their loved one is ready to go home - and then gently let them know that they'll pay for it with difficult days, sleepless nights and unexpected expenses they may not be able to afford.
Because the fact is, their loved one will almost certainly need more care after the hospital, and those family members will have to provide most of it. It doesn't matter that every adult in the family may already be working fulltime; Medicare doesn't cover caregiving, and neither does commercial medical insurance. Most people don't have long-term care insurance, because it's expensive and hard to find. I usually don't even bother to mention the shortage of professional caregivers, such as home health aides, which is expected to worsen over the coming years.
In short, I'm telling the family that they've just landed in the middle of our national caregiving crisis. Every day for the next 12 years, 10,000 baby boomers will turn 65, but we're woefully unprepared to deal with the needs of an aging population. Some of this is the downside of medical success. People are living longer than ever before, but many of them have chronic conditions like diabetes and heart disease, or they are too frail to take care of themselves. In addition, when people are hospitalized these days, they're sent home "quicker and sicker" than in decades past, leaving family members to pick up the slack.
All of this makes a tough job even tougher. Everyone has heard that informal caregiving is associated with a host of problems, including anxiety, depression, worry, social isolation and even increased mortality risk, and I've seen the strain on the faces of my patients' family members to prove it. And yet my perspective, as a geriatrician and as a one-time family caregiver myself, is hopeful.
Recent reappraisals of the research suggest that when caregivers have adequate internal and external resources, the experience can offer health benefits and be intensely meaningful. That too fits with my experience of adult caregivers who tell me about creating a different kind of relationship with aging parents or who are glad that their own children are witnessing what it means to give back.
So how can we provide the support needed to make caregiving feasible and even rewarding? Solutions are bubbling up, and we have to look for them, build on them and demand more of them.