The Netherlands is one of the countries that spends the most on long-term care, accounting for 4,1% of GDP, with 94% funded by the state budget. However, nearly half of the country's elderly population still relies on family and friends for basic activities like bathing, shopping, or paying bills.
In the US, public spending for this sector accounts for 1,3% of GDP. Many Americans believe that professionals will handle elder care, and with savings, they can live independently in nursing homes. This is a misconception. In fact, over 80% of Americans over 65 who need care rely on relatives, with about two-thirds relying entirely on family resources. The rate of unpaid care work, performed by relatives, in the US is trending upwards.
Analysis in 10 high-income countries indicates that even with expanded public services, elderly people still require family support. Even when they can afford it, many elderly individuals object to entering nursing homes or having strangers provide in-home care. Accepting a medical assistant often means confronting one's own declining health. Especially for those struggling with cognitive decline, a change of residence or care from strangers can induce fear.
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An elderly American receives in-home care assistance from staff. Photo: NBC News
Susan Fordham, an accountant in West Virginia, US, began caring for her 84-year-old mother after surgery last year. Each morning, she brews coffee and pours milk into a small pitcher because her mother cannot lift a large one herself. She always has to be ready to drop work, having taken emergency leave two times in one week to take her mother to the emergency room.
Fordham's mother is fortunate to have close relatives providing care. In reality, the majority of elderly people or their aging family members tend to avoid the need for elder care.
This caregiver shortage partly stems from changes in modern social structures. Demographer Sarah Patterson of the University of Michigan states that elder care today presents a paradox: Relatives with obligations, like children, often live far away, while those living nearby, such as neighbors, lack connection.
Sociologist Deborah Carr of Boston University adds: "Whether you have children or not, no one can be certain who will care for them in their final years."
Having cared for her mother-in-law for the final 8 years of her life, Jody Day, a psychotherapist in Ireland, says she understands the pressures of this work. As she has no children, she is now preparing her own support network as she approaches 60.
Day is developing an "alterkin" model, a family-replacement circle. Her group consists of 6 people living close to each other, ranging from middle-aged to nearly 80 years old. They sign a written commitment to "help each other with difficult tasks at any time," and they reread this content monthly.
"Currently, I don't need much physical care, but this system provides psychological support and a sense of security," Day says.
Experts emphasize that to prepare well for old age, each individual needs to learn to openly ask for help and be willing to assist those around them, regardless of blood relation. Even as technology advances, people still need each other in their twilight years.
Bao Nhien (According to Atlantic)
