MICHEL MARTIN, HOST:
I'm Michel Martin and this is TELL ME MORE from NPR News. Coming up, we'll have the latest tweet in our poetry series, Muses and Metaphor. That's in just a few minutes.
But first, we want to spend some time talking about a story that nearly 10 million Americans are living every day. That's adult children caring for their aging parents. When a parent or other senior loved one needs care, adult children often find themselves in a confusing maze of decisions that come on seemingly without warning. It might be figuring out where a parent will live or sorting out power of attorney, living wills and health insurance.
And an increasing number of adult children are now also helping to pay for their parents' care. Those who do, spend, on average, $3,500 per month, according to Met Life.
This week, a number of NPR programs have been taking a close look at that challenge in NPR's series, Family Matters: The Money Squeeze. Those stories are digging into the difficult decisions that families are facing in managing the needs of families with several generations living together.
And, as we will see, managing these needs can be tough, even for people who otherwise have it all together. We found three such women to show us the ropes. They are Marilyn Geewax. She's NPR's senior business editor and one of our trusted guides on matters of the economy and personal finance issues. Also with us - Joan Lunden. She is an author and former longtime host of ABC's "Good Morning America." She cares for her elderly mother and is the mom, herself, of seven children. And Annise Parker is the mayor of Houston, Texas. She and her partner Kathy Hubbard have been caregivers to Mayor Parker's grandparents and Mayor Parker also addresses issues of aging residents in her city.
I welcome you all and I thank you so much for being willing to talk about this difficult topic.
MARILY GEEWAX, BYLINE: Hi, Michel.
JOAN LUNDEN: Pleasure to be here.
ANNISE PARKER: Glad to be with you.
MARTIN: Marilyn, why is this such a big deal now? It seems like, five years ago, we didn't talk about this at all and now we're talking about it all the time. Why now?
GEEWAX: Michel, we have demographic and economic forces that are coming together right now. Americans are living longer and, mostly, that's a good story. You know, we want to be healthier. We want to live longer. In 1950, the life expectancy for an American was just 68 and now it's about 79 and a lot of people are living well beyond 79. There are about six million Americans who are over 85. That's a good news story if you enjoy a long life, but it also is a tough story because it's expensive to care for people who are over 80.
And that surge of older Americans has come in the wake of the great recession, so we've got a lot of economic troubles, too.
MARTIN: Joan Lunden, that's your story. Your mom is 93. She's doing well now, in a small care facility in San Francisco, but I understand that this is something that just kind of - I don't want to say fell into your lap, but it really was a crisis, wasn't it?
LUNDEN: But I think I'm very typical, really, because while I had been taking care of my mom and, frankly, my brother, who is just a year older than I was, but he had Type II Diabetes from a young age and, therefore, it just kind of ravaged his body and he had a lot of different problems, health problems, and really couldn't hold down a job. So I took care of my mom and my brother, financially, from the time I was in my mid-30s.
And I put them in one condo and everything was great and they kind of relied on each other. And then, all of a sudden, about seven years ago, my brother passed away from some of the complications of the diabetes. And, you know, I flew out to California and you sit in this house and millions of Americans could listen to this and say, oh, my God, I was there. And, if they haven't been there, they're going to be there.
You are there amidst everything that is important to your parent and you have to make this decision. You have to sell the house, sell the car, touch everything in that apartment, make a decision of what to be kept and what to take with them and find a new life for that parent.
And then, you have to sit down and have that very hard conversation where you say, you know, Mom, you can't stay here by yourself. I had people that were coming in on a daily basis and taking care of them, but there was no way she was going to be able to stay there alone.
And you're literally thrust into this world which, frankly, is very complex. The array of different options for senior housing and the complications of Medicare - there's so much information that you need to know and legal documents that you need to have in order to run their life and ensure their safety.
MARTIN: Mayor Parker, can you just talk about - if you don't mind - how this...
PARKER: Actually...
MARTIN: ...came upon you.
PARKER: Actually, I - as Joan was describing, dealing with her parents - I had exactly that same situation with my grandparents. This was 20 years ago for us, and they came to live with Kathy and with me because we were the closest, physically, and I had already had a lot of the responsibilities. They lived in east Texas and I could commute on the weekends, but it would have been extremely difficult for my mother to care for them - not because she couldn't or wouldn't - but the family dynamic was such that they recognized me as an adult, in a way that they didn't my mother.
And it caused the family to have a lot of conversations about money, about responsibilities, about what Kathy and I expected from my sibling and my mother in terms of respite. But it worked, because my life partner officed(ph) out of the house and she was able to be there with them during the day and then I could be with them in the evenings.
And we asked and did receive contributions to our monthly budget from my grandparents and, again, a hard conversation with all the family members of what was the value of this.
We kept them in their home as long as we could, but there's only so much you can do long distance. And when you make the move, you have to understand that you are moving them away from not only the comfort of a home they know, but their friendship network, their support network and into a completely unfamiliar environment.
And what usually, in my view, triggers that move, is when you can no longer find the caregivers in place. You know, maybe you have the housekeeper come in once a month, or once a week or once a day. At what point do you get to where you think, you know, I don't know what's going on with them and they have to be where I can be with them?
MARTIN: If you're just joining us, you're listening to TELL ME MORE from NPR News. We're talking about the experiences of Americans who are caring for aging parents.
I'm joined by Annise Parker. She is the mayor of Houston, Texas. Joan Lunden is an author and journalist and a former host of ABC's "Good Morning America." And Marilyn Geewax, NPR's senior business editor.
So I want to wheel around now and talk about the kinds of conversations that I think all of us wish we had had before the crisis struck. Marilyn, you've reported that many people are dipping into their own retirement funds and savings to pay for their parents' care, and, as we've talked about on this program, most Americans aren't saving enough for retirement in the first place.
And, on top of that, on Monday, a report by the trustees of Medicare warned that, by 2024, the system won't be able to cover seniors' hospital benefits and they're warning that Social Security will have to cut back in about 20 years. That's a pretty bleak picture.
So, Marilyn, why don't you start us off by saying what are the conversations you think people should be having around these issues.
GEEWAX: We really need to talk about saving more, because there are some facts that are just not going to go away. Number one is that investments haven't been generating all that much. Interest rates are low and the stock market has been dicey. So even if you're saving for retirement, it's not growing all that much on its own, so you have to save more.
And then, of course, we have these new reports about Social Security and Medicare. It's pretty obvious from looking at the federal budget, that Uncle Sam will be less generous in the future and we're going to have all of these needs coming together. The truth is, we have to cut our spending some more and save a little bit harder so that we can prepare for these coming demographic changes.
MARTIN: Joan Lunden, what are some of the conversations that, perhaps, you wish you had had before the tsunami hit in your world?
LUNDEN: You know...
MARTIN: And, again, I want to say thank you to all of you for being willing to talk about this, because one of the striking things about this is that these are things that, you know - you're all accomplished professionals and these are the kinds of things you think, well, I've got it handled. I've got it covered. And then something like this strikes and you feel, maybe I don't.
LUNDEN: But almost everybody you talk to and you ask, have you had the talk? It's the elephant sitting in the middle of the living room at every Thanksgiving. Nobody wants to have this talk. They don't want to have the talk with their parents. Many times, the parents are resistant to having the talk. They feel it's, you know, having to face their own mortality.
But if you approach it in the right way and you say, I want to talk to you about how you envision the final chapters of your life living out. And then it is imperative that you ask, what is your financial situation? Do you have advanced health care insurance? I asked my mom that question. She said, yes. Guess what? She had only purchased a three year policy. I am here to tell you that that's long gone and the $80,000, $85,000 a year it takes to keep her where she lives is my responsibility.
And, if you're an elderly person today, listening, the best gift you can ever give to your adult children is to sit them down and have this conversation. Let them understand where your finances are. Make sure that they have a durable power of attorney, both legal and medical.
Nobody knows what's around the corner, tomorrow. You need to know their doctors, their prescriptions, who wrote them and you need to be able to know that you can carry on business for them. You need to have your name on their bank account. I'm here to tell you, my mom's social security - it wasn't much, but it was going into her bank account and, if you're not signed on that, then you're paying for the senior housing, but you're not being able to put your hands on that money.
And then the other thing - and so many people think, oh, my parents have a will. Well, a will is for after they've gone. You need that living will and, you know, it might sound overwhelming, but it's really only about six or eight documents. You can download them off the Internet in most cases.
MARTIN: Mayor Parker, would you like to pick up the thread here? What are some of the other things that you've learned in the course of this journey that you've been on? And I'd also be interested in your perspective as a policymaker and as a political leader, about things that communities could be doing to address this.
PARKER: I was the one that had to have my grandfather turn over his keys to me and pull the car and - when it came down to it, I finally said, you know, we would love to have you in our home. We want you to move with us. I have to say that it was - having my grandfather live for 10 months with us - kind of, a lot of physical care, bathing and dressing and toileting and so forth. It was a lot of very intimate personal contact with him.
It was one of the most wonderful experiences in my life. It was also one of the most difficult. It caused huge family fights, but it also ultimately brought the family together.
As a policymaker, though, I think there's a broader issue that we have to understand. We have an unbalanced society and a very mobile society. There are cities in America where the young people have fled to other parts of the country looking for jobs. Their parents are back home someplace, and it's increasingly falling on those cities to provide the services for family members who can't or won't assume that responsibility.
And it means that our tax dollars are going to provide those services for seniors who may or may not have family members who could assume this care, should they choose to do so.
MARTIN: I'm just going to ask for a final thought about, really, what the best piece of advice is that you can give for people who are confronting this situation. Joan Lunden?
LUNDEN: Yeah, Michel. I was going to say everything turned around for me when I got expert advice. I moved her into a place in the beginning that I thought was going to be perfect, but it wasn't perfect for the mother that existed today. It was for the mother that I knew 20 years ago. The day I got a senior care advisor and, I mean, you know, I'm here. I'm in New York and my mom's in California. I was able to find a senior advisor who could immediately help me assess my mom's needs, my financial situation, what beds were available in her region, and what kind of care needs did she really need on a daily basis. And that's something that's not always so easy for us to figure out.
And they helped me find an elder lawyer. And, you know, it wasn't very expensive, quite frankly, to get the durable powers of attorney and to get all the papers in order that I needed. And between that senior advisor at a place for mom and the elder lawyer, I got my ducks in a row. And, ever since then, it's really gone quite well and I'm happy to say I just threw a 93rd birthday party for my mom and she's got a new boyfriend, Joe...
MARTIN: Oh, my goodness. All right. Well...
LUNDEN: ...who moved in a few months ago. And, you know - and she's happy, safe and I know she's well cared for, but it was in a whole world that I didn't really know that much about and I just think that you need to, A, have the talk. B, assess your parents and then call in the experts.
MARTIN: Mayor Parker, what's your best advice?
PARKER: I cannot improve on that advice. The interfamily communication is critical. A realistic assessment of everybody's needs are and abilities, as well. And then I, too, used a senior advisor - it was actually a gerontology program here in Houston - that made all the difference.
MARTIN: Marilyn Geewax, I'm going to ask you to give us a final thought and we've just scratched the surface. I hope we'll talk again about this very important and ongoing issue. Marilyn?
GEEWAX: Well, I just want to remind people that it's not quite as dire as we make it sound.
LUNDEN: Yeah.
GEEWAX: And, in a way, if you make small changes early. Don't wait until you're 64 and a half to try to figure out what you're going to do about your retirement or taking care of your parents. Think about it when you're younger.
Do you know, if you put away $30 a week from the time you're 45 'til you're 65, with just a reasonable amount of interest, you'd save about $50,000. So start now. Save some money. Even small changes that are five, six dollars a day. And you could actually secure for yourself a roof over your head in your own retirement.
MARTIN: To be continued. Marilyn Geewax is NPR's senior business editor. She was with us here in our studios in Washington, D.C. Annise Parker is the mayor of Houston, Texas. She was with us on the line from her office. And Joan Lunden is a journalist and author and you surely remember her as the longtime host of ABC's "Good Morning America." And she was with us from NPR New York.
Ladies, thank you all so much for this very important conversation. To be continued.
GEEWAX: Oh, you're welcome.
LUNDEN: Thank you.
MARTIN: To hear more from NPR's series, Family Matters: The Money Squeeze, just visit NPR.org. Transcript provided by NPR, Copyright NPR.