Last year I wrote a piece talking about people who are providing full-time care to an elderly parent at home. I particularly pointed out this situation here, where my wife no longer can work at her profession, nor leave the house for any length of time (an hour or so every couple weeks) because she is caring full-time for her elderly mother.
I wasn't able to conclude how we can actually address this situation; there is no real Government program to assist her (nor are we looking for one) in providing the best possible care for her mother. No one could handle her mother's case better; in fact, we were just talking about preparing for the next time her mother gets sick and has to go to the hospital.
The last time, a year ago, was relatively disastrous. A pacemaker install led to a five-week hospital stay, the typical hospital-induced infection, talk of hospice care, and havoc wreaked on the patient's expectation of life. The admitting physician was not part of her internal medicine group or her cardiology group but, being the admitters, they had control of her care. My wife, who had far better understanding of the impact of the slightest change in dose of any of her 88-year-old mother's 15 medications, had to stay 14 hours every day in the room lest someone from a practice that did not know the patient take a guess and change a prescription or try a new drug -- which they did anyway.
The patient was ultimately discharged and, instead of hospice care, went home to her daughter's full-time care. As a result, she has a good quality of life, and her daughter has no freedom. Groovy, ain't it? Her medications are managed to the microgram, and the doctors from her actual internal medicine and cardiology practices now comfortably rely on her daughter, practically as a medical peer, able to do certain tests and tweak dosages accordingly.
The next time her mother goes to the hospital, as we were discussing, my wife will bring weeks of hospital processes experience and many months of direct care; though that may be all for naught if the wrong practice happens to do the admitting. But that's a separate case.
The "case" in point is that while all this is going on, an otherwise productive member of society, with a skill set in demand in her profession, is home, incapable of working -- while she is saving her mother's life. The Government is getting zero taxes from her because she can't work, but is saving huge Medicare costs because of the detailed, expert care she is providing for free, the lack of which would lead to far more costly medical care at Government expense.
So here's at least something. My wife is barred from making tax-free contributions to an IRA because she is not employed and has no "earned income." Ironically, by not being employed but helping avoid an expensive hospitalization, she is saving the government a great deal in reimbursable medical costs. Would it not be at least something if she -- and other home caregivers, many of whom are over 50 or even 60 with working spouses -- were exempted from the earned-income requirement, and provided a high contribution ceiling for a tax-deferred account, so that the income tax expense is deferred until years later at presumably lower rates? It would be something, essentially making her efforts on behalf of her mother treated as the labor of love that it is.
And since the tax would eventually get paid, it doesn't really cost the Government all that much, certainly not nearly what the Government saves by their sacrifice. Give it a thought.
Care a little.
Copyright 2015 by Robert Sutton
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