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The caregiving tsunami

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My friend John — a young boomer — is learning Czech.

He’s not learning Czech because he loves the language. He’s learning it because his mom’s main home aide has gone back to the Czech Republic to clear up some family problems, and the main aide recommended a woman who speaks only Czech as her temporary replacement.

John went on a Web forum for caregivers to ask what he should do, whether he should look harder for a fill-in aide who can speak some English. The other, more experienced caregivers on the forum told him: Get real. Learn Czech.

If you have a dependable, kind aide that you like and can afford, you do what you can to keep that aide, the veteran caregivers told him.

John wondered, vaguely, what putting his mother in a nursing home might cost him. He noodled around on his phone while we were at brunch, ended up on a website posted by Genworth Financial Inc., Richmond, Va. (NYSE:GNW). Genworth informed him that the median annual cost of a private nursing home room in John’s mother’s state is now about $140,000.

John then started musing about the cost of long-term care in Mexico.

The people who help run the long-term care insurance (LTCI) operation at Genworth understand exactly what John’s going through: They’re going through it, too, with their own parents, at a time when the economy is in the doldrums, the 

nation as a whole is too scared to think about an investment with a payoff likely to come more than about 30 days in the future, and rating analysts and securities analysts do cartwheels and somersaults when insurers announce they are getting out of the LTCI market.

Genworth sent a team into New York recently to announce that it was taking an inexpensive, risk-free, but potentially life-saving component of its LTCI business — the LTC information, counseling and assessment services program — and marketing that component as a stand-alone LTC life preserver through an affiliate of AARP, Washington.

AARP President W. Lee Hammond dutifully presented caregiving statistics similar to those he has presented many, many times before.

“There are 4 kinds of people in the world,” Hammond said. “Those who have been caregivers, those who are currently caregivers, those who will be caregivers, and those who are going to need care. In other words, caregiving is an issue that’s going to affect virtually all of us at some point in our life.”

In the United States, relatives and friends are already helping to provide informal care for 10 million Americans, and that care has a value of about $450 billion per year, Hammond said.

“In 2040, the number receiving care will likely be more than 20 million,” Hammond said.

AARP surveys conducted for about a decade show that most Americans know little about any kind of LTC, including caregiving, Hammond said.

Amy Goyer, a blogger and official AARP “family expert,” tried to break through the soundproof glass wall between caregivers and everyone else by talking about her life as the daughter of two rapidly aging parents. She has had to move to Phoenix, from Washington, to be with them, and, even though she has been a specialist in aging issues for years, she was not sure where to turn for information about the Phoenix LTC market when her parents started to need more help than she could provide on her own.

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As Goyer was giving the Genworth presentation in New York, a caregiver was with her father while a feeding tube was being reinserted.

“We go from one crisis to the next,” Goyer said.

But Goyer said that, even as she coped with the crises, she was doing whatever she could to protect her parents’ quality of life.

Otherwise, Goyer asked, “What’s the point?”

The package of services Genworth will sell through AARP includes LTC facility quality data.

One attendee at the press conference grilled Genworth executives about how they would handle reports about poor quality care. The reporter went on at some length about how she was suing the nursing home company that had cared for her own father.

Dr. Bruce Margolis, the Genworth Long Term Care Insurance medical director — a pulmonologist and an LTC expert with a master’s degree in business — said he and his brother have had to put together a patchwork quilt of caregivers to look after their own parents.

“We really didn’t know in that area where to turn,” Margolis said. 

He said his brother told him, “We’re always one phone call away from the next crisis.”

Caregiving can quickly come to demand 10 to 30 hours of time per week, or more, and become a working son or daughter’s second full-time job, Margolis said.

The National Council on Aging, Washington, recently asked the remaining major presidential candidates what they would try to do to support caregivers.

Rick Santorum and Mitt Romney gave no answer at all.

Dr. Ron Paul, a medical doctor, gave no response.

President Obama said his people had designated 2011 to be the Year of the Caregiver.

Newt Gingrich had some ideas — use Medicare money to train caregivers, and speed technology that could help caregivers and their loved ones through the Food and Drug Administration approval process.

But the current caregivers generally seem to feel as if they are invisible ghosts on a beach, trying get everyone else to go somewhere, climb somewhere, do something — while most of the people on the beach stare blankly out to sea, enjoying the pleasant view.