Trump Has Made Caring For The Elderly Before Death Harder: And That Means Me Sooner Or Later
By
Leonard Zwelling
https://www.nytimes.com/2025/11/24/opinion/caregiving-crisis.html
“Cosmo, I just want you to know…no matter what you do, you’re gonna die, just like everybody else.”
Olympia Dukakis in Moonstruck
Screenplay by John Patrick Shanley
“I’m obsessed with death. It’s a very important subject to me.”
Woody Allen in Annie Hall
Michelle Cottle relates the awful experience that she and her sister had caring for their aging (but my age) parents in Houston in her piece in The New York Times November 29. Her mother had several falls that left her first in a hospital for surgery, then in a re-hab center. Her father was at first confused, driving aimlessly all over the city, then received a bladder cancer diagnosis, and then Alzheimer’s was unmasked by the chemotherapy treatments. The sisters’ misfortune and that of their parents is not the point of her piece or mine.
What her piece emphasized is the difficulty adult children have in caring for older parents from a distance and the tag team work needed to get the elderly the care they need. It also stressed the very high cost of the care, much of which is not covered by insurance, Medicare, or Medicaid. And finally, the article describes the effects of the policies of the Trump Administration on finding care for the aged and infirm.
I want to focus on the latter.
First, as everyone should know, the Trump Administration wants to cut a huge amount of Medicaid funding. Many, in excess of 70 million Americans, depend on Medicaid for their health care. A large proportion of those over 65 (thus Medicare eligible) also depend on Medicaid for benefits (“the dual eligibles”). That number is over 9 million. Thus, Trump Medicaid cuts will hurt the elderly greatly by making their care even harder to obtain by their adult children.
And who dominates those who provide that care? Immigrants. So, the Trump immigration policy will also hurt the elderly and their adult children seeking care by decreasing the pool of people who are willing to provide elder-care.
I think about this for the obvious reason that at any minute, that patient needing that care could be me or Genie or both of us. I have a son in Pennsylvania with children of his own whose care he and his wife need to provide. The last thing they need is to be shuttling back and forth to Houston caring for us. My other son is in Austin and closer, but he and his wife have lives of their own, too. We do not want to be burdens on them or disrupt their lives and careers.
When Genie’s parents were growing older, her mother contracted lymphoma, diagnosed at MD Anderson. She chose to be treated at home in Cleveland. She was pretty functional until the end, but died at age 70. Genie’s Dad was fully functional after his retirement and the death of his wife. He moved to Florida. He was killed in a head-on automobile collision, cause unknown. We really didn’t have to care for either one of them.
My father toughed it out to the very end with a multiplicity of ailments, but lived with my mother in Florida, despite my urging them to move to Houston. At least 4 years before my father’s death, my mother’s dementia manifested itself as she could no longer keep score on the golf course or play cards. She went downhill very quickly. We were able to convince them (actually, my father) to move into an assisted living facility in Florida and they did have help caring for their affairs before my father’s death. My sister moved my mother near her in Pittsburgh where she lived another 9 years in assisted living. All of that was paid for by Medicare and Medicaid. I am not sure it would be today.
Now, the focus has shifted. I am the aging parent with an aging wife. So far, we are both doing fine, but we have no illusions that this lasts forever as Olympia Dukakis and Woody Allen make clear above. Our deaths are coming. Yes, I think about it and yes, I want it not to be a burden on my kids.
We have prepared for what happens after our deaths completely. We are pretty sure we are covered for what comes before, at least financially. I really do want to die at 545 College Street, Bellaire, Texas, but I know there is no guarantee.
Read the Cottle piece and consider the number of people whose “before death” experience and that of their families will be adversely affected by Trump Administration immigration and economic policies. Is this what you voted for? I’ll keep asking that question until the country wakes up to the fact that it got taken by a huckster and everyone one is in danger of paying the price.
This should be a major issue at the mid-terms and beyond. How do we care for our elderly BEFORE they die, but after they can care for themselves. Right now, it’s a national problem. Our current solution is a national disgrace. We can do better.
